58481:HERPES SIMPLEX VIRUS (HSV) 1 & 2 ANTIBODIES, IgG & IgM

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58481:HERPES SIMPLEX VIRUS (HSV) 1 & 2 ANTIBODIES, IgG & IgM
Methodology: Enzyme-Linked Immunosorbent Assay (ELISA), HSV 1&2 IgM / Multiplex Flow Immunoassay (Luminex), HSV 1&2 IgG
Edit Date: 6/11/2010
Performed: Daily 1&2, IgG
Monday, Wednesday, Friday 1&2 IgM
Released: Same day as tested
CPT Code: 86694 / 86695 / 86696
Specimen Collection Details
Collection: One 7.5 mL serum separator tube (SST). Also acceptable: One 5 mL red top tube.
Handling: Allow to clot, centrifuge and separate serum from cells immediately. Refrigerate. Freeze at -20º C if specimen cannot be assayed within 48 hours. Allow no more than one freeze/thaw cycle. If other testing is ordered, send separate specimen for this test.
Standard Volume: 1 mL serum.
Minimum Volume: 0.5 mL serum
Transport: Refrigerated, or frozen on dry ice.
Comments: See also Torch Antibodies, IgG & IgM (58961).
Rejection Criteria: Gross lipemia; bacterial contamination; specimen frozen and thawed more than once.

HSV type 1 Glycoprotein G-Specific Antibody, IgG
0.90 AI (AI=Antibody Index)
<0.9 AI Negative: No significant level of detectable IgG antibody to HSV type 1 glycoprotein G.
0.9-1.0 AI Equivocal: Questionable presence of IgG antibody to HSV type 1. Repeat testing in 10-14 days may be helpful.
≥1.1 AI Positive: IgG antibody to HSV type 1 glycoprotein G detected, which may indicate a current or recent HSV infection.
HSV type 2 Glycoprotein G-Specific Antibody, IgG
<0.9 AI Negative: No significant level of detectable IgG antibody to HSV type 2 glycoprotein G..
0.9-1.0 AI Equivocal: Questionable presence of IgG antibody to HSV type 2. Repeat testing in 10-14 days may be helpful.
≥1.1 AI Positive: IgG antibody to HSV type 2 glycoprotein G detected, which may indicate a current or recent HSV infection.
Individuals infected with HSV may not exhibit detectable IgG antibody to glycoprotein G in the early stages of infection and 5-10% of infections may occur with glycoprotein G deficient virus. Detection of antibody presence in these cases may only be possible using a nontype-specific screening test.
HSV 1 and 2 IgM Antibodies Result Interpretations, ELISA Method:
<0.90 IV (IV = Index Value)
<0.90 IV Negative: No significant level of detectable HSV antibody.
0.90-1.09 IV Equivocal: Repeat testing in 10-14 days may be helpful.
≥ 1.10 IV Positive: IgM antibody to HSV detected, which may indicate a current or recent infection or reactivation.
Appearance of an IgM antibody response normally occurs 7-14 days after the onset of disease. Testing immediately post-exposure is of no value without a later convalescent specimen. While the presence of IgM antibodies suggests current or recent infection, low levels of IgM antibodies may occasionally persist for more than 12 months post-infection. Such a residual response may be distinguished from early IgM response to infection by testing sera from patients 2-3 weeks later for changing levels of specific IgM antibodies.

False positive and false negative IgM test results may occur in specimen with extremely high level of rheumatoid factor and high autoimmune antibodies.

A negative serological test does not exclude the possibility of past infection. Following primary HSV infection, antibody may fall to undetectable levels and then be boosted by later clinical infection with the same or heterologous type. Such a phenomenon may lead to incorrect interpretations of seroconversion and primary infection, or negative antibody status. In addition, specimen obtained too early during primary infection may not contain detectable antibody.

Some persons may fail to develop detectable antibody after Herpes infection.