Two types of herpes simplex virus (HSV) exist. HSV type 1 (HSV-1) causes orofacial herpes; HSV type 2 (HSV-2) causes genital and neonatal herpes. Serologic differentiation is difficult; therefore, type-specific antibody tests are required.
These tests identify the herpes simplex infections. Human HSV is found worldwide and is transmitted by close personal contact. The clinical course is variable, and symptoms may be mild enough to go unrecognized. Major signs and symptoms include oral and skin eruptions, genital tract infections and lesions, and neonatal herpes. Herpes simplex is also common in individuals with immune system deficiencies (e.g., cancers, HIV/AIDS, chemotherapy treatment). HSV antibody testing is also widely used for bone marrow recipients and donors.
Collect a 7-mL blood serum sample in a red-topped tube. Observe standard and contact precautions.
Label the specimen with the patient’s name, date, and test(s) ordered and place in a biohazard bag for transport to the laboratory.
Follow-up testing is usually required.
Most persons in the general population have been infected with HSV by 20 years of age. After the primary infection, antibody levels fall and stabilize until a subsequent infection occurs.
Diagnosis of current infection is related to determining a significant increase in antibody titers between acute-stage and convalescent-stage blood samples.
Serologic tests cannot indicate the presence of active genital tract infections. Instead, direct examination with procurement of lesion cultures should be done.
Newborn infections are acquired during delivery through the birth canal and may present as localized skin lesions or more generalized organ system involvement.
Pretest Patient Care
Assess patient’s knowledge regarding the test. Explain test purpose and procedure.
Follow guidelines in Chapter 1 for safe, effective, informed pretest care.
Posttest Patient Care
Review test results; report and record findings. Modify the nursing care plan as needed. Counsel the patient regarding abnormal findings; explain the need for possible follow-up testing and treatment. See Interpreting Results of Immunologic Tests. Advise pregnant women that the newborn may be infected during birth when active genital area infection is present.
Institute or maintain contact precautions for positive cases of HSV.
Follow guidelines in Chapter 1 for safe, effective, informed posttest care.