Comparison of enzyme immunoassay, shell vial culture, and conventional cell culture for the rapid detection of herpes simplex virus.

Specimens submitted for the detection of herpes simplex virus (HSV) were inoculated into conventional cell-culture tubes and fresh MRC-5 shell vials. The shell vial centrifugation cultures (SVCs) were examined at 16 hr postinoculation for HSV by using type-specific monoclonal antibodies (SVC-FA); they were also analyzed for HSV antigen by using an enzyme-linked immunoassay (SVC-ELISA). Mink Lung (ML) and rhabdomyosarcoma (RD) cells were used in the cell-culture tubes. Of 182 specimens, 35 (19%) were positive in cell-culture tubes, 16 (9%) were positive by SVC-ELISA, and 22 (12%) were positive SVC-FA. All specimens that were positive by SVC-ELISA, SVC-FA, and in culture tubes displayed cytopathic effect (CPE) at 16 hr. Those specimens that had a negative ELISA and/or FA result and were positive in culture were evaluated for the time in which it took to detect CPE. At 16 hr, 48% of the positive tubes were detected; at 40 hr (second day), 83% of the positive tubes were detected; and by the third day, 94% were detected. The RD cell line displayed CPE at the same time or earlier than ML cells did in 92% of the positive cases. The sensitivity of the SVC-ELISA at 16 hr was 46% with 100% specificity. The sensitivity of the SVC-FA at 16 hr was 63% with 99% specificity. Given the increased sensitivity, rapid display of CPE, and reduced cost and handling time of cell cultures, our laboratory found that rapid SVC-ELISA and SVC-FA procedures for HSV detection have no clinical or laboratory advantage.