Herpes Simplex Virus (HSV-1 & HSV-2) and Varicella Zoster Virus (VZV), NAAT, Lesion Swab
Test Mnemonic
HSVVZV
CPT Codes
- 87529 - QTY (2)
- 87798 - QTY (1)
LOINC ®
33027-4
Aliases
- HSVVZV
- SQHSVVZV
Includes
- Herpes Simplex Virus 1 (HSV-1) DNA
- Herpes Simplex Virus 2 (HSV-2) DNA
- Varicella Zoster Virus (VZV) DNA
Performing Laboratory
Cleveland Clinic Laboratories
Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| 3 mL | Swab(s) | Universal Transport Media (UTM) | Refrigerated | Acceptable specimen types include flocked swabs from active cutaneous or mucocutaneous lesions submitted in universal transport medium (UTM) or an equivalent viral transport medium. 1. Obtain a collection kit which includes a sterile flocked swab and a container including universal transport media (UTM). An example is Oracle #1063581, Diagnostic Hybrids #402C. 2. Vigorously swab the base of the unroofed lesion, applying enough pressure to collect vesicular fluid and/or epithelial cells. 3. Place the swab in the tube containing UTM and break off the tip. Close the cap. |
Alternate Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| 3 mL | Swab(s) | Viral Transport Media | Refrigerated |
Stability
| Environmental Condition | Description |
|---|---|
| Ambient | 24 hours |
| Refrigerated | 7 days |
| Frozen | 30 days |
Days Performed
7 days a week
Turnaround Time
0 - 3 days
Methodology
| Name | Description |
|---|---|
| Real-Time Polymerase Chain Reaction (RT-PCR) |
Clinical Info
Herpes simplex virus types 1 and 2 (HSVâ€1 and HSVâ€2), and varicella-zoster virus (VZV), are DNA viruses of the family Herpesviridae. 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. Primary VZV infection results in chickenpox (varicella), which may rarely result in complications including encephalitis or pneumonia. Even when clinical symptoms of chickenpox have resolved, VZV remains dormant in the nervous system of the infected person (virus latency). In approximately 10 to 20% of cases, VZV reactivates later in life producing shingles. This lab-developed multiplex real-time PCR assay simultaneously qualitatively detects and differentiates HSV-1, HSV-2, and VZV DNA targets. Viral nucleic acid is extracted from clinical samples using the EZ2 Connect (Qiagen). Viral DNA is 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 (SQHSVVZV) can be used to order this test on mucocutaneous lesion swabs. Utilize SQHSPCRC for HSV testing on CSF; SQHSVNEO for HSV testing on neonatal surface swabs; SQHSVPCR for HSV testing on all other non-lesional specimen types; and SQVZVPCR for VZV testing on all other non-lesional specimen types.
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.
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. Nikolic D, Kohn D, Yen-Lieberman B, Procop GW. Detection of Herpes Simplex Virus and Varicella-Zoster Virus by Traditional and Multiplex Molecular Methods. Am J Clin Pathol. 2019 Jan 1;151(1):122-126. doi: 10.1093/ajcp/aqy111. PMID: 30239569.