What a Positive HSV-2 IgG Result Means
A positive HSV-2 IgG antibody test indicates you have been infected with herpes simplex virus type 2 at some point in your life, and the virus remains in your body permanently in a latent state. 1
Understanding Your Result
The test confirms past exposure and ongoing latent infection with HSV-2, as IgG antibodies develop within several weeks of infection and persist indefinitely for life. 1
This test cannot tell you when you were infected – it does not distinguish between a recent infection acquired last month versus one acquired years ago. 1
HSV-2 is primarily a genital infection, transmitted through sexual contact, and causes genital herpes with higher rates of symptomatic recurrences compared to HSV-1 genital infections. 1
Critical Caveat: Confirm Low-Positive Results
If your test shows a low-positive index value (between 1.1-3.0), you need confirmatory testing before accepting the result as truly positive. 1
Index values of 1.1-2.9 have only 39.8% specificity, meaning more than half are false positives. 1
Index values ≥3.0 have improved specificity of 78.6%, but still carry significant false-positive risk. 1
For any result with index value <3.0, request confirmation with a second test using a different glycoprotein G antigen (such as the Biokit HSV-2 rapid assay), which improves specificity from 93.2% to 98.7%. 1
False positives are especially common if you have HSV-1 infection, as cross-reactivity can occur. 1
What This Means Clinically
You may experience recurrent genital herpes outbreaks, or you may remain completely asymptomatic while still capable of transmitting the virus to sexual partners. 1
Most HSV-2 infections (80-90%) progress subclinically without obvious symptoms, but can become symptomatic at any time. 2
Even without symptoms, you can shed virus and transmit infection to partners through asymptomatic viral shedding. 3
Recurrences arise with variable frequency – from once every few years to several times per month – and typically last less than 10 days. 2
Management Options
Treatment includes either episodic therapy for outbreaks when they occur, or daily suppressive therapy to reduce both recurrence frequency and transmission risk to partners. 1
The same antiviral medication dosages are used regardless of whether you have symptoms. 1
Suppressive therapy significantly reduces transmission risk to uninfected partners and decreases outbreak frequency. 1
Counseling should address the chronic nature of infection, potential for recurrent episodes, asymptomatic viral shedding, and sexual transmission risk. 3
Important Timing Consideration
If you were potentially exposed to HSV-2 within the past 12 weeks, a negative result could represent the "window period" before antibodies develop, and you should retest after 12 weeks from exposure. 1, 3