Diagnosis of herpesviruses and approaches to difficult diagnoses

Abstract

Herpesviruses are a ubiquitous family of DNA viruses, with 40–60% of the adult population seropositive for cytomegalovirus (CMV), and more than 90% for Epstein-Barr virus (EBV) and varicella zoster virus (VZV). Following primary infection, herpesviruses become latent in the host and may reactivate during periods of immunosuppression, such as in transplant recipients, HIV-positive patients and pregnant women. The clinical course following reactivation presents a screening and diagnostic challenge, particularly as reactivation in immunosuppressed patients may have a clinical presentation consistent with many different infections. For example, CMV pneumonitis produces disease clinically consistent with other viral pneumonias such as influenza infection. It is, therefore, imperative to obtain as relevant and accurate diagnostic information to correctly diagnose herpesvirus infections.