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HSV2 Igg tests low positive

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So, recently diagnosed, never had obvious symptoms (except for occasional soreness/rash that I have always explained by just mechanical action :-/ ). My HSV1 Igg is >22, but HSV2 came back at 1.7 and 1.4 (both done within a week). My GF is freaking out obviously and wants me to request Western Blot to be done.


Question: do Igg tests still have cross-reactivity between HSV1/HSV2? Seems like Igm tests were highly susceptible, but what about Igg?

Does it make sense to request the WB? Since its only done in UoW this will be a challenge. How specific is the HSV2 Igg?



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I was just looking at a test result of a patient who had HSV IgG testing and there was a note at the bottom about cross reactivity. I didn't pay much attention, but the mention of it makes me think it's still possible.


If it makes you feel better, I just took this off of quest diagnostics:


The HSV-2 IgG Western blot assay has historically been considered the gold standard for identifying HSV-2 IgG reactivity. However, Ashley-Morrow et al have clearly demonstrated that the HSV-2 IgG Western blot is less sensitive than the HerpeSelect HSV-2 IgG ELISA for detecting IgG seroconversion following newly-acquired HSV-2 infection: the median interval between symptom onset and IgG seroconversion was 21 days for the HerpeSelect ELISA versus 68 days for the Western blot assay.3 There is thus a window of approximately 47 days in which the Western blot assay may give false-negative confirmatory results. In contrast, true-positive specimens in this window are positive (>60% inhibition) in the HSV-2 IgG inhibition assay. In addition to increased sensitivity, the turnaround time for the inhibition assay is shorter than that of the Western blot assay.


Hope that helps.

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I had a low IgG value for HSV2 and a higher value for HSV1, like you. The Western Blot confirmed I do have HSV2. It's expensive, but in my mind, it's worth the hassle to be sure. The six weeks between my initial diagnosis and the Western Blot made me a nervous wreck! At least now I can move forward.

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  • 7 months later...

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