外周皮肤及黏膜单纯疱疹病毒和水痘带状疱疹病毒感染的实验室诊断进展

Advance in Laboratory Diagnosis of Peripheral Cutaneous and Mucosal Herpes Simplex Virus and Varicella-Zoster Virus Infections

单纯疱疹病毒（herpes simplex virus,HSV）和水痘带状疱疹病毒（varicella zoster virus,VZV）是外周皮肤和黏膜感染的主要病毒病原体.HSV和VZV的外周感染具有潜伏、发病、反复复发以及传播的复杂性.HSV和VZV外周感染的实验室诊断对制订疾病治疗方案和控制感染至关重要.既往的细胞学检查、抗原检测由于其低灵敏度或特异度,已经逐渐被淘汰.HSV和VZV特异性抗体检测对感染鉴别、感染状态和复发状况的判定,在临床诊断上应用有限.普通或壳瓶细胞培养方法作为实验室诊断HSV和VZV感染的金标准,仍就在一些实验室应用.但其耗时长,需要专业细胞培养设备,同时需要经验丰富的技术人员.基于体外核酸扩增技术的分子生物学方法以其特有的高灵敏度和特异度成为临床实验室诊断HSV和VZV感染的主要手段.

Herpes simplex virus （HSV） and varicella-zoster virus （VZV） are common pathogens of cutaneous and mucous membranes.The laboratory diagnosis of HSV and VZV infections is essential for the treatment of these diseases as well as infections control.Cytological,morphological examination,and antigen detection methods have been gradually eliminated from clinical use because of its low sensitivity or/and specificity.HSV and VZV specific antibody detection methods have limited application in clinical diagnosis for determination of the infection status,identification of recurrence infections and documentation of acute infections.Isolation of the viruses using tube and shell vial cell cultures continues to be the gold standard method for identification of active HSV and VZV infections in some laboratories.However,viral culture is timeconsuming,requires specialized cell culture equipment and needs experienced technicians to perform.In recent years,molecular methods have become the primary diagnostic methods for detection and differentiation HSV 1/2 and VZV due to their high sensitivity,specificity,rapid test turnaround time as well as potential high throughput and automation.Although molecular assays detect HSV 1/2 and VZV more quickly,the significance of positive results requires proper interpretation in the individual patient.