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 by PCR (0060041)).

Mnemonic
HSVMCCSF
Methodology

Semi-Quantitative Enzyme-Linked Immunosorbent Assay

Performed

Sun-Sat

Reported

1-2 days

New York DOH Approval Status
Specimens from New York clients will be sent out to a New York DOH approved laboratory, if possible.
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

Specimen types other than CSF. Contaminated, heat-inactivated, or hemolyzed specimens.

Remarks

Indicate source on test request form.

Stability

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

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.

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