Evaluation of a New Point-of-Care Serologic Assay for Herpes Simplex Virus Type 2 Infection

Herpes simplex virus type 2 infection is one of the most common sexually transmitted diseases. Because presentation is often atypical or subclinical, serologic testing is necessary for diagnosis, treatment, and counseling. In an urban clinic that specializes in the treatment of sexually transmitted dis-ease, a new point-of-care rapid serologic test was compared with enzyme-linked immunosorbent assay or Western blot for the detection of herpes simplex virus type 2. With use of an enzyme-linked immunosorbent assay index cutoff value of 1.1, the rapid test was found to have a sensitivity of 97%, a specificity of 98%, a positive predictive value of 92%, and a negative predictive value of 99%. Increasing the cutoff in-dex value to 3.5 increased the test sensitivity to 100%. Genital herpes due to herpes simplex virus type 2 (HSV-2) infection is common and remains underdiagnosed in the United States [1]. Appropriate counseling and treatment are predicated on an accurate diagnosis of genital herpes. Because most HSV-2 infections are subclinical or unrecognized, sero-logic testing is often necessary to make a diagnosis; after a diagnosis is made, infected patients can be counseled that symp-tom awareness, condom use, and suppressive treatment may all decrease the risk of transmission to uninfected partners [2, 3]. Western blot is considered the gold standard for HSV-2 se-rologic testing [4], but because of its cost and limited avail-ability, commercially available type-specific HSV-2 serologic as-says are more commonly used for screening [5]. Rapid HSV-