Herpes Simplex Virus (HSV I & II)-IgG

Bacterial/ Viral

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No Fasting Required

Details

Detects IgG antibodies specific to: HSV-1: Commonly causes oral herpes (cold sores), HSV-2: Primarily causes genital herpes

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Herpes Simplex Virus (HSV I & II)-IgG Test Information Guide

Why is it done?
- Test Purpose: Detects IgG antibodies against Herpes Simplex Virus types 1 and 2 to determine past or present HSV infection and immune status
- Primary Indications: Confirmation of past HSV infection; Screening before pregnancy or immunosuppressive therapy; Evaluation of recurrent oral or genital lesions; Assessment of immunity status; Sexual health screening; Investigation of neurological symptoms suggestive of HSV encephalitis
- Typical Timing: Performed weeks to months after suspected infection (when IgG antibodies have developed); During routine health screening; Pre-conception counseling; Immunocompromised patient evaluation; Following initial HSV symptoms to confirm serology status
Normal Range
- Reference Values: Negative/Not Detected: <0.9 IV (Index Value) or <0.75 mIU/mL (varies by laboratory); Borderline/Equivocal: 0.9-1.1 IV; Positive/Detected: >1.1 IV
- Units of Measurement: IV (Index Value) or mIU/mL (milliunits per milliliter); Results typically reported as Negative, Borderline, or Positive with specific numerical values
- Interpretation of Results: Negative: No detectable IgG antibodies; indicates no past or current HSV infection or recent infection before antibody development; Borderline: Indeterminate result; repeat testing recommended in 1-2 weeks; Positive: Detectable IgG antibodies; indicates past or current HSV infection with established immunity
- Clinical Significance: Normal (negative) suggests no prior HSV exposure; Abnormal (positive) confirms previous infection and indicates lifelong immunity but continued risk of reactivation; Does not differentiate HSV-1 from HSV-2 type-specific serology is needed for that purpose
Interpretation
- Negative Result (<0.9 IV): No HSV-specific IgG antibodies detected; Patient has never been infected with HSV-1 or HSV-2; May indicate recent primary infection before seroconversion (typically 7-14 days); Susceptible to future HSV infection
- Borderline Result (0.9-1.1 IV): Equivocal or indeterminate; Early seroconversion phase with antibody levels rising; Non-specific cross-reactivity possible; Recommend repeat testing after 1-2 weeks; Clinical correlation with symptoms essential
- Positive Result (>1.1 IV): HSV-specific IgG antibodies present; Confirms past or current HSV infection; Indicates established immunity; Risk of reactivation exists; Cannot determine timing of infection or distinguish acute from remote infection
- Factors Affecting Results: Timing of test (before seroconversion yields false negative); Immunocompromised status may delay or prevent antibody formation; Cross-reactivity with other viruses; Presence of IgM may indicate acute infection; Previous vaccination or exposure history; Laboratory methodology variations
- Combined Testing Interpretation: HSV-1 and HSV-2 IgG together with IgM determines infection status; Positive IgG + Negative IgM indicates past infection; Positive IgG + Positive IgM suggests acute or recent infection; Type-specific serology differentiates HSV-1 from HSV-2 infections
Associated Organs
- Primary Organ Systems Involved: Integumentary system (skin and mucous membranes); Nervous system (peripheral and central); Reproductive system (genitals); Ophthalmologic system (eyes); Systemic immune response
- Diseases and Conditions Associated with Positive Results: Orolabial herpes (cold sores); Genital herpes; Herpes keratitis; HSV encephalitis; Herpes meningitis; Disseminated HSV; Neonatal herpes; Herpetic whitlow; Eczema herpeticum; Postherpetic neuralgia; Bell's palsy (HSV-1 associated); Immunocompromised-related severe HSV
- Complications and Risks Associated with HSV Infection: Recurrent infections causing chronic pain and psychological distress; Secondary bacterial superinfection of lesions; HSV encephalitis (potentially fatal if untreated); Blindness from keratitis; Neonatal infection causing severe morbidity/mortality; Increased risk of HIV acquisition; Complicating pregnancy and delivery; Severe infections in immunocompromised patients; Chronic pain syndromes
- Related Conditions and Seropositivity Concerns: Approximately 50-90% of population is HSV-1 seropositive; 15-30% is HSV-2 seropositive; Seropositivity does not indicate active infection; Reactivation occurs unpredictably throughout life; Pregnancy complications if primary infection occurs; Screening critical for immunocompromised patients
Follow-up Tests
- Recommended Follow-up Testing Based on Results: If Negative: Repeat test in 1-2 weeks if acute infection suspected; HSV PCR on lesion swab if active symptoms; Counsel on prevention strategies; No further testing if chronically negative
- If Borderline: Repeat HSV IgG testing 1-2 weeks later; Check HSV IgM for recent/acute infection; HSV PCR if symptomatic; Consider alternative diagnoses
- If Positive: Type-specific HSV-1 and HSV-2 IgG serology to differentiate infection type; HSV IgM to assess for recent infection; HSV PCR on lesion swab if active lesions present; Consider neuroimaging if CNS symptoms present; Counseling on transmission prevention
- Further Investigations for Special Populations: Pregnant women: Baseline HSV serology; antiviral prophylaxis decisions; Consider cesarean delivery if primary infection near delivery; Immunocompromised patients: Frequent monitoring; Consider prophylactic antivirals if seropositive; HIV-positive: CD4 count correlation; Enhanced surveillance for reactivation; Patients with CNS symptoms: CSF HSV PCR; Brain MRI; EEG if seizures present
- Complementary and Related Tests: HSV IgM (acute infection marker); HSV PCR (viral detection and load); HSV culture (primarily historical); Varicella-zoster virus serology (similar presentation); VZV PCR; Cytomegalovirus serology; Epstein-Barr virus serology; Other viral serology if differential diagnosis needed
- Monitoring Frequency for Ongoing Conditions: Chronic HSV requires clinical monitoring not serologic monitoring (IgG remains positive); Immunocompromised patients may need periodic CD4 assessment; Pregnant women with seropositivity monitored throughout pregnancy; No routine re-testing of IgG in seropositive patients unless clinically indicated
Fasting Required?
- Fasting Status: No
- Fasting Requirements: Fasting is NOT required for HSV IgG serology testing; Test can be performed at any time of day; Food and drink do not affect test results
- Sample Collection Requirements: Blood serum or plasma sample; Venipuncture performed by trained phlebotomist; Standard tube collection using sterile needle and tube; No special handling required
- Medications: No medications need to be avoided or held prior to testing; Antiviral medications do not interfere with serology results; Continue all regular medications as prescribed
- Other Patient Preparation: Wear loose, comfortable clothing for easy venipuncture; Remain calm and relaxed during blood draw; Inform phlebotomist of previous difficult venipunctures; Hydration is encouraged before testing; No specific restrictions on physical activity; If collecting lesion specimen for HSV PCR, swab actively draining lesions with sterile swab
- Timing Considerations: Allow 7-14 days after symptom onset for IgG to develop (seroconversion period); Testing too early may yield false negative; Repeat testing recommended if high clinical suspicion with initial negative result

How our test process works!