The HSV-1/2 IgG ELISA is a type-specific antibody test that looks for long-lasting IgG antibodies to herpes simplex virus: HSV-1 (often oral, sometimes genital) and HSV-2 (typically genital). Many modern assays target glycoprotein G (gG1 for HSV-1, gG2 for HSV-2) to improve specificity. Results are usually reported as Positive / Negative (some labs include Equivocal or give an index value). A positive IgG means past exposure and immune memory; it does not prove a current outbreak, identify where on the body infection is located, or indicate when exposure occurred. A negative IgG suggests no detectable prior exposure, but very recent infections can be missed during the window period—antibodies typically appear 2–12 weeks after exposure (some HSV-2 cases take up to 16 weeks). If testing soon after a potential exposure or if symptoms began recently, retest at 6–12 weeks, and consider 16 weeks for HSV-2 to be sure. Low positive index values (e.g., ~1.1–3.5 depending on the kit) can occasionally be false positives; if clinical stakes are high (e.g., pregnancy, discordant couples) consider confirmatory testing with a second, type-specific assay or a reference method. IgM testing is not recommended because it’s prone to false positives and can’t reliably distinguish HSV-1 from HSV-2 or new from old infection. Management is based on symptoms and goals: people with recurrent genital herpes may discuss episodic or suppressive antivirals, and asymptomatic individuals may still consider risk-reduction strategies (condoms/dental dams, avoiding contact during prodrome/outbreaks, disclosure to partners). In pregnancy, coordinate with your clinician early. As with all serology, lab cutoffs are assay-specific; interpret your result using the performing lab’s ranges and the clinical picture.
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