Health topic

Herpes simplex virus (HSV-1 and HSV-2)

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A common and lifelong infection


Herpes simplex virus (HSV) is one of the most common sexual transmitted infections (STI). It is spread through oral and/or genital sexual contact and it persists in the human body for life. Since the infection often has mild symptoms or none at all, detecting the presence of antibodies in the blood is a reliable method to identify the disease.

The virus has two serotypes: herpes simplex type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). More than 3.7 billion people worldwide under the age of 50 are infected with HSV-1 and HSV-2, while an estimated 417 million people aged 15-49 have HSV-2 infection.

HSV-1 and HSV-2 are different viral infections that usually affect different parts of the body. Where HSV-1 is commonly transmitted from person to person through kissing and usually causes cold sores around the mouth, HSV-2 is primarily spread through sexual contact, and symptomatically exhibits lesions on the genitals. Though less common, HSV-1 may be transmitted to the genitals of a partner, and HSV-2 may be transmitted to the mouth of a partner through oral sex.

Determining the type of HSV a person is infected with has an important impact on patient management and treatment decisions—HSV-2 recurrence is considerably higher than that of HSV-1.1

Molecular testing by polymerase chain reaction (PCR) technology is regarded as the most sensitive method of direct detection for HSV-1 and HSV-2.2


Economic burden of HSV-2


HSV-2 is responsible for an estimated $540.7 million per year in the US, and is one of the most overlooked STIs. Clinical presentation for HSV infection is frequently varied. Signs and symptoms can be easily confused with other conditions, further complicating efforts for detection and treatment of infection.

Approximately 70 to 90% of patients with reactive serology for HSV-2 have not been diagnosed with genital herpes.


Severe health consequences


Untreated and undiagnosed HSV can lead to varying and severe health consequences, including painful chronic infection, miscarriage or premature birth, and fatal infection in newborns.

Differing outcomes regarding disease severity, sequelae, and recurrence rates, make it essential to differentiate between HSV-2 or HSV-1 infections.


Important role of laboratories


For all patients with suspected genital herpes, laboratory confirmation is recommended using methods that directly demonstrate the virus in genital specimens.

Herpes viruses are continuing to evolve and evidence of drug resistance is being reported. Laboratories play an increasingly important role in accurately identifying and typing HSV to direct therapy, prevent recurrence, and limit transmission of the virus.

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cobas® 4800 System

Fully automated sample preparation with real-time polymerase chain reaction (PCR) technology for amplification and detection.



  1. World Health Organization (WHO). Herpes simplex virus. Accessed May 13, 2016.
  2. Patel et al. 2011 European guidelines for the management of genital herpes. Int J STD and AIDS. 22(1):1-10.
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