Diagnosis of herpes simplex virus encephalitis by the detection of intrathecal viral antigen with chemiluminescence assay.

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The purpose of this research is an establishment of a technique for detecting HSV antigen in cerebrospinal fluid(CSF) by measuring the antigen-antibody complex-activated complement-stimulated chemiluminescence in normal granulocytes. The materials consisted of 17 CSF samples from 10 patients with HSVE (10 from 6 pathologically and/or serologically definite HSVE,7 from 4 serologically probable HSVE), and 26 CSF samples from 22 patients with a non-HSVE,inflammatory disease of the central nervous system, and 30 CSF samples from 30 patients with non-infectious neurological diseases. The chemiluminescence of normal granulocytes was measured in two assays, one including CSF(assay A)and the other including CSF and anti-HSV antibody(assay B). The difference in chemiluminescence was evaluated as the ratio of the two values(B/A ratio)for each sample. The B/A ratios of all CSF samples taken from the 5th to 38th day of HSVE exceeded 1.3, while those for all non-HSVE were lower than 1.0. This assay required only 5 h to yield a result. Cultured HSV was diluted in a control CSF to a concentration of 10^0 to 10^6 infectious units. The chemiluminescence values of the diluted samples were measured in assay B.The relationship between the common logarithm of the infectious units and chemiluminescence values was statistically linear. This method represents a new valuable, especially quantitative and rapid diagnostic tool for intrathecal HSV antigen in HSVE ; it is sensitive, specific and even quantitative.