Herpes Simplex Virus (HSV-1/2) PCR, Non-Lesion
Test Mnemonic
HSVPCR
CPT Codes
- 87529 - QTY (2)
LOINC ®
16130-7, 16131-5
Aliases
- HSVPCR
- PCRHSV
- SQHSVPCR
- SQPCRHSV
Includes
- Herpes Simplex Virus 1 (HSV-1) DNA
- Herpes Simplex Virus 2 (HSV-2) DNA
Performing Laboratory
Cleveland Clinic Laboratories
Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| 0.5 mL | Fluid, ocular | Sterile container | Refrigerated | Collect ocular fluid using standard protocol. An absolute minimum of 250 uL is required for testing (for HSVPCR and VZVPCR combined). For specimen volumes below 5 mL, leave the fluid inside the sterile syringe to allow maximal recovery. The needle MUST be removed and syringe capped before transport to the lab. | |
| 0.5 mL | Bronch (BAL) | Sterile container | Refrigerated | Collect 2-3 mL into a sterile, leak-proof, screw-cap collection cup or sterile dry container (ie. Oracle 1619591). If aliquoting is necessary, sterile aliquot tubes must be used. Do not dilute with transport media. | |
| 0.5 mL | Plasma | EDTA PPT (White) | Refrigerated | Collect EDTA plasma according to standard protocol. Separate plasma by centrifugation (at 1,100 RCF for a minimum of 10 minutes) within 24 hours of collection. Plasma must be aliquoted first if sample is to be frozen. Sample cannot be shared with a test performed outside of Molecular Microbiology. Sample can only be shared with CMVQNT, HCQPCR, HIVRNA, HBVDNU, EBVQNT, BKQUAN, HSVPCR, or VZVPCR. |
Alternate Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| 0.5 mL | Washings, bronch | Sterile container | Collect 2-3 mL into a sterile, leak-proof, screw-cap collection cup or sterile dry container (ie. Oracle 1619591). If aliquotting is necessary, sterile aliquot tubes must be used. Do not dilute with transport media. | ||
| 0.5 mL | Plasma | EDTA (Lavender) | Collect EDTA plasma according to standard protocol. Centrifuge (at 1,300 RCF for a minimum of 10 minutes) and aliquot into a sterile secondary tube within 24 hours of collection. Plasma must be aliquoted first if sample is to be frozen. Sample cannot be shared with a test performed outside of Molecular Microbiology. Sample can only be shared with CMVQNT, HCQPCR, HIVRNA, HBVDNU, EBVQNT, BKQUAN, HSVPCR, or VZVPCR. |
Minimum Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| 0.25 mL | Absolute minimum volume accepted is 0.25 mL (250 uL) for HSVPCR and VZVPCR combined. This minimum should be enforced for all specimen types except ocular fluid. For ocular fluid received below this minimum amount, do not cancel testing. Instead, forward specimen onto testing lab for determination of sufficiency and possible conversion to alternative testing if needed. |
Stability
| Environmental Condition | Description |
|---|---|
| Ambient | 24 hours |
| Refrigerated | 7 days |
| Frozen | 30 days |
Days Performed
3 days per week
Turnaround Time
1 - 3 days
Methodology
| Name | Description |
|---|---|
| Real-Time Polymerase Chain Reaction (RT-PCR) |
Reference Range
| Herpes Simplex Virus 1 (HSV-1) DNA | |||||
|---|---|---|---|---|---|
| Sex | Age From | Age To | Type | Range | Range Unit |
| Not Detected | |||||
| Herpes Simplex Virus 2 (HSV-2) DNA | |||||
| Sex | Age From | Age To | Type | Range | Range Unit |
| Not Detected |
Clinical Info
Herpes simplex viruses (HSV-1 and HSV-2) are enveloped DNA viruses that are members of the alpha-herpesviridae subfamily. HSV infections in humans can cause lesions at a variety of cutaneous and mucocutaneous sites. These lesions can be a result of the primary infection by the virus or they can result from a reactivation of the latent virus, causing recurrent episodes of the disease. While testing is typically performed on mucocutaneous swabs, more unusual presentations of disseminated disease, pneumonitis, central nervous system infection, or intraocular infection may require testing of alternative specimen types. Nucleic acid amplification tests are a sensitive method for detection of HSV in plasma, lower respiratory specimens, CSF, and ocular fluid. This lab-developed multiplex real-time PCR assay simultaneously qualitatively detects and differentiates HSV-1 and HSV-2 DNA targets. Viral nucleic acid is extracted from clinical samples using the EZ2 Connect (Qiagen). HSV-1 and HSV-2 DNA are amplified and detected using the RealStar alpha Herpesvirus PCR kit 1.0 (Altona) using species-specific primers and fluorescently labeled hydrolysis probes on a RotorGene Q (Qiagen) thermocycler. This specific procedure code (SQHSVPCR) can be used to order this test on plasma, bronchoalveolar lavage, bronchial wash, and ocular fluid specimens. Utilize alternative orders for the following specimen types: SQHSVVZV for mucocutaneous lesion swabs, SQHSPCRC for CSF, SQHSVNEO for neonatal surface swabs.
Clinical Limitation
As with any nucleic acid amplification test, positive results do not rule out coinfection with other organisms, detected organisms may not be the definite cause of disease, and negative results do not rule out infection. Dilution of ocular fluid at the point of collection may decrease assay sensitivity.
Clinical Reference
1. Yip CCY, Sridhar S, Leung KH, Cheng AKW, Chan KH, Chan JFW, Cheng VCC, Yuen KY. Evaluation of RealStar® Alpha Herpesvirus PCR Kit for Detection of HSV-1, HSV-2, and VZV in Clinical Specimens. Biomed Res Int. 2019 Oct 9;2019:5715180. doi: 10.1155/2019/5715180. PMID: 31687393. 2. Harper TW, Miller D, Schiffman JC, Davis JL. Polymerase chain reaction analysis of aqueous and vitreous specimens in the diagnosis of posterior segment infectious uveitis. Am J Ophthalmol. 2009 Jan;147(1):140-147.e2. doi: 10.1016/j.ajo.2008.07.043. Epub 2008 Oct 2. PMID: 18834576.