HSV for tumour lysis

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Practical considerations in diagnosing HSV infections in the clinic

Presented by M Steben, Insititut National de Santé Publique du Québec, Québec, Canada.

An accurate diagnosis of herpes simplex virus (HSV) infection is essential for its effective management. It provides both evidence of lesion aetiology and a basis for which to provide education and counselling for the patient.

A diagnosis of HSV infection requires that:

Patients must present at the clinic with active lesions, or at least inform their physician if the lesions have since healed (public education need);

Physicians must consider the range of possible HSV presentations; Management guidelines must encourage physicians to carry out type-specific testing (continuing professional education need);

Tests must be available to the physician (services need).

Clinical examination together with history taking is sometimes insufficient to diagnose HSV infection, as many lesions are atypical and others may mimic herpes. Laboratory tests are necessary to confirm the clinical impression. All patients presenting with acute or recurrent shedding lesions in the territory of S2 and S3 dermatoma should be tested by a viral identification test.

HSV type-specific serological testing can be used:

To distinguish between HSV-1 and HSV-2 infections;
As a diagnostic tool when there is suspicion of clinical genital herpes, and viral identification is negative at least twice;
If lesions and visit times do not coincide;
If lesions are too infrequent to allow viral identification;
As a case management tool;
If viral identification tests are not available or not practical
as a basis for discussing prevention of herpes and antiviral prophylaxis in HSV serodiscordant couples;
To identify individuals infected with HSV for other purposes such as pregnancy or risk of acquiring HIV.

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Last Updated : 14/04/2004 10:46:47