Development and Use of a Type-Specific Antibody Avidity Test Based on Herpes Simplex Virus Type 2 Glycoprotein G

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Abstract
It is difficult to discriminate between lesions resulting from recently acquired versus established genital herpes simplex virus type 2 (HSV-2) infection. Methods not based on history or serum IgM status are needed. Our goal was to use type-specific gG-2 antibody avidity determinations based on HerpeSelect HSV-2 enzyme-linked immunosorbent assay (ELISA) to identify new infections. Sera (N = 168) from 71 patients with first-episode genital herpes and 45 sera from 21 patients with recurrent episodes were tested. Median avidity increased from 30.2 in sera drawn ≤6 weeks to 54.9 >6 weeks after infection (P <0.001). Patients with recurrent episodes and established HSV-2 infections (median, 6.1 years’ duration) had higher avidity antibodies (median, 92.7; range, 55.1–100) than patients after first episodes (median, 33.7; range, 6.4–73.9; P <0.001). Avidity testing based on HerpeSelect ELISA could be a cost-effective method to identify patients with new HSV-2 infections.

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