Clinical Significance

Herpes simplex virus (HSV) types 1 and 2 are members of the Herpesviridae family and produce infections that range from mild stomatitis to disseminated and fatal disease. Clinical conditions associated with HSV infection include gingivostomatitis, keratitis, encephalitis, vesicular skin eruptions, aseptic meningitis, neonatal herpes, genital tract infections, and disseminated primary infection.

Infections with HSV types 1 and 2 can differ significantly in their clinical manifestations and severity. HSV type 2 primarily causes urogenital infections and is found almost exclusively in adults. HSV type 1 is closely associated with orolabial infection, although genital infection with this virus can be common in certain populations.

The diagnosis of HSV infections is routinely made based on clinical findings and supported by laboratory testing, primarily using polymerase chain reaction to detect viral DNA. However, in instances of subclinical or unrecognized HSV infection, serologic testing for IgG-class antibodies to type-specific HSV glycoprotein G may be useful. There are several circumstances where it may be important to distinguish between infection caused by HSV types 1 and 2 (eg, risk of reactivation). In addition, the results of HSV type-specific IgG testing are sometimes used during pregnancy to identify risks of congenital HSV disease and allow for focused counseling prior to delivery.