TABLE 11.

Detection of herpes simplex virus DNA by real-time PCR in cerebrospinal fluid specimens

ReferenceNo. of specimensNo. positive (%)Test platform/gene targetComparison studiesComments
Ryncarz et al. 1999 (422)38042 (11.1)ABI Prism/glycoprotein BOf 58 total positive specimens, 13 were positive only by conventional PCR; 3 were positive only by real-time PCR.Probes specific for HSV-1 or HSV-2 were used to differentiate genotypes in separate reactions.
Kessler et al. 2000 (218)5920 (33.9)LightCycler/DNA polymerase20 positive samples were detected by both conventional and real-time PCR methods. Four samples yielded discrepant results: two positive by conventional PCR only; two positive by real-time PCR only.The real-time PCR assay on the LightCycler instrument proved to be very quick and laborsaving (<1 h) compared with conventional PCR (4 h).
Peter et al. 2001 (374)3,20062 (1.6)aABI Prism/DNA polymeraseA preponderance of HSV-2 over HSV-1 infections was obtained in specimens submitted for routine diagnostic testing.No inhibitors of PCR detected.
Aberle et al. 2002 (3)576153 (26.6)ABI Prism/HSV-1 DNA binding protein; HSV-2 glycoprotein GAmount of virus varied among the individual diseases, associated with HSV-1, HSV-2, VZV, and CMV. Low levels of EBV and human herpesvirus 6 DNA were detected in CSF specimens.Overall broad testing for different viruses in CSF clearly leads to a significant increase in the detection rate of viral CNS infections.
Kimura et al. 2002 (220)28 (from neonates)20 (71.4)bABI Prism/DNA polymeraseA real-time PCR assay was applied to quantitate the viral load in the conventional PCR-positive specimens.Patients with CNS infection had the highest viral loads in CSF. Patients with HSV-2 infection had more CNS involvement and neurological impairment and higher viral load in CSF than did patients with HSV-1.
Stöcher et al. 2003 (467)308 (26.6)LightCycler/DNA polymeraseDetection limits with herpesvirus type-specific DNA spiked into CSF, serum, or plasma was 250 or 500 DNA copies/ml.Four LightCycler PCR tests were developed (CMV, EBV, HSV-1 and HSV-2, VZV) with standard test parameters.
  • a Totals, 26 HSV-1 and 36 HSV-2.

  • b Results obtained by conventional PCR: 6 of 7 CSF samples from patients with disseminated HIV disease; 11 of 11 patients with CNS infection; 3 of 10 CSF samples with skin, eye, or mouth infection.