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Test Name:
Herpes Simplex Virus IgG and IgM Antibodies with HSV-1 and HSV-2 IgG Antibodies if Indicated, Serum

• SBMF No:
  28049
• Performance Lab Name:
  Immunology
• Test Mnemonic:
  HSV GM-RFX
• ABN:
  Not required
• CPT Code:
  86694; 86695; 86696
  If indicated, add 86695; 86696
• LOINC Code:
  26927-4; 52981-8; 50758-2; 7909-5; 7912-9
• Test Includes:
  HSV IgG Antibody, Type Non-Specific
  HSV IgM Antibody, Type Non-Specific
  HSV 1 Type-Specific IgG Antibody (If indicated)
  HSV 2 Type-Specific IgG Antibody (If indicated)
• Also Known As:
  HSV IgG and IgM Abs, Type Non-Specific, with Reflex
• Spec Type:
  Serum
• Spec Container:
  Gold top (SST) or red top (serum) tube
• Pref Vol:
  1.0 mL
• Min Vol:
  0.4 mL
• Fasting:
  No
• Spec Collect:
  Routine venipuncture
  Parallel testing is preferred
  Label samples as: "acute" or "convalescent"
  Convalescent samples must be received within 30 days from receipt of acute samples
• Spec Store Transport:
  Refrigerated
• Spec Stability:
  1 week refrigerated (2-8°C)
  3 months frozen (-20°C) – Do not use frost-free units that undergo repeated freeze/thaw cycles
• Spec Reject:
  Hemolyzed, severely lipemic or heat-inactivated sample
• Methodology:
  Type Non-Specific IgG: Chemiluminescent Enzyme Immunoassay
  IgM: Indirect Immunofluorescence Assay
  Type-Specific IgG (If Indicated): Multiplex Flow Immunoassay (MFI)
• Use:
  Herpes Simplex Virus (HSV) antibody testing can be used to aid in the diagnosis of initial or primary infections due to either Herpes Simplex Type 1 or Type 2 viruses, reinfection or reactivation of latent viruses, and also to determine immunologic status or experience with HSV
  
• Clinical Significance:
  Herpes Simplex Virus (HSV) Type 1 is generally associated with oral infections and other infections above the waist whereas HSV Type 2 is generally associated with genital infections and other infections below the waist. This distinction, however, is not completely specific as either viral type can be associated with either oral or genital infections. Type 1 and Type 2 viruses share many common antigens so antibodies that form in response to one viral type often cross-react with the other. Specific testing for antibodies against one viral type are available but nonspecific type antibody testing can be used as a screening tests and are often less expensive.
  Testing of paired sera samples for IgG antibodies from 10 day to 2 week intervals can be useful in the detection of active infections including primary, reactivated or recurrent infections. Generally a fourfold or greater increase in IgG titer between acute and convalescent sera indicates recent or active infection. The presence of IgM antibodies to HSV in a single sample also usually reflects an active infection, although not necessarily a primary one. Note: In some patient populations the presence of HSV antibodies (mainly IgG) can be detected in as many as 1/2 to 2/3 of newborn infants due to passive transplacental transfer from the mother. The number of antibody-positive infants then decreases to a very small percentage at 6 months to one year of age. In children, that percentage then gradually increases to 40-70% by age 14 and to even higher percentage in late adulthood. Therefore, a single laboratory result, particularly for IgG antibodies, is often not very meaningful.
  Other limitations of HSV antibody testing include the report that some individuals fail to develop detectable antibody levels after infection indicating that lack of seroconversion does not exclude the possibility of infection. HSV antibody test should not be used by themselves for the diagnosis of current HSV infection in pregnant women. Also, a rising serum antibody titer is not sufficient for diagnosing HSV encephalitis. However, it should be considered in a presence of high antibody level in cerebrospinal fluid. Testing results on immunocompromised or immunosuppressed patients may be difficult to interpret or even misleading. Patients with positive test for Rheumatoid Factor may exhibit false positive HSV IgM antibody testing.
  
• Reference Range:
  

  Herpes Simplex Virus (HSV) Type Non-Specific IgG Antibody
  Less than 0.9 - Negative
  0.9-1.09 - Indeterminate (samples reported "indeterminate" for HSV IgG have been repeated; recommend retesting in 1 week with fresh sample)
  1.1 or greater - Positive

  Herpes Simplex Virus (HSV) Type 1 and/or 2 IgM Antibody
  Less than 1:10 - Negative
  1:10 or greater - Positive

  Herpes Simplex Virus (HSV) 1 Type-Specific IgG Antibody (If Indicated)
  Less than 0.90 IV - Negative
  0.90-1.10 IV - Equivocal (Samples reported "equivocal" for HSV-1 IgG have been repeated. Recommend retesting in 4 to 12 weeks with fresh sample)
  1.10 IV or greater - Positive

  Herpes Simplex Virus (HSV) 2 Type Specific IgG Antibody (If Indicated)
  Less than 0.90 IV - Negative
  0.90-1.10 IV - Equivocal (Samples reported "equivocal" for HSV-2 IgG have been repeated. Recommend retesting in 4 to 12 weeks with fresh sample)
  1.10 IV or greater - Positive

  Interpretive Information for Herpes Simplex Virus (HSV) Type 1 and/or 2 IgM Antibody by IFA:
  HSV type 1 and 2 share common antigens, therefore, antibodies formed in response to stimulation by one viral type cross-react with the other. Elevated titers to both HSV-1 and HSV-2 may represent cross-reactivity of HSV antibodies rather than exposure to both HSV-1 and HSV-2. Specific type of HSV may be assumed if only one type showed positive result.

• Day Run:
  Mon, Thu
• Time Run:
  8:00 am
• Time Reported:
  5:00 pm
• Test Type:
  INFECTIOUS ANTIBODY