Herpes simplex virus diagnosis. Antigen detection by ELISA and flow microfluorometry.

Rapid diagnosis of herpes virus (HSV) infection is essential, primarily in the clinical management of the obstetrical patient. We developed an ELISA procedure for viral antigen detection within 24 hours. The assay is sensitive and specific, detecting as little as 2 X 10(-3) micrograms antigen protein and reactivity with mock antigen or unrelated viruses (not observed). Good (91.6%) correlation is observed between ELISA and virus isolation. However, direct quantitative comparison indicates that the ELISA is approximately 100-1000-fold more sensitive than virus culture. Based on the established association of HSV-2 with squamous cervical cancer, and the finding of HSV antigen in atypical cervical cells, studies in our laboratory have focused on the possible use of immunologic markers for screening of abnormal cells in patients with early cervical lesions. A microfluorometric procedure is described that uses multiparameter measurements including: (1) HSV antigen, (2) DNA content, and (3) cell size to screen for abnormal cervical cells. The procedure is specific and it results in a significant enrichment of atypical cells. Its potential as a screening procedure is discussed.