OBJECTIVE: To develop a rapid quantitative real-time polymerase chain reaction (PCR) to detect herpes simplex virus (HSV) in the genital secretions of women that may be used in labor. METHODS: Samples of genital secretions from women in labor, swabs of active genital lesions, and swabs of buffer solution were analyzed using a newly developed rapid HSV PCR assay to detect HSV glycoprotein B gene and quantitate virion copy number. A previously validated TaqMan PCR to detect HSV glycoprotein B gene was performed as the comparator gold standard. Positivity determination that optimized sensitivity and specificity was determined with receiver operating characteristic curves. RESULTS: The median time to result for rapid HSV PCR was 2 hours (range 1.5-3.5 hours). A positivity determination rule that required both wells of the rapid test to detect 150 copies or greater of HSV per milliliter maximized specificity (96.7%) without appreciable loss of sensitivity (99.6%). Among positive samples, the correlation between the rapid test and TaqMan for the quantity of HSV isolated was excellent (R=0.96, P<.001). The rapid test had a positive predictive value of 96.7% and a negative predictive value of 99.6% in a population with HSV shedding prevalence of 10.8%, based on the prevalence of genital HSV previously found among HSV-2 seropositive women in labor. CONCLUSION: Rapid HSV PCR provides results with excellent sensitivity and specificity within a timeframe that could inform clinical decision making for identifying neonates at risk of neonatal HSV infection. LEVEL OF EVIDENCE: II.
OBJECTIVE: To develop a rapid quantitative real-time polymerase chain reaction (PCR) to detect herpes simplex virus (HSV) in the genital secretions of women that may be used in labor. METHODS: Samples of genital secretions from women in labor, swabs of active genital lesions, and swabs of buffer solution were analyzed using a newly developed rapid HSV PCR assay to detect HSV glycoprotein B gene and quantitate virion copy number. A previously validated TaqMan PCR to detect HSV glycoprotein B gene was performed as the comparator gold standard. Positivity determination that optimized sensitivity and specificity was determined with receiver operating characteristic curves. RESULTS: The median time to result for rapid HSV PCR was 2 hours (range 1.5-3.5 hours). A positivity determination rule that required both wells of the rapid test to detect 150 copies or greater of HSV per milliliter maximized specificity (96.7%) without appreciable loss of sensitivity (99.6%). Among positive samples, the correlation between the rapid test and TaqMan for the quantity of HSV isolated was excellent (R=0.96, P<.001). The rapid test had a positive predictive value of 96.7% and a negative predictive value of 99.6% in a population with HSV shedding prevalence of 10.8%, based on the prevalence of genital HSV previously found among HSV-2 seropositive women in labor. CONCLUSION: Rapid HSV PCR provides results with excellent sensitivity and specificity within a timeframe that could inform clinical decision making for identifying neonates at risk of neonatal HSV infection. LEVEL OF EVIDENCE: II.
Authors: A M Arvin; P A Hensleigh; C G Prober; D S Au; L L Yasukawa; A E Wittek; P E Palumbo; S G Paryani; A S Yeager Journal: N Engl J Med Date: 1986-09-25 Impact factor: 91.245
Authors: Christine Johnston; Jia Zhu; Lichen Jing; Kerry J Laing; Christopher M McClurkan; Alexis Klock; Kurt Diem; Lei Jin; Jeffrey Stanaway; Elizabeth Tronstein; William W Kwok; Meei-Li Huang; Stacy Selke; Youyi Fong; Amalia Magaret; David M Koelle; Anna Wald; Lawrence Corey Journal: J Virol Date: 2014-02-19 Impact factor: 5.103
Authors: Thaís Duquia Moraes Caldeira; Carla Vitola Gonçalves; Gisele Rodrigues de Oliveira; Tânia Vieira da Fonseca; Regina Gonçalves; Clair Teixeira do Amaral; Vanusa Pousada da Hora; Ana Maria Barral de Martinez Journal: Rev Inst Med Trop Sao Paulo Date: 2013 Sep-Oct Impact factor: 1.846