A sensitive enzyme-linked immunosorbent capture assay with biotin and streptavidin (capture B/SA ELISA) was developed to detect herpes simplex virus (HSV) antigen. Rabbit anti-HSV antibody (immunoglobulin G fraction) was coated on flat-bottom, irradiated, 96-well polystyrene microtiter plates and served to capture HSV antigen. Clinical specimens from patients with genital herpes were added. Biotin-linked rabbit anti-HSV immunoglobulin G was used as the second antibody. The antigen-antibody complex was detected with alkaline phosphatase-conjugated streptavidin, which linked to the biotin. With clinical specimens, the test had a sensitivity of 95.6% and a specificity of 91.4% when compared with the tissue culture method. The presence of HSV antigen in specimens devoid of infectivity was confirmed by blocking the reaction with unlabeled rabbit and human antibody to HSV. The level of antigen detected by the capture B/SA ELISA did not necessarily correlate with the infectivity titer of the specimens. HSV antigens could be detected by the capture B/SA ELISA when the virus infectivity was destroyed at 37 degrees C, by UV irradiation, or by Triton X-100 treatment, but not when hypochlorite treatment was used. Greater sensitivity was obtained when HSV-1- and HSV-2-specific antibody reagents were used simultaneously in each test. The capture B/SA ELISA provides a relatively rapid method (4.5 h) which is quite sensitive and specific when compared with other non-tissue culture, direct assay methods.