Genital Herpes: Review of the Epidemic and Potential Use of Type-Specific Serology

Prevention of genital herpes simplex virus (HSV) infections is desirable from both a public health standpoint and the patient’s perspective. A key factor in the spread of genital herpes infections is the high proportion of undiagnosed infections. Persons with subclinical or unrecognized infections are best diagnosed by accurate, type-specific antibody tests. Unfortunately, these tests are only now becoming widely available. The use of current, conventional (non-type-specific) serologic tests for diagnosis of herpes infections has resulted in confusion and misdiagnosis of patients. This review provides recent information on the epidemiology of genital herpes infections, describes the importance of subclinical herpes infection and shedding, summarizes the status of HSV type-specific serologic assays being developed, and provides indications for using such assays.

从公共卫生与患者视角出发，预防生殖器单纯疱疹病毒（HSV）感染均具有重要意义。生殖器疱疹传播的关键诱因之一，是未被确诊的感染占比极高。对于亚临床或隐匿性感染者，精准的分型特异性抗体检测是最佳诊断手段。遗憾的是，此类检测直至今日才逐渐实现广泛应用。当前使用的常规（非分型特异性）血清学检测用于疱疹感染诊断，曾导致患者诊疗混淆与误诊问题。本综述梳理了生殖器疱疹感染流行病学的最新研究进展，阐述了亚临床疱疹感染与病毒排毒的重要性，总结了正在研发中的HSV分型特异性血清学检测方法的现状，并明确了此类检测的临床适用指征。