Interpretation of HSV Test Results
Your test results indicate established HSV-1 and HSV-2 infection with no active viral replication at the time of testing. The positive type-specific IgG antibodies (11.20 for HSV-1 and 13.9 for HSV-2) confirm past infection with both viral types, while the negative DNA tests indicate no active outbreak when samples were collected 1, 2.
What These Results Mean
Antibody Test Interpretation
HSV-1 IgG of 11.20: This strongly positive result (well above the typical cutoff of 1.1) confirms established HSV-1 infection 1, 3.
HSV-2 IgG of 13.9: This strongly positive result confirms established HSV-2 infection 1, 3. Index values above 3.0 have significantly better specificity (78.6%) compared to lower positive values 1.
Both values are well above the threshold where false positives are common (1.1-3.0 range), making these results highly reliable 1, 4.
DNA Test Interpretation
HSV-1 and HSV-2 DNA not detected: This indicates no active viral shedding at the time of sample collection 1, 2.
This does NOT mean you are cured or virus-free—HSV remains latent in nerve ganglia and can reactivate 5.
DNA testing is most sensitive during active lesions; negative results between outbreaks are expected 1, 2.
Clinical Management Recommendations
If You Are Currently Asymptomatic
No antiviral treatment is required if you have no symptoms 5. However, counseling and preventive strategies are essential:
Understand that asymptomatic viral shedding occurs, particularly with HSV-2, even without visible lesions 5.
Transmission can occur during asymptomatic periods—most cases are transmitted when no lesions are present 6, 5.
Condom use should be encouraged during all sexual exposures to reduce (but not eliminate) transmission risk 6, 5.
Inform current and future sexual partners about your HSV status 5.
If You Have Frequent Recurrences (≥6 per year)
Daily suppressive therapy is recommended and reduces recurrence frequency by at least 75% 6:
Preferred suppressive regimens 5:
Acyclovir 400 mg orally twice daily, OR
Valacyclovir 500 mg orally once daily (less effective if ≥10 episodes/year), OR
Valacyclovir 1,000 mg orally once daily, OR
Famciclovir 250 mg orally twice daily
Suppressive therapy does not eliminate asymptomatic shedding or transmission risk entirely 6.
After 1 year of continuous suppressive therapy, discontinue to reassess recurrence rate 6.
If You Develop Active Lesions (Recurrent Episodes)
Treatment during recurrent episodes provides limited benefit unless started during prodrome or within 2 days of lesion onset 6:
Episodic treatment regimens 5:
- Acyclovir 400 mg orally three times daily for 5 days, OR
- Acyclovir 800 mg orally twice daily for 5 days, OR
- Valacyclovir 500 mg orally twice daily for 5 days, OR
- Famciclovir 125 mg orally twice daily for 5 days
Special Considerations
For Women of Childbearing Age
Inform obstetric providers about your HSV status if you become pregnant 6, 5.
The risk of neonatal infection is highest with primary infection near delivery (25-44%) but only 1% with recurrent infection 7.
Antiviral prophylaxis from 36 weeks until delivery is recommended if you have had genital herpes during pregnancy 7.
If Immunocompromised (HIV, transplant, chemotherapy)
You may require higher doses and longer treatment courses 5, 6.
Consider acyclovir 400 mg orally 3-5 times daily for suppression 5, 6.
If lesions persist despite treatment, acyclovir resistance should be suspected—consult an infectious disease specialist 5, 8.
Important Caveats
About Antibody Testing Limitations
HSV-1 IgG tests have lower sensitivity (70-88%), meaning some infected individuals may test negative 1, 9, 3.
False-negative antibody results can occur in 10-30% of patients with confirmed recurrent HSV infection 9.
Your high index values make false positivity unlikely, but be aware that 12-30% of patients with proven recurrent HSV can have negative serology 9.
About Transmission Risk
You can transmit HSV even without symptoms or visible lesions 5, 10.
HSV-2 sheds asymptomatically more frequently than HSV-1, especially in the first 12 months after infection 5.
Suppressive antiviral therapy reduces but does not eliminate transmission risk 6, 10.
Monitoring and Follow-up
No routine follow-up testing is needed unless you develop symptoms or have specific concerns 1.
If you develop lesions that don't respond to standard antiviral therapy within 7 days, return for evaluation—this may indicate drug resistance 8.
Abstain from sexual activity when lesions or prodromal symptoms are present 6, 5.