HERPES TEST MISSES MANY CASES

By Tom Paulson P-I Reporter

Thursday, June 4, 1992

Section: News, Page: B1

The standard approach to testing women for genital herpes misses more cases than it identifies, a University of Washington researcher reported in today's New England Journal of Medicine.

``Many people are infected with genital herpes virus who do not know they are infected," said Dr. Laura Koutsky, an assistant professor of epidemiology at the UW School of Public Health and Community Medicine.

Koutsky said this inadequate testing contributes to the spread of the disease and also indicates a need to improve methods of diagnosis and prevention of genital herpes.

``Overall, standard methods of history-taking and clinical examination identified only 39 percent of the women with genital herpes infection," she said. More than 60 percent of the cases were missed, Koutsky reported.

The study, conducted at Harborview Medical Center's sexually transmitted disease clinic, looked at 779 women who were randomly selected for research upon their visit to the clinic.

Koutsky and her colleagues found that 48 percent of these women were infected with Herpes simplex virus-2 though only 22 percent showed signs of infection. Of the infected, 16 percent had had symptoms in the past while 61 percent of the cases had gone undetected.

Standard testing for genital herpes involves viral cultures. While this was found to be highly effective in women having their first episode of infection, Koutsky said it appeared the tests are ``insensitive" for women with recurring cases.

Of the women tested in the study, 374 had genital herpes. Of those, the standard viral test identified only 39 percent. Blood tests were used to identify the others.

The UW researcher said her team is now looking at blood serum testing at the clinic. Serologic techniques test for antibodies to the virus while cultures attempt to reproduce the virus for identification.

``(HSV-2 serologic testing) hasn't been used widely because it was just recently developed," Koutsky said.

The researchers note that women with unrecognized infections will pass on the virus to their partners. A UW study last year reported that undetected herpes infections in pregnant women put newborns at much higher risk of brain damage.

Koutsky's co-authors for the UW study include Drs. King Holmes, Rhoda Ashley, Nancy Kiviat, Lawrence Corey and Cathy Critchlow, all affiliated with the UW Center for AIDS and STDs (sexually transmitted diseases).

ns/rh

INSIDE SEATTLEPI.COM