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TABLE 2

Maternal Infection Classification by Genital HSV Viral Type and Maternal Serologya

Classification of Maternal InfectionPCR/Culture From Genital LesionMaternal HSV-1 and HSV-2 IgG Antibody Status
Documented first-episode primary infection Positive, either virus Both negative 
Documented first-episode nonprimary infection Positive for HSV-1 Positive for HSV-2 AND negative for HSV-1 
Positive for HSV-2 Positive for HSV-1 AND negative for HSV-2 
Assume first-episode (primary or nonprimary) infection Positive for HSV-1 OR HSV-2 Not available 
Negative OR not availableb Negative for HSV-1 and/or HSV-2 OR not available 
Recurrent infection Positive for HSV-1 Positive for HSV-1 
Positive for HSV-2 Positive for HSV-2 
Classification of Maternal InfectionPCR/Culture From Genital LesionMaternal HSV-1 and HSV-2 IgG Antibody Status
Documented first-episode primary infection Positive, either virus Both negative 
Documented first-episode nonprimary infection Positive for HSV-1 Positive for HSV-2 AND negative for HSV-1 
Positive for HSV-2 Positive for HSV-1 AND negative for HSV-2 
Assume first-episode (primary or nonprimary) infection Positive for HSV-1 OR HSV-2 Not available 
Negative OR not availableb Negative for HSV-1 and/or HSV-2 OR not available 
Recurrent infection Positive for HSV-1 Positive for HSV-1 
Positive for HSV-2 Positive for HSV-2 
a

To be used for women without a clinical history of genital herpes.

b

When a genital lesion is strongly suspicious for HSV, clinical judgment should supersede the virological test results for the conservative purposes of this neonatal management algorithm. Conversely, if in retrospect, the genital lesion was not likely to be caused by HSV and the PCR assay result or culture is negative, departure from the evaluation and management in this conservative algorithm may be warranted.

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