Effective Wednesday, August 24, 2011, there will be changes to the ordering options for mail-out testing related to diagnosis of herpes viruses.  These changes were prompted by several factors including (a) analysis of test ordering patterns, (b) incorporation of guidelines from CDC and published literature, and (c) changes of some test offerings by reference laboratories.  Test names have been updated to keep a consistent nomenclature to avoid confusion in ordering.

The mail-out test offerings related to herpes viruses will be:

Epic #	New Name	Comments
Testing directed at HSV types 1 and 2
LAB2334	HSV 1&2 IGG NON-TYPE SPECIFIC ABS	• Common screening test for herpes exposure • High sensitivity and specificity for herpes infection. • Will NOT distinguish between herpes type 1 or 2 (positive    result may occur with past infection to either virus)
LAB3373	HSV 1&2 IGM NON-TYPE SPECIFIC ABS	• Limited clinical utility • Poor sensitivity and specificity for herpes infections
LAB3371	HSV 1&2 TYPE SPECIFIC IGG ABS (GLYCOPROTEIN G)	• Differentiates between infection with either HSV 1 or HSV 2    by detection of antibodies against the glycoprotein G    molecules unique to each virus. • May not detect recent infection
Testing directed at HHV-6, HHV-7, and HHV-8
LAB4619	HERPESVIRUS 6 (HHV-6) QUANT BY PCR	• CSF or plasma acceptable
LAB3308	HERPESVIRUS 6 (HHV-6) AB PANEL	• Limited clinical utility
LAB3313	HERPESVIRUS 6 (HHV-6) DNA DETECTION	• Variety of specimen types acceptable (serum,  plasma,    CSF, or amniotic fluid)
LAB3315	HERPESVIRUS 7 (HHV-7) QUANT	• Variety of specimen types acceptable (whole blood,    bone marrow, BAL fluid, CSF, pericardial fluid, pleural    fluid, and tissue)
LAB3316	HERPESVIRUS 8 (HHV-8) PCR	• Variety of specimen types acceptable (whole blood,    bone marrow, BAL fluid, CSF, pericardial fluid, pleural    fluid, and tissue)

As part of these changes, three tests are being eliminated from the Epic test menu:

Epic #	New Name	Alternatives
LAB3369	Herpes simplex virus type 1 and 2 antibodies, IGG & IGM	If testing for IgG and IgM both desired, should order both LAB2334 and LAB3373
LAB3370	Herpes simplex virus type 1 glycoprotein G-specific antibody	Order LAB3371 instead
LAB3372	Herpes simplex virus type 2 glycoprotein	Order LAB3371 instead

Epic order sets will be updated to reflect the changes in tests.

Other herpes-related tests such as "HSV QUALITATIVE PCR" (LAB2467) or "HERPES SIMPLEX VIRUS DFA WITH REFLEX TO CULTURE" (LAB7540) are not affected by these changes.

Questions should be directed to Matthew Krasowski, MD, PhD, medical director of the Clinical Chemistry and Point of Services Laboratories (384-9380, matthew-krasowski@uiowa.edu).