What this test measures
HSV IgG is the immunoglobulin-G antibody against herpes simplex virus. It typically appears 2–6 weeks after primary infection and persists for life. Older combined assays detect total HSV IgG without distinguishing HSV-1 (mostly oral/cold sores) from HSV-2 (mostly genital). Modern type-specific assays use glycoprotein G targets to separately quantify HSV-1 and HSV-2 antibody — much more clinically useful.
A positive IgG indicates lifelong infection with HSV — the virus establishes latency in nerve ganglia and can reactivate periodically.
Why it matters
HSV is extremely common globally — over 60% of adults are HSV-1 positive and 10–20% are HSV-2 positive worldwide. In India, HSV-1 seroprevalence is even higher (>80% in adults). Most infections are asymptomatic or unrecognised.
HSV IgG is used in: (1) pregnancy workup, where maternal seroconversion (especially HSV-2) in the third trimester carries risk of severe neonatal herpes; (2) recurrent oral or genital ulcer evaluation; (3) HIV co-infection assessment (HSV-2 increases HIV acquisition risk); (4) partner counselling in discordant couples. Type-specific testing is strongly preferred over combined HSV IgG for clinical decisions.
How to prepare
No fasting required. Mention pregnancy status, recurrent ulcers, partner status, or HIV status.
Markers & reference ranges
Reference ranges below are typical adult values. Your lab's reported range may differ slightly based on the assay platform and patient demographics — always read your report against the range printed on it.
| Marker | Normal range | If low | If high |
|---|---|---|---|
| Anti-HSV IgG (Combined) (Index / Reactive-Non-reactive)[1][2] | Reactive in past or established HSV infection | Non-reactive — no past HSV exposure. Susceptible to primary infection. Less common in adults. | Reactive — past or established HSV-1 or HSV-2 infection. Combined assay does not distinguish type; type-specific testing is preferred. In pregnancy, prior maternal HSV is generally less risky than primary infection acquired during pregnancy. |
HSV serology — when to use which test
| Scenario | Best test | Why |
|---|---|---|
| Genital ulcer (active) | HSV PCR from lesion | Direct detection |
| Recurrent oral/genital ulcers, no lesion now | Type-specific IgG (HSV-1 & HSV-2) | Distinguishes type |
| Pregnancy screen | Type-specific IgG | Identifies seronegative women at risk |
| Partner discordance counselling | Type-specific IgG | Confirms exposure status |
| Combined HSV IgG | Generic past exposure | Limited clinical utility |
Frequently asked questions
I have a positive HSV IgG. Does that mean I have herpes?
Yes, you have been infected with HSV at some point. Most people have HSV-1 (oral) and never realise. Whether the infection is HSV-1 or HSV-2 needs type-specific testing.
Why is type-specific testing preferred over combined HSV IgG?
Combined IgG cannot distinguish HSV-1 (mostly oral) from HSV-2 (mostly genital, with stronger implications for partners and HIV risk). Type-specific assays use different antigens to separate the two.
How long does HSV IgG stay positive?
For life. Once infected, the virus and antibody persist permanently.
Can I transmit HSV if my IgG is positive but I have no symptoms?
Yes — asymptomatic viral shedding occurs and can transmit the virus to sexual or close contacts even without visible lesions. Antiviral suppressive therapy can reduce shedding.
I am pregnant and HSV IgG is positive. Will my baby be affected?
Pre-pregnancy maternal HSV (with positive IgG before conception) carries low risk of neonatal herpes. Primary HSV acquired in the third trimester is the highest-risk scenario. Discuss with your obstetrician.
How is HSV treated?
Antiviral medications (aciclovir, valaciclovir, famciclovir) shorten outbreaks and reduce frequency with suppressive therapy. There is no cure — the virus remains latent.
Can I get HSV from sharing utensils?
HSV-1 can spread through close contact including kissing and sharing utensils during active oral lesions. Outside active lesions, transmission risk is very low.
Related Infectious Disease tests
Tests commonly ordered alongside HERPES SIMPLEX VIRUS (HSV)-IgG, or that help interpret an unexpected result.
Sources & references
- CDC — Genital Herpes · accessed 2026-05-30T00:00:00.000Z
- NIH MedlinePlus — Herpes Test · accessed 2026-05-30T00:00:00.000Z
- NCBI StatPearls — Herpes Simplex Virus · accessed 2026-05-30T00:00:00.000Z
- IDSA — HSV Guidance · accessed 2026-05-30T00:00:00.000Z
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