Viral tissue cultureThis is the most common diagnostic test used in clinical practice, but the diagnostic yield of culture is highest in the early stages of disease, when lesions are typically vesicular, and declines rapidly as the lesions begin to heal. Fluids and material for culture should be obtained from the base of a vesicle or of a freshly ulcerated lesion or unroofed lesion. Failure to properly collect and transport the sample could lead to false negative results. This modality can yield positive results within 48 hrs of inoculation. Immunofluorescent staining of the tissue culture cells can be used to quickly identify HSV and can distinguish between types 1 and 2.
This is the most sensitive test but may not be available in all clinical settings. Real -time HSV PCR assays have emerged as a more sensitive method to confirm HSV infection in clinical setting where available. It is particularly useful for the detection of asymptomatic viral shedding.
Tzanck smearThe characteristic cytologic changes induced by HSV can also be demonstrated in Tzanck smears (a superficial scraping from the base of freshly ruptured vesicle stained with Wright's-Giemsa stain). A positive Tzanck result is the finding of multinucleate giant cells, but it does not differentiate between HSV-1 and HSV-2. Rapid diagnosis is possible based on the histologic appearance of the lesion. Multinucleated giant cells and epithelial cells containing eosinophilic intranuclear inclusion bodies distinguish the lesions of herpes viruses. This is a less sensitive test.
Monoclonal antibodies directed to type-specific antigens in enzyme immunoassay (EIA) and fluorescence -immunoassay formats are the methods most laboratories use in HSV diagnosis. Cells scrapped from ulcer bases can also be stained with a direct fluorescent antibody (DFA) which differentiates HSV-1 from HSV-2. DFA can also distinguish different herpes viruses and non herpes viruses.
Serological assaysHighly sensitive and specific type-specific serological assays include immunodot enzyme assays (IEA). Type specific IgG testing directed against glycoprotein G of HSV-1 or that of HSV-2 can distinguish HSV-1 infection from HSV-2 infection. When measured against western blot, sensitivity of 97-100% and specificity of 94-98% has been documented. Serologic testing is recommended to confirm a clinical diagnosis of genital herpes in patients with recurrent genital symptoms, atypical lesions, or with healing lesions and negative HSV cultures. Type specific HSV antibodies can take from two weeks to three months to develop. Thus, in a person with newly acquired herpes, the initial absence of IgG antibodies specific for glycoprotein G and subsequent development of such antibodies after 12 weeks confirm new HSV infection.
Now you are armed with up-to-date information so you can ask your primary care MD or gynecologist to get more accurate testing. Once you have your diagnosis, you can consider several treatment options. Acyclovir is the standard pharmaceutical that is recommended for life to reduce the viral load. It does not kill the virus, but keeps the virus from replicating.
Ozone, on the other hand, can reduce the viral load and in many cases can eradicate the virus. We add the injectable specialized medicine for herpes to lure it out of tissue storage into the bloodstream where it is exposed to ozone.