疱疹

单纯性疱疹检测用于鉴别急性疱疹感染或检测一种以往感染了疱疹的指标疱疹抗体。作为最常见的病毒感染之一，单纯疱疹病毒（HSV）有两种类型，HSV-1和HSV-2。这两种类型都具有传染性，周期性地引起小的热病性疱疹（小囊泡），破损后形成开放性病灶。HSV-1主要引起口腔或唇周的大水泡或“唇疱疹”；而HSV-2常引起生殖器区域的损伤。然而，两者中任何一种都能影响口腔或生殖器区。

        单纯性疱疹病毒能通过皮肤接触传播给其他人，不论溃疡面是开放性的还是在愈合，有时存在肉眼不可见的创面的无症状感染也能传播。HSV-2常引起性传播疾病，而HSV-1在生殖区可见，也能通过口交获得。根据美国社会卫生协会及其国家疱疹资源中心，在美国大约有50%—80%的成人感染HSV-1，大约20%的成人感染HSV-2。由于症状可轻微，90%感染HSV-2的患者不知道自己已被感染。

When someone is first infected, he or she may have obvious and painful blisters at the site of infection, which usually appear within two weeks after the virus is transmitted and usually heal within two to four weeks. The blisters can appear in the vaginal area, on the penis, around the anus, or on the buttocks or thighs. This primary episode can include a second outbreak of blisters and even flu-like symptoms of fever and swollen glands. However, not everyone develops blisters and sometimes symptoms are so mild that they are unnoticeable or mistaken for something else, such as insect bites or a rash.

        一旦某人感染了疱疹病毒，最初的感染消退，病毒会处于潜伏状态。当应激或疾病时，病毒恢复活性。大多数案例，HSV的爆发不是对健康的威胁而是一件痛苦的事情，病毒也能引起新生儿疱疹（具有有活性的生殖器疱疹的母亲在分娩过程中使婴儿感染病毒）和脑炎。这些疾病可以是致命的，可导致幸存者严重的永久性神经损伤。免疫系统受抑制的患者，比如HIV/AIDS或器官移植者，发生HSV爆发更频繁，严重程度更大。

        HSV试验，检测病毒本身、病毒DNA或病毒抗体。在急性原发感染或复发时，病毒可通过下列试验检测：

• 疱疹培养：从开放性疮口收集分泌物标本（最常见的标本）。在营养环境中孵育以分离出病毒。试验敏感性和特异性好，但需要2天以上的时间。新鲜的疮伤最好。泄出的病毒随着时间的延长而减少，可导致假阴性结果。一旦培养出病毒，就应该确定它是HSV-1还是HSV-2。
• HSV DNA检测：用于检测患者标本中HSV的遗传物质。该方法能给病毒分型及定量，在病毒存在的数量较少的情况下（如病毒性脑膜炎）或对陈旧性创面也能很好检测。由于该试验提高了灵敏度，且脑脊液不是培养试验好的培养基，HSV DNA检测是检测HSV脑膜炎、脑炎或角膜炎最好的方法。
• HSV 抗体检测：抗体是机体对抗感染，产生并释放到血液中的特殊蛋白质。HSV IgM抗体产生开始于HSV原发（最初的）感染后几天，在血中持续存在几周。HSV IgG抗体的出现晚于HSV IgM抗体，在血中的浓度升高、下降，然后维持在稳定水平。一旦某人感染了HSV，他们会持续产生少量IgG抗体。HSV抗体试验能同时检测两种类型的病毒（HSV-1和HSV-2），能检测早期的IgM抗体，也能检测永远存在于被感染者体内的IgG抗体。

注：第二第三段英文版有修改，其中第三段新增。

医生从嘴或生殖器的水泡或溃疡处取拭子或刮取物。当可疑脑炎或脑膜炎时，从脊柱抽取脑脊液（CSF）。当进行抗体检测时，从肘静脉抽取血液标本。

       不需要

疾病: 性传播疾病
专题: The Universe of Genetic Testing: Infectious Disease Testing

Centers for Disease Control and Prevention: Genital Herpes, CDC Fact Sheet
American Social Health Association: Learn About Herpes
Planned Parenthood: Herpes
MedlinePlus Medical Encyclopedia: Genital Herpes

Sources Used in Current Review

Wu, A. (2006). Tietz Clinical Guide to Laboratory Tests, Fourth Edition. Saunders Elsevier, St. Louis, Missouri. Pp 1568-1569.

Centers for Disease Control and Prevention. Genital Herpes - CDC Fact Sheet. Available online at http://www.cdc.gov/std/Herpes/STDFact-Herpes.htm through http://www.cdc.gov. Accessed July 2009.

Hunt, Richard. Virology: Herpes Viruses (Chapter 11). Microbiology and Immunology On-line. University of South Carolina School of Medicine. Available online at http://pathmicro.med.sc.edu/virol/herpes.htm through http://pathmicro.med.sc.edu. Accessed July 2009.

Lifestyle from Yahoo Canada. Herpes virus - 8 types. Available online at http://health.lifestyle.yahoo.ca/channel_section_details.asp?text_id=1364&channel_id=1028&relation_id=22614 through http://health.lifestyle.yahoo.ca. Accessed July 2009.

Deborah Fornstrom, M.T. (ASCP). The Children's Hospital, Aurora, CO.

Kristi Lookner, M.T. (ASCP). The Children's Hospital, Aurora, CO.

Sources Used in Previous Reviews

Thomas, Clayton L., Editor (1997). Taber's Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, PA [18th Edition].

Pagana, Kathleen D. & Pagana, Timothy J. (2001). Mosby's Diagnostic and Laboratory Test Reference 5th Edition: Mosby, Inc., Saint Louis, MO.

(2004 May 24, Updated). Genital Herpes. CDC, STD Facts & Information, National Center for HIV, STD and TB Prevention, Division of Sexually Transmitted Diseases [On-line information]. Available online at http://www.cdc.gov/std/Herpes/STDFact-Herpes.htm through http://www.cdc.gov.

Wener, K. (2004 February 3, Updated). Herpes genital (genital Herpes simplex). MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/000857.htm.

(2004 May, Updated). Herpes: What It Is and How to Deal With It. AAFP familydoctor.org [On-line information]. Available online at http://familydoctor.org/x5050.xml.

(2003 November 21, Updated). Genital Herpes. NIAID Fact Sheet [On-line information]. Available online at http://www.niaid.nih.gov/factsheets/stdherp.htm through http://www.niaid.nih.gov.

(2004). Herpes Simplex Virus (HSV). ARUP's Guide to Clinical Laboratory Testing [On-line information]. Available online at http://www.arup-lab.com/guides/clt/tests/clt_a281.jsp#1151353 through http://www.arup-lab.com.

(2003 August 07). Mayo Clinic Staff. Genital herpes. MayoClinic.com [On-line information]. Available online at http://www.mayoclinic.com/invoke.cfm?id=DS00179 through http://www.mayoclinic.com.

(2000 May 17). Herpes Simplex Virus DNA UltraRapid 24 hr turn around. Specialty Laboratories [On-line test information]. PDF available for download at http://www.specialtylabs.com/education/download_PDF/tn_1106.pdf through http://www.specialtylabs.com.

(2004). Sevall, J. and Blum, R. Herpes Simplex Viruses. Specialty Laboratories, Use and Interpretation of Laboratory Tests Books [On-line information]. Available online at http://www.specialtylabs.com/books/display.asp?id=367 through http://www.specialtylabs.com.

(2001). Herpes: Get the Facts. ASHA National Herpes Resource Center [On-line information]. Available online at http://www.ashastd.org/hrc/educate.html through http://www.ashastd.org.

(2004 May 24). Herpes More Prevalent Than Thought. MedlinePlus by UPI [On-line News]. Available online (until June 23 2004) at http://www.nlm.nih.gov/medlineplus/news/fullstory_17929.html.