Ordering Recommendation

Not recommended for herpes simplex virus (HSV) testing. IgM lacks adequate predictive value for acute infection. Molecular testing is preferred; refer to Herpes Simplex Virus (HSV-1/HSV-2) Subtype by PCR (2010095).

New York DOH Approval Status

This test is not New York state approved. There are no New York state-approved laboratories available and NYDOH is not accepting Non-permitted Laboratory Requests (NPL). Do not submit sample to ARUP.

Specimen Required

Patient Preparation
Collect

CSF.

Specimen Preparation

Transfer 0.5 mL CSF to an ARUP Standard Transport Tube. (Min: 0.2 mL)

Storage/Transport Temperature

Refrigerated.

Unacceptable Conditions

Contaminated, heat-inactivated, hemolyzed, icteric, or severely lipemic specimens.

Remarks

Indicate source on test request form.

Stability

Ambient: 8 hours; Refrigerated: 2 weeks; Frozen: 1 year

Methodology

Semi-Quantitative Enzyme-Linked Immunosorbent Assay

Performed

Sun-Sat

Reported

1-2 days

Reference Interval

0.89 IV or less Negative - No significant level of detectable HSV IgM antibody.
0.90-1.09 IV Equivocal - Questionable presence of IgM antibodies.  Repeat testing in 10-14 days may be helpful.
1.10 IV or greater Positive - IgM antibody to HSV detected, which may indicate a current or recent infection. However, low levels of IgM antibodies may occasionally persist for more than 12 months post-infection.

Interpretive Data

The detection of antibodies to herpes simplex virus in CSF may indicate central nervous system infection. However, consideration must be given to possible contamination by blood or transfer or serum antibodies across the blood-brain barrier.
Fourfold or greater rise in CSF antibodies to herpes on specimens at least 4 weeks apart are found in 74-94% of patients with herpes encephalitis. Specificity of the test based on a single CSF testing is not established. Presently PCR is the primary means of establishing a diagnosis of herpes encephalitis.
This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.

Compliance Category

Modified FDA

Note

Hotline History

N/A

CPT Codes

86694

Components

Component Test Code* Component Chart Name LOINC
0050408 HSV 1 and/or 2 Antibodies IgM, CSF 63432-9
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.

Aliases

  • HSV
  • HSV antibodies
  • HSV IgM
Herpes Simplex Virus Type 1 and/or 2 Antibodies, IgM by ELISA, CSF