Health topic

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

Complications of an often underdiagnosed infection

Affecting almost half the worldwide population, herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2) pose a serious threat to immunocompromised patients and pregnant women.1

Transmission of HSV most often occurs without symptoms.1 HSV-1 is spread through oral-to-oral contact and primarily causes cold sores, while HSV-2 is transmitted almost entirely through sexual contact, causing genital herpes.2 As the majority of these infections are asymptomatic or unrecognized—up to 90% of patients with genital herpes may be undiagnosed—patient management remains a challenge.3

This is especially true for vulnerable patient groups. Transplant recipients and the immunocompromised, for example, are more susceptible to severe manifestations of HSV infection and may be slower to respond to therapy.4 Additionally, pregnant women risk transmitting the virus to the fetus or child which can cause significant disease and even death in infants.5

Adult patients with untreated infections may experience any number of complications, from increased risk of contracting other sexually transmitted infections (STIs) —including HIV —bladder problems, meningitis, and rectal inflammation.6 The virus can also have a significant negative impact upon a person’s mental wellness and personal relationships.

Correct monitoring and treatment can help lower the risk of spreading the infection, underscoring the need for reliable diagnostic testing.

The importance of the right diagnostic approach in HSV testing

Laboratories play an important role in identifying and informing patient management decisions that may reduce recurrence and limit transmission of the virus.

Several testing options are available for diagnosing an HSV infection, including a combination of serological and virologic techniques. However, molecular testing using polymerase chain reaction (PCR) technology is regarded as the most sensitive methodology to directly detect HSV-1 and HSV-2.

Since the type of infection affects prognosis and subsequent counseling, type-specific testing to distinguish HSV-1 from HSV-2 is recommended.

Given the difficulty in making the clinical diagnosis of HSV, the growing worldwide prevalence, and the availability of effective antiviral therapy, rapid and accurate laboratory diagnosis is a necessity.

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Efficiently identifying HSV infections with innovation


Providing clinicians with the highest value information requires the right mix of technology. To help laboratories meet the demands of customers and communities, Roche developed a collection of serology and molecular assays to guide testing and result interpretation.


Using type-specific HSV-1 and HSV-2 serology tests, laboratories can inform proper development of strategies to prevent transmission to partners and neonates, counselling, and management of the disease.7 For direct detection of viral agents, Roche offers an innovative dual-target HSV assay as well as a multiplex test for HSV-1/2 and Varicella zoster virus (VZV). These run on fully automated systems. The detection of multiple targets allows for simultaneous detection and differentiation from one sample, while absolute automation allows laboratories to significantly streamline HSV workflows compared to traditional culture.

By reducing costs, improving turnaround times, and increasing walk-away time through automation, laboratories can redirect more resources to other value-added work. This level of efficiency can elevate the organizational role of a laboratory, give healthcare professionals the reliable results they need, and ensure patients get the timely answers they deserve.

Two female technicians working in a lab


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  1. Globally, an estimated two-thirds of the population under 50 are infected with herpes simplex virus type 1. Accessed 10 October 2020.
  2. Herpes simplex virus: global infection prevalence and incidence estimates, 2016. Accessed 10 October 2020.
  3. Ashley RL, Wald A. Genital herpes: review of the epidemic and potential use of type-specific serology. Clin Microbiol Rev. 1999;12(1):1-8.
  4. Wilck MB, Zuckerman RA; AST Infectious Diseases Community of Practice. Herpes simplex virus in solid organ transplantation. Am J Transplant. 2013 Mar;13 Suppl 4:121-7.
  5. James SH, Sheffield JS, Kimberlin DW. Mother-to-Child Transmission of Herpes Simplex Virus. J Pediatric Infect Dis Soc. 2014;3 Suppl 1(Suppl 1):S19-S23.
  6. Genital herpes. Accessed 10 October 2020.
  7. Patel R, Kennedy OJ, Clarke E, et al. European guidelines for the management of genital herpes. Int J STD AIDS. 2017;28(14):1366-1379.
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