Molecular diagnosis of herpes simplex virus infections in the central nervous system

• Published in: Journal of clinical microbiology Vol. 37; no. 7; pp. 2127 - 2136
• Main Authors: TANG, Y.-W, MITCHELL, T. P. S, ESPY, M. J, SMITH, T. F, PERSING, D. H
• Format: Journal Article
• Language: English
• Published: Washington, DC American Society for Microbiology 01.07.1999
• Subjects: Biological and medical sciences; Central Nervous System Infections - diagnosis; Central Nervous System Infections - therapy; Central Nervous System Infections - virology; DNA, Viral - cerebrospinal fluid; Herpes Simplex - diagnosis; Herpes Simplex - therapy; Herpes simplex virus 1; Herpesviridae - isolation & purification; Human viral diseases; Humans; Infectious diseases; Medical sciences; Minireviews; Polymerase Chain Reaction; Viral diseases; Viral diseases of the nervous system; Encephalitis; Nervous system diseases; Herpesviridae; Alphaherpesvirinae; Review; Cerebral disorder; Infection; Virus; Polymerase chain reaction; Viral disease; Central nervous system disease; Meningitis; Herpesvirus hominis; Diagnosis
• ISSN: 0095-1137; 1098-660X
• DOI: 10.1128/jcm.37.7.2127-2136.1999

Herpes simplex virus (HSV) causes a wide spectrum of clinical manifestations in the central nervous system (CNS) of infants (encephalitis with or without disseminated visceral infection) and adults; the virus likely accounts for at least 10 to 20% of all viral encephalitis in the United States. Effective antivirals - acyclovir (9-[2-hydrorulteoxymethyl]guanine), vidarabine, and as of recently the prodrugs valacyclovir (converted to acyclovir) and famciclovir (converted to penciclovir) - are available for therapeutic intervention. Rapid laboratory diagnosis is now essential for timely treatment of CNS disease caused by HSV, and as is the case for human immunodeficiency virus (HIV), the use of molecular diagnostic testing in this setting has become popular because of the availability of a specific and effective antiviral therapy. In this minireview, we describe the technical aspects of the test required for successful implementation for routine diagnostic testing, the extended information now made available by molecular analysis, and the expanded clinical spectrum of disease now recognized by use of this assay.