單純疱疹病毒之血清學診斷

目的：探討疱疹病毒血清學檢驗在臨床上的應用，提供給醫療人員作為診斷時的參考。方法：回顧與疱疹相關的書籍、文獻等，加以整理。結果：單純疱疹，通常感染後數週內，型別特異性抗體(type-specific antibody)會出現，而且無限期持續下去，約有70~90%的成人體內具有HSV-1抗體。其中測HSV-2抗體檢驗方法之敏感性在80~98%之間，可能有偽陰性，尤其是在感染初期；也有可能偽陽性，尤其是在低可能感染之狀況下，而其特異性大於96%。所以型別特異性血清檢查(type-specific serologic test)用於臨床診斷之確定及未確知感染之診斷非常有幫助，而僅有少於10%的病例，在復發期間抗體之力價會上升，所以力價升降之利用價值有限，也不宜當作療效之指標。HSV-2抗體(+)者，其病毒幾乎會不定期活化，所以具有潛在傳播危險性。結論：疱疹病毒特異性血清檢查可以幫助臨床診斷之不足，而且對於已被感染但未發病之病例有其診斷之效果，同時可以鑑別HSV-1或HSV-2感染，在臨床應用及衛生教育上有其實用價值。「感染」不等於「發病」，所以不宜只根據檢驗報告異常就施以治療，亦不宜以力價之升降作為有無療效之指標。

關鍵字

疱疹病毒；型別特異性抗體

並列摘要

Background and Purpose: To study the importance of the serology of Herpes Simplex Virus on a clinical diagnosis and then offer a correct treatment. Methods: To review the papers of Herpes Simplex. Results: Type-specific antibodies to HSV develop during the first several weeks following infection and persist indefinitely. About 70%-90 % of adults have HSV-1 antibodies. The sensitivities for detection of HSV-2 antibody vary from 80% to 98%, and false-negative results may occur, especially at early stages of infection. The specificities are ＞96%. False-positive results can occur, especially in patients with low likelihood of HSV infection. Typespecific tests are useful in confirming a clinical diagnosis of genital herpes. Less than 10 % of patients with recurrent episodes of disease experience a serological rise in antibody titer between acute and convalescent sera. Demonstration of rise in anti-HSV antibody titer in sera drawn early and after an episode of disease has limited utility. It appears that nearly all persons with HSV-2 antibodies reactivate virus periodically and hence are potential transmitters of infection. Conclusions: Type-specific tests are useful in confirming a clinical diagnosis of genital herpes. Infection does not mean clinical attack. The titers are not reliable for evaluation of necessity and effect of treatment.

並列關鍵字

herpes simplex virus ； type-specific antibody

國際替代計量

單純疱疹病毒之血清學診斷

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