Rapid detection of HSV from cytologic specimens collected into ThinPrep fixative

OBJECTIVE: Herpes simplex virus (HSV) infection is associated with substant ial morbidity and mortality in neonates. A diagnosis of HSV on cervical cyt ologic studies could lead to a cesarean section, with an increase in the ri sk of maternal morbidity. The identification of viral lesions in sexually a ctive women has medical and social implications. There have been reports of false positive diagnoses of HSV in patients with altered endocervical cell s and with cervical intraepithelial neoplasia 3. We evaluated a polymerase chain reaction (PCR)-based assay to detect HSV-1 and HSV-2 in routinely col lected cervical cytology specimens in ThinPrep fixative (Cytyc Corp., Marlb orough, Massachussets, U.S.A.). STUDY DESIGN: DNA was extracted from five cases that demonstrated cytologic changes suggestive of an HSV infection. PCR amplification with subsequent gel electrophoresis was performed to detect the presence of HSV. RESULTS: HSV DNA was detected in three of five cases that were cytologicall y diagnosed as suspicious or strongly suspicious for HSV infection. CONCLUSION: The combination of the ThinPrep liquid-based method for cervica l cytology with PCR allows prompt confirmation of the diagnosis of HSV with out sacrificing the diagnostic morphology on the slide.