Herpes simplex virus (HSV) antibodies - serum, CSF

Last updated: Friday, 04, June, 2010

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5-10 mL blood or 2 mL CSF in plain tube.

Acute and convalescent (10-14 days) samples.


Immunoassay, EIA


Of very limited usefulness in the diagnosis of primary oral or genital herpes.

If testing is indicated clinically, viral antigen testing is the preferred test, with PCR being the most sensitive method.

See Virus detection, culture.


A seroconversion from negative to positive or a four-fold rise in titre between acute and convalescent samples supports the diagnosis of primary herpes infection.

Antigenic cross reactivity occurs between HSV-1 and HSV-2.

Recurrent infections may not stimulate a significant increase in antibody titre.

Viral culture and direct antigen detection performed on vesicle fluid or material scraped from the base of a vesicle/ulcer are more rapid and reliable methods to diagnose both primary and recurrent HSV-1 or HSV-2 infection.

Serum antibody testing has not been of value in herpes encephalitis, although the presence of IgM antibodies in CSF may support a presumptive diagnosis.

(PCR) is the preferred test for the diagnosis of HSV encephalitis.

See Virus detection, culture.


Ashley RL and Wald A. Clin Microbiol Rev 1999; 12: 1-8.