Herpes Simplex Type 2 Exposure
HSV-2 IgG tells you if you've been infected with herpes simplex virus type 2—the classic cause of genital herpes. Like HSV-1, once infected, the virus is lifelong. About 12% of US adults are HSV-2 positive. Many carriers are unaware because they have no symptoms or mild symptoms they don't recognize as herpes.
What is HSV-2 IgG Antibody?
HSV-2 IgG detects past/chronic HSV-2 infection using type-specific glycoprotein G-based assays. Important: low-positive index values (1.1-3.5) have a ~50% false positive rate and need confirmatory testing (e.g., BiokitHSV-2 or Western blot). Seroconversion takes 2-12 weeks.
↑ What High HSV-2 IgG Antibody Means
Positive: you have been infected with HSV-2. Primarily associated with genital herpes. Most transmission occurs from partners who don't know they're infected (asymptomatic shedding). The virus is manageable with antivirals.
Common symptoms:
Many carriers never have recognized outbreaks · Genital: painful vesicles/ulcers, tingling, itching · First outbreak: often more severe (fever, malaise, lymphadenopathy) · Recurrences: typically milder and shorter · Frequency decreases over years
↓ What Low HSV-2 IgG Antibody Means
Negative: no prior HSV-2 infection. Low-positive results (index 1.1-3.5) should be confirmed with a different assay (high false positive rate in low-positive range).
Common symptoms:
Negative: no symptoms
Why It Matters
When normal:
Confirms genital herpes serostatus
Guides counseling and partner notification
Important for pregnancy planning (neonatal herpes risk)
Guides suppressive therapy decisions
Risks if abnormal:
Positive: lifelong genital herpes with periodic reactivation
Asymptomatic shedding: can transmit without visible outbreak
Neonatal herpes risk if active lesions at delivery
Psychological impact of diagnosis requires supportive counseling
What Can Cause Abnormal Levels?
Sexual Transmission
95% likelyHSV-2 is almost exclusively sexually transmitted.
Vertical Transmission
Mother to infant during delivery (neonatal herpes).
What You Can Do
Low-positive result (index 1.1-3.5): confirm with supplemental assay
Impact: ~50% of low-positives are false positives. Don't diagnose on a single low-positive. \u00B7 Timeline: Before counseling
Episodic treatment: valacyclovir 500mg twice daily × 3 days
Impact: Shortens outbreaks when started early \u00B7 Timeline: At outbreak onset
If lifestyle changes aren't enough:
Daily suppressive therapy: valacyclovir 500mg daily
Impact: Reduces outbreaks 70-80%, reduces transmission ~50% \u00B7 Timeline: Ongoing
Use condoms (reduces transmission ~30% additionally)
Impact: Combined with suppressive therapy, substantially reduces transmission \u00B7 Timeline: Ongoing
Recommended retest: One-time serostatus test; confirm low-positives with supplemental assay
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