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STDs

Understanding blood tests for herpes

herpes-virus-armed-and-dangerous_2There is a lot of misinformation about herpes, both among health providers and the general public. When I lecture at a medical conferences about herpes I hear, “I didn’t know that,” all the time. I know people want more information, because I posted a piece in 2011 on the difference between type 1 and type 2 last year and it has over 48,000 hits and counting.

One big area of misunderstanding is blood testing and herpes infections. Blood testing means looking for antibodies. The immune system produces antibodies in response to an infection, and so the presence of antibodies means that at some point there was an infection somewhere with herpes. Now keep in mind that most people with herpes are unaware they have been infected because most people don’t get recurrent cold sores on their lips or genitals, most people have a silent infection and simply periodically shed the virus.

What you need to know about blood testing before you have it:

1) There is only one reliable and commercially available type of blood test for herpes antibodies called a Type Specific IgG. This test can reliably distinguish between herpes 1 and herpes 2 antibodies. There are labs that will run tests that are not type specific, but these are essentially useless. It is unfortunately not illegal to offer a useless test and some providers just don’t know the difference and may just tick off the first box for “herpes” that they see. The University of Washington (the mecca of herpes research) also offers a Western Blot test for herpes antibodies. This is the gold standard, but only performed at the University of Washington. The American Social Health Association has a great guide to the brand names of the reliable tests. If it’s not one of these tests, don’t get it. You may have to ask your health provider to check, because they might not know.

2) Blood tests take 3-6 months to turn positive after exposure because it takes 3-6 months for your body to make IgG antibodies in response to an infection.

3) There is no blood test that can tell you immediate exposure/recent infection. Some less than scrupulous labs and providers might tell you to get an IgM test. IgM antibodies are produced very soon after an infection. If your provider offers an IgM test, get up and leave because they do not know anything about herpes or testing. IgM tests for herpes are highly unreliable for the diagnosis of herpes virus infections and should never be ordered (the FDA doesn’t prevent companies from offering bad tests, just doesn’t approve them).

4) A positive IgG to herpes does not tell you when you acquired the infection, just that at some point you did. Often people are exposed to the virus but don’t have their first outbreak for months or even years later. A positive herpes IgG test only tells you that at some point in time you acquired the herpes virus (1 or 2 or both depending on your results). Many people pick up herpes 1 as a child. This is innocent exposure from sharing slobbery toys in daycare or kisses from someone who is shedding the virus but has no active cold sore.

5) A positive IgG also doesn’t tell you where you have the virus. This is very important, because 50% of new genital lesions are due to herpes type. Basically, if you test positive for herpes type 1 and negative for 2 that does not mean you don’t have genital herpes. You could be carrying herpes type 1 in the mouth, the genitals, or in both places. Recurrent sores on the mouth are more likely to be type 1 and recurrent sores on the genitals are more likely to be type 2, but that’s more likely not always. If you only test positive for type 2, that could have been an oral infection.

6) How will the test change your behavior? Will it make you be more careful sexually? Well, you should be more careful anyway. Will you only date people who are negative for both herpes 1 and 2? (remember, herpes type 1 can cause genital infections). If that’s the case, will you have a sexually chaste relationship, even abstaining from kissing, for 6 months to be rested to see if you are still negative? What if you are just positive for herpes 1, because that doesn’t rule out genital herpes? If you are positive for herpes 2 and have never had a genital outbreak, it is possible that the herpes 2 you have is an oral infection and not genital.

8) The CDC does NOT recommend routine blood testing for herpes . There is no evidence that testing changes sexual behavior (see above). And the mental gymnastics about how to manage the test results are just too complex (see above).

The best reason for blood testing is when there is a specific question or diagnostic dilemma. Three scenarios might be…

1) A person has a recurrent genital ulcer that seems atypical for herpes. As part of the work up, blood tests for herpes may be ordered and, if negative, repeated in 4-6 months. This is part of a medical work up of a specific problem.

2) A person with known genital herpes who wishes to reduce the risk of transmitting the infection to their sexual partner. Taking antiviral medications can reduce this risk by about 50%. However, if the partner is positive for the same herpes virus, then the medications might not be needed. This scenario is really partner testing.

3) There is also an argument that goes back and forth about testing during pregnancy as a new infection during pregnancy close to delivery can be very dangerous to the baby. This would require weeks of posts to address appropriately, but suffice it to say that The American College of OB/GYN (ACOG) does not recommend routine blood testing for herpes during pregnancy.

Before you decide to get a blood test for herpes, get informed. Herpes blood tests are expensive and can’t tell you when you caught herpes or even if the virus in your mouth or on your genitals. What if you just want to be “Screened for everything?” Herpes blood tests are not screening tests, but tests that should be used to answer a specific problem. If your question is, “Do I have genital herpes,” that answer can’t be answered reliably with a blood test.

Remember, this post is not direct medical advice

Discussion

332 thoughts on “Understanding blood tests for herpes

  1. I got tested for HSV Type 2-Specific Ab, IgG
    My result was <0.91
    Index 0.00-0.90
    Negative 1.09
    They couldn’t tell me anything about my results, only that It’d be wise to retest at a later date. Can anyone help me understand these test results. Am I positive or negative? Do I have it or not? A guy I was previously with has it, and has symptoms and all. He claims he’s either gotten it from me, or his ex of whom he supposedly didn’t hook up with until I was already out of the picture. He’s saying that he’s either gotten it from me or her but it’s been since the beginning of September when we had relations and I have no symptoms at all. I’m worried that he’s had it all along and might’ve passed it on to me.

    Posted by Jane | October 22, 2015, 10:34 am
    • I got tested for HSV Type 2-Specific Ab, IgG
      My result was <0.91
      Index 0.00-0.90
      Negative 1.09
      They couldn’t tell me anything about my results, only that It’d be wise to retest at a later date. Can anyone help me understand these test results. Am I positive or negative? Do I have it or not? A guy I was previously with has it, and has symptoms and all. He claims he’s either gotten it from me, or his ex of whom he supposedly didn’t hook up with until I was already out of the picture. He’s saying that he’s either gotten it from me or her but it’s been since the beginning of September when we had relations and I have no symptoms at all. I’m worried that he’s had it all along and might’ve passed it on to me.

      Posted by Jane | October 22, 2015, 10:37 am
    • Your result is negative I don’t understand why they didn’t tell you negative that’s what the lab says on your report

      Posted by Kristy | October 29, 2015, 4:37 am
  2. Your values are negative are your outbreaks inside vagina or outer lips cause herpes don’t go on outer lips just mucusy areas and yes many things can cause clear blisters was it a cluster or just one

    Posted by Kristy | October 26, 2015, 9:58 am
    • They are on the outer lips. It looked like just one and very small.

      Posted by Jen | October 26, 2015, 11:16 am
      • What about the culture that came back positive? What do i make of this?

        Posted by Jen | October 26, 2015, 11:16 am
      • Everything I have read says you can still have HSV 2 on the outer lips and inside the vagina. Why do you think if my sore is on the outer lips they don’t go on the outer lips?

        Posted by Jen | October 26, 2015, 11:46 am
      • They do not go on outer lip labia majora but yes inner lips and vagina they like mucosy areas and it would most likely be a cluster did they say it was genital herpes

        Posted by Kristy | October 26, 2015, 1:15 pm
      • They dont go on the labia majora where the hair is any gynecologist will tell you that only on labia minora lips and inner vagina

        Posted by Kristy | October 26, 2015, 3:03 pm
      • ok. The sores are on the area where there is hair, not on the labia minora lips or the inner vagina. The dr said I was positive because the HSV 2 culture came back positive. When I had my first outbreak in Aug I had several sores, about 8-10. These too were not on the labia minora or inner vagina. The dr did examine them and couldnt tell if they were clustered. This is when she broke open one and cultured it and you already know what my Igg value came back as. So I am confused and really dont know if I have HSV2 or not.

        Posted by Jen | October 27, 2015, 8:39 am
      • I was always told that no they don’t go on labia majora where hair is I’m a nurse but what was your hsv 2 igg and when you say outbreak what did they look like did they crust over and were they pain ful also I would get a second opinion

        Posted by Kristy | October 27, 2015, 10:19 am
      • My Igg was .24. When I had the outbreak the sores did not crust over, they just went way after about a week and did not hurt. The only discomfort I had was an achy feeling around the area and near the anal area. I had no pain and the irritating feeling of hair growing back after shaving.(maube because the sores were rubbing against my underwear) i shave the entire area including the anal. I thought I had a UTI and a yeast infection which is what I was initially diagnosed with the day before I went to my dr.(went to urgent care) then I find out I am positive for HSV 2.

        Posted by Jen | October 27, 2015, 10:42 am
      • .24 is negative it sounds contact dermatitis and also have u had any more breakouts and also when does it happen around period ….I don’t think u have herpes I would get a second opinion

        Posted by Kristy | October 27, 2015, 12:00 pm
      • You can get HSV on the outer lips of vagina, the same way you can on out
        Lips on the mouth. The virus passss through mucusy areas but does not necessarily recur there. The nerve channels can mean sometimes people get outbreaks on other parts of there face or groin area. It’s sounds like HSV to me, but a second opinion can help.

        Posted by Kelly | October 27, 2015, 12:25 pm
      • Very rare you would get them on labia majora usually labia minora or inside vaginal area …I mean now a days doc look at a blister and say yes herpes with out knowing for sure there have been false positive with culture too I would always get a second opinion for sure especially with an incurable std many have been misdiagnosed which is a horrible feeling I suppose anything is possible but I would go for tests

        Posted by Kristy | October 27, 2015, 7:32 pm
      • I have had three outbreaks. The first was in Aug. the second in Sept and the Third Oct. The Sept and Oct outbreak was one sore each time exactly one week before my menstrual cycle.

        Posted by Jen | October 27, 2015, 1:26 pm
      • When you say sore you mean blister ? And also usually in cluster something doesn’t sound right

        Posted by Kristy | October 27, 2015, 2:03 pm
      • Could it be HSV 1? My husband gets bad cold sores all the time, but I never thought you could get HSV 1 in the genitals from oral play.

        Posted by Jen | October 27, 2015, 1:31 pm
      • Yes you can but most likely only when he has a cold sore also hsv 1 prefers lips cause they lay dormant in a certain nerve I personally don’t think you have hsv 2 regardless of what swab culture says why don’t you get another igg test for hsv 1&2 or western blot

        Posted by Kristy | October 27, 2015, 2:06 pm
      • Yes you can get hsv 1 on genital during oral sex but most often when one has a cold sore out on lip .also they say hsv 1 out breaks don’t occur as much as hsv 2 . did you ever get a second opinion

        Posted by Kristy | October 27, 2015, 7:27 pm
      • I have not gotten a second opinion yet, but will soon. I just find this whole experience odd. I never even had any itching or tingling in the area I had the sores. To answer your earlier question, yes they look like a blister, the fluid is clear, no blistering that I can tell.

        Posted by Jen | October 28, 2015, 5:24 am
      • Did they look like a cold sore I personally would get more tests hsv 1&2 igg also cultures aren’t always accurate there has been misdiagnosed false positive

        Posted by Kristy | October 28, 2015, 9:44 am
      • I mean no clustering that I can tell.

        Posted by Jen | October 28, 2015, 5:27 am
      • Are they tiny fluid filled blisters , if they come back get a second opinion from different doctor ….and have lab work done hsv 1&2 igg …how often do you get these do you have sensitive skin does your partner have hsv 2

        Posted by Kristy | October 28, 2015, 6:39 pm
      • It was just one small blister, no clustering that I could tell. I have had one small blister In Sept and Oct, both exactly one week before my cycle, but I also fully shaved both times too. My husband does not have HSV 2.

        Posted by Jen | October 29, 2015, 7:11 am
      • Yes something sounds strange like I said usually after you contract it u have symptoms 2-14 days after I personally myself go to another doctor when you get another and don’t say anything about what other doctor said and see what they say maybe a folluculitis …just seems strange honestly no pain no other symptoms just a very small blister

        Posted by Kristy | October 29, 2015, 12:02 pm
  3. My western blot said positive antibody for hsv 1&2 interpretation said evidence of past infection with hsv 1&2 never had outbreak and always tested positive for hsv 1 low range and never had cold sore ? The only thing I had was shingles 1 year ago ….this is very frustrating but I read if I you test positive for both could be oral vs genital only diffinitive test is cx of lesions if you have out break anyone else have this problem and they say western blot doesn’t cross react with other herpes family’s

    Posted by Kristy | November 7, 2015, 6:38 am
  4. Dr. Jen,

    Is there a difference between PCR test and IGG test? I have recently had some risky encounters . I’m not showing any symptoms but I would like to know if I have been infected. I heard that it can take up to 6 months for the antibodies to show up in a test but I feel like I don’t have the time to wait that long. Would a PCR test help detect infection earlier?

    Posted by eric | November 7, 2015, 11:02 pm
  5. Hi Dr. Jen,
    My gf got her first cold sore after 38 years. I used to get them but haven’t had one in 8. Her doctors have put the blame squarely on me; that I was shedding and infected her. They are running a test that they claim will determine if her antibodies are old or new. This sounded preposterous to me that they could test for this which led me to your site. Is there any test that can do this? I’d gather if an IgG came back negative that could suggest a recent infection.

    Also, she didn’t get hers where I used to get mine. If I had a silent infection, would kissing her cause an outbreak on a different part of her face?

    Thank you.

    Posted by JF | December 3, 2015, 2:59 pm
  6. Hi Jen, I feel like I’m in a nightmare situation. I am 30 and I suspect I got hsv2/and or 1 from childhood sexual contact obviously not my fault. But the other individual was child also. I have all typical symptoms. Genital lesions and mouth. The nightmare is I have lived with my family my entire life and they’ve had cold sore outbreaks. My brother has really bad skin..appears to be acne all over body. His doctors just give topical creams for acne. However they recently discovered his white blood cell count was low and they’re monitoring. I was in the ER for low hemoblogin and I asked them about STD possibly causing infection related to my cold sores. She said she’d know from the white blood cell count. My white cells came back fine. So my question is: can I determine if I’m fine based on my white cells. And can we determine if my brother may have it based on his severe skin outbreaks and low white cells? Now my sister claims she was actually tested for all stds at a check up and everything came normal and clean. She also gets cold sore outbreaks on mouth and face. In addition she gets bad eye infections claiming she can’t see. They all also experience strange episodes of vomiting …except for me. It just seems like something hits them and attacks their body periodically and they have these vomit attacks. This is my nightmare that they’ve been infected. I can’t get tested now myself for safety reasons because my mom is violent and I still live at home as stated. But do yoy think there’s a connection here. What does my brother white blood test suggest? My sisters negative results and my lower white count? Is it possible this is something other than herpes despite my genital lesions?? I need a miracle…

    Thank you.

    Posted by Alexis Davis | December 10, 2015, 9:50 am
  7. If you passed herpes to other people is it normal for them to vomit. Also if you have had herpes for about 20 years…but never got a herpes test…could you also suspect it’s herpes from a low white blood cell count. If you have other symptoms such as cold sores in mouth and genitals…and coupled with a low white cell count…could that be herpes? And finally, there’s something seriously wrong with your peers. It seems as though they’re in denial about it and are afraid to test for it…it’s almost unethical. I told a doctor every symptoms and she negated everything I said and told me to see a psychiatrist for depression. She tested me for syphillis which was negative but she talks me out of hsv tests. What is going on??

    Posted by sarah | December 13, 2015, 4:10 am
    • Wbc having no relation to hsv 2 were your sores cultured and also have you ever had blood work and it showed positive hsv 2 although they say hsv 2 is genital you can also have it somewhere else

      Posted by Kristy | December 13, 2015, 8:37 am
  8. Ok so question. I just got my results back HSV 1 was 50.70H and HSV 2 was 14.20H. What exactly do these results mean?

    Posted by Shemeka H | December 21, 2015, 9:34 am
    • Did you ever have outbreak ? Did they tell you had herpes genitals not necessarily does hsv 2 always mean genital

      Posted by Kristy | December 22, 2015, 10:23 am
      • No I have never had an outbreak at all. I looked back at my past HSV test and they were negative. Now I did notice that this time it was HSV 1/2 IGG and the last time it was HSV 1/2 PCR… I’m not sure of the difference. The MA called and was just like doc wants to just make sure you are aware. So at this point I don’t really understand what this means.

        Posted by Shemeka H | December 22, 2015, 1:16 pm
      • She was probably thinking the medical assistant that you knew that you had hsv 2 and its amazing cause some people will say hsv 2 is always genital but not true and why did you have test done any way …I am a nurse myself and also why did you have previous pcr test ?

        Posted by Kristy | December 22, 2015, 7:17 pm
      • I only got them done because they were part of my well women visit. It’s included in the STD testing.

        Posted by Shemeka H | December 22, 2015, 7:21 pm
  9. Have you ever had cold sores on your mouth I know its frustrating hearing oh well you have hsv 2 and they want to jump automatically to genital herpes have you talked to your doctor about this .then they say you can have no symptoms and still spread virus through asymptomatic shedding but mostly you spread it through break outs …CDC doesn’t even recommend hsv testing …so did your doctor say its genital

    Posted by Kristy | December 22, 2015, 9:15 pm
  10. I am a follower of your blog. I know you have very lucidly answered or commented on blood testing for Herpes. My very close friend has gone through some traumatic times recently. She was tested negative for IgG but +be with IgM at 6.11. I am not sure where she got it as she feels that her husband is monogamous. Embarrassed to ask. She did suffer from small pox few years back. Question is IgM antibodies are created for all kinds of disease or this is herpes specific. Your answer is appreciated. Seasons greetings and merry Christmas.

    Posted by Manhar desai | December 24, 2015, 5:12 pm
  11. I was tested for herpes by culture and blood, the blood came back negative and culture positive can this be wrong? ? I want to DIE PLEASE HELP ME UNDERSTAND? ? I was only with one person and I am freaking out.

    Posted by Tiffany | January 3, 2016, 1:39 pm
  12. Cultures aren’t always accurate , did you have an outbreak …many things can resemble herpes . I would get a 2nd opinion why did you get a culture to begin with ?

    Posted by Kristy | January 3, 2016, 7:21 pm
  13. Hello Dr. Jen,

    I am a 26 year old male and as long as I can remember, I have always had mild canker sores, usually on the inside of my lips or gums. Probably something associated with common HSV 1. I have never shown signs of genital herpes or out breaks other than the canker sores my whole life. Recently a partner of mine showed signs of what may be genital herpes about 5 months into our relationship. We do have mostly unprotected sex and perform oral on a normal basis. My previous partner has showed no similar signs ( she was my partner for over 2 years). The symptoms for her have just shown up as of late. I had never been tested prior for HSV so I did a few days ago. The results were quick and as follows:

    HSV 1 IgG , type spec – Result: 40.70 / Flag: High – on an index Negative (1.09).

    HSV 2 IgG, type spec -Result: <0.91 / Flag: NA – on an index Negative (1.09).

    I wanted so insight on what these results may mean for me personally and my relationship with my partner?

    Thank you.

    Posted by Bradley | January 29, 2016, 7:08 pm
  14. My obgym just told me I have type 2 thru a blood test I’m 14 weeks pregnant could it be a false positive??

    Posted by Lexismommy | February 4, 2016, 1:09 pm
  15. What if I took blood tests 5 months ago and they testes me positive for herpes and I still didn’t het any sighs of it that came back it doesn’t make sense I don’t even get cold sores.

    Posted by raldo | February 8, 2016, 10:48 pm
  16. Hi Dr. Jen

    Just to confirm, it takes at least 3 – 6 months for the body to create antibodies for hsv2? Thanks.

    Posted by J.k. | February 14, 2016, 2:31 pm
  17. Cold sores are recurrent. My kids mother, son and daughter have them 3 to 4 times a year. Hvs-1 So you are wrong about that.

    Posted by Scott | February 14, 2016, 5:01 pm
  18. About 5 years ago I had a positive culture for hsv2. Last year, I broke up with my partner and I went for an std check after learning he had cheated. Anyway, I forgot to tell my nurse that I didn’t need checked for hsv2 because I already had it. Well my blood tests came back, and my doctor told me I was fine and I was negative for stds. I told him no im not of course because I had been tested positive for hsv2. So he looked up my records and realized that I was right. He said there were no antibodies found in my blood. Not for hsv1 or hsv2. I asked him what that meant and he didn’t know. My nurse told me I was lucky because it meant I didn’t have it bad enough for my body to fight it off. I have looked everywhere online and I cannot find another story like mine. Even my doctor is confused. Do you know what could cause this? Or what it means?

    Posted by stillmeee | February 17, 2016, 5:48 pm
  19. My partner is Igg positive for HSV 1 & 2 (2/29/16). I tested Igg negative for HSV 1 & 2, but my culture was positive for HSV 1 (2/1/16). Am I correct in thinking that my Igg HSV 1 test should soon be positive? Can I clearly say that I did not have the disease prior to this outbreak? Further, is it possible to determine whether I contracted the disease from him or vice versa? My husband is presuming I have contracted the disease and given it to him.

    Posted by KFB | March 2, 2016, 10:47 am
  20. I am a healthcare professional and I feel that your statement about if a provider offers you an IgM test, you should get up and leave because they don’t know what they are talking about is harsh. I am sure that in your clinical experience as a physician, you have learned new aspects of medicine that you may not have known before but that does not make you incompetent or a bad physician. Medicine is always evolving and changing. It is impossible to know everything.

    Posted by F | March 12, 2016, 4:16 pm
  21. I was tested positive for type 1 and 2 within 2 days of blood drawn. Is there a chance that it was false positive? Should I repeat the test to make sure?

    Posted by Anna | March 24, 2016, 5:47 pm
  22. Why did you get tested were you having symptoms?

    Posted by Kristy | March 24, 2016, 7:43 pm
  23. Dr. Jen If I got tested and my swab was negative and then got a blood test for a igg and a igm antibody and they are saying that it is positive.. does this mean I am positive or should I get a different test done?? I’m super confused..

    Posted by Stef | March 27, 2016, 5:25 pm
  24. HSV 1 IGG Type specific AB out of range >5.00 H.. What does that mean?
    The Dr. said it only indicates a past history of fever blisters/ cold sores, and not generally considered sexually transmitted.

    What does all this mean?

    Posted by John Smith | March 29, 2016, 10:29 am
  25. 10 years ago, I tested positive for genital HSV, but didn’t know which kind. I just got the blood test to see if it’s HSV1 or HSV2 and neither came up as positive. Did I get a false positive or heal, or did I get a false negative blood test after over 10 years of infection?

    Posted by curious | March 30, 2016, 11:01 am
  26. Hi sir, I am 28 male from India. Suffering from legs pain and genital pain rectum pressure when prolonged sitting or standing and burning frequent urine. My hsv 1&2 igg is positive. And igm is negative for both. So I am confused between igm and igg. Igg positive mean I have hsv ? Please help

    Posted by Amit kumar | April 1, 2016, 2:40 am
    • Even I had same problem I tested for igg which came positive with 1.31 value again I retested after two days which came to 0.82 .now I am confused whether I have virus or not

      Posted by xxxx | April 4, 2016, 10:32 pm
  27. Hello,

    You say it is possible type1 occurs at the genitals and type 2 in the mouth.
    1. Does the same apply for herpes zoster? It is often on the skin, can it occur in the mouth or genitals too?

    2. When somebody gives you type1, and that guy/girl has it on the genitals. But type1 is often in mouth, then, do you have a higher risk to get it on the genitals too?

    3. assume you have type1 but it exposes itself somewhere else than the mouth. Is it possible the virus transforms to another type? If your “type1” is exposed at the genitals, is it possible the type1 is transforming itself to type2? Or are they competely different virusses?

    Regards,

    Posted by jornvl90 | April 11, 2016, 11:59 am
  28. Hi my name is Krista I ve been diagnosed with herpes ever since 10-26-2015 .I am only 18 and don’t know will there ever be a cure for herpes or is there this ain’t fair that bcuz my ex cheated on me by Rapin underage girls that I have suffer with herpes I have type 2 genital herpes to be exact

    Posted by Krista | April 16, 2016, 9:07 am
  29. I was diagnosed over 5 years ago and have never gotten a breakout in any area on my body….does this mrani need a 3rd opinion?

    Posted by Tabrice Brewer | April 20, 2016, 8:05 am
  30. Why did u have the test to begin with and they say just cause your positive for hsv 2 type doesn’t always mean genitals

    Posted by Kristy | April 20, 2016, 8:34 pm
  31. I hope this post, if you can please take a sec to answer this I would appreciate it very much. I have always had a chaffing rash on my leg for yrs that has been almost impossible to get rid of. 2014. I got a sore from a YMCA pool. I went swimming and a brown spot around my knee turned neon green. I scratched it and the brown spot went away but it became a sore, that itched and spread…Please not in 1984 after a accident that almost killed me I was given a lot of blood. I lived but they gave me hep c. I found out in 92. I was mortified. By 2014 I was dying literally, this was prior to the final treatment out. So..at this point in 2014, I have Hep C a rash on the inner leg and 4 spots of a different rash on my left leg…and I am dying. A Doctor..bless his soul, ran every test known o man and put me in Ribbovirin, Savaldi AND Interferon, He saved my life but I was left with Stage 4 cirrhosis. My immune System is in the dirt, 2015 I was in the ER 10 times getting IV antibiotics, steroids and Rosephin for a cold…….there is a reason I am saying this, my internal med Dr who is separate from the liver is the one I have talked to about this rash. 2 Dermatologists haven’t a clue what it is and gave me laundry soap with out dyes.. Last week after being sent to a Cancer Center for Hemocromotosis, After I was diagnosed with Anemia with an iron level of 1000 . I received a call from the IM Dr saying..you have herpes.. I almost passed out, crying hysterically I had to go to the Office pick up a script and a HIV test result. Please note I haven’t had sex since May 16, 1989. I was then called in a 850.00 tube of an ointment for my herpes but I didn’t have HIV all of this after being put on 200k in drugs for the Hep C. I have been put threw hell and you are saying this test doesn’t mean anything??? Do you have any idea how many STD tst I have had since 1992?? I feel so used, mistreated and horribly misdiagnosed. I cant tell you how damaging it is to tell a person they have something and they don’t..how how many people on this post alone are frantic over the possibility of having herpes only to find out it almost looks like you are saying most people could have it but really if they could of gotten it after slobbering as a toddler how can it be called a sexually transmitted disease. Could the fact that a lot of money is being made off of the “thought” of a person having a “Disease”. his is sickening to think the people who took an oath to help their patients are only concerned about how much money they can made off their patients. Very sad

    Posted by Very Sad | May 9, 2016, 10:02 pm
  32. Everything else I have read says igG antibodies will be present within 6 weeks of initial exposure… What is your source for it taking 3-6 months for antibodies to be reliably tested

    Posted by G | May 31, 2016, 6:01 pm
  33. I too am very confused. I tested positive for HSV 2 from a culture take from a lesion but the IGG test was negative. Shouldn’t I have antibodies in my blood if I have the virus. If I take another IGG test in 3 months and it still negative is it possible the culture was a false positive?

    Posted by Katie | June 8, 2016, 10:06 am
  34. I just got the hsv igg test done I tested positive for hsv 1 and 2 I have so much questions but still no answers I have never had a out brake and no one that I have been with have never had one I know that as a child I had cold sores but nuh since I have been on adult. Can I still test positive for hsv 2 if I have only been exposed to hsv 1

    Posted by Krissy | June 22, 2016, 3:29 pm
  35. Ok…so I have been dating this beautiful lady for 4 weeks now…and we have been really close to being intimate with each other…she asked me if I would mind going to be tested to all std’s….I said yes…not a problem…just got my results back…and if I’m reading this correct I’m positive for both strands…I do have cold sores/ fever blisters…so I expected that to be positive. ..we have already talked about that…not a problem. ..but when the 2 strand came back positive I was floored. ..I have never had any kind of blisters or sores on or near my penis….even being 50 yrs old…I’ve never been one to go from woman to woman…so stressed about this…I have a feeling that this will be a straw to break the camels back…unfortunately. ..I have already developed feeling and so has she…I’m planning on handing her the results and being total honest. ..any help would be greatly appreciated

    Posted by Eddie Ragsdale | June 24, 2016, 6:20 pm
  36. if you test positive via a blood test for the antibody but the pap smear proves negative, do you still have the herpes virus and can you pass it to a partner?

    Posted by Deborah Chau | July 5, 2016, 8:54 am
    • You cannot diagnose herpes by Pap

      Posted by Dr. Jen Gunter | July 5, 2016, 10:10 am
      • so is having the anti body a definite proof that you have herpes virus? and can you pass it to your partner?

        Posted by Deborah Chau | July 5, 2016, 10:41 am
    • Docs say that they diagnosed via outbreak also have been told that alot of people test positive for antibodies but just cause you test positive for hsv2 doesn’t always mean genital

      Posted by Kristy | July 5, 2016, 12:55 pm
      • thank you so much for all your information

        Posted by Deborah Chau | July 5, 2016, 1:24 pm
      • Why did u have blood work done in the first place or did you have an actual outbreak ….I hope for everyone’s sake there’s a cure soon

        Posted by Kristy | July 5, 2016, 7:24 pm
      • because a man my friend slept with said she burned him so she went to the doctor to have all tests run in case he gave her something.

        Posted by Deborah Chau | July 5, 2016, 8:19 pm
      • Did she get her results back yet ? Cdc doesn’t even recommend hsv testing

        Posted by Kristy | July 5, 2016, 8:26 pm
      • she did and they said she had type 2 but no outbreaks

        Posted by Deborah Chau | July 5, 2016, 8:32 pm
      • What was her index value was it high

        Posted by Kristy | July 5, 2016, 8:34 pm
      • they never told her an index

        Posted by Deborah Chau | July 6, 2016, 5:29 am
      • Well even though she had blood test and was positive that alone isnt enough to say you have genital herpes

        Posted by Kristy | July 6, 2016, 7:12 am
      • that’s what I told her, so she feels a little better about it but will be very careful

        Posted by Deborah Chau | July 6, 2016, 7:15 am
      • Did her doctor also tell her that I mean the only real way is to diagnose with a culture then do hsv testing to determine the type …was.this the first time being tested she could have these antibodies for a long time …

        Posted by Kristy | July 6, 2016, 8:57 pm
      • yes she is aware that she could have had the antibody for a long time with out knowing

        Posted by Deborah Chau | July 7, 2016, 7:41 pm
      • Did doc say you have genital herpes

        Posted by Kristy | July 7, 2016, 8:27 pm
  37. she had no signs of any issue but needed to find out for sure

    Posted by Deborah Chau | July 5, 2016, 8:20 pm
  38. What happens when a person test positive for herpes on one test but then negative in another test what does this mean?

    Posted by Jessica | July 17, 2016, 12:08 am
  39. Hi. I went to the doctor to get tested for herpes, my tests came back negative, which is to be expected I suppose as it is only 9 weeks post exposure and tests take up to 3-6 months to turn positive. Though my tests came back navigate my index value was higher than normal, 1.02. ( . 1.09= positive) I’m very aware that this number could be raised if it’s an early infection, but my question is, what else would cause that number to raise? If I am actually negative for herpes.

    Posted by Concerned Lover | July 21, 2016, 1:58 pm
  40. Dear Dr. Gunter,

    I hope you are having a great day. I got tested over a year ago with the IGG and it was negative. I have not had sex or kissed anyone in over a year. I just got tested and my IGG is still negative but my IGM is positive??? This is the first time I got the IGM. To me this does not make sense??? My IGM was 1.33. I had a bit of a cold/flu when I took it as well. Can you get HSV from a sauna or hot tub? I was at hot springs the week before?? Should I just not pay attention to the results? I am very scared and confused because I have had no sexual contact of any kind and have had no lesions ever. The midwife that called said the IGM showed that I had a current infection.

    Thanks Kindly,

    Posted by jepson | August 2, 2016, 6:33 pm
  41. I want to emphasize that the difference between type 1 and type 2 are increasingly unclear and should be understood, but not used to draw dramatic distinctions between them that in truth, do not exist. Both types are a hassle, both can have serious health effects in particular circumstances, and neither type warrants ending a relationship or ruling out having a relationship with someone. Type 2 recurs more often genitally than type 1 (60-90%, compared to 25%, http://jcm.asm.org/content/39/9/3321.ull). But 25% is a lot, and it could be higher for type 1 because it has been studied so much less than type 2. Type 1 carries similar risk as type 2 in terms of dangers of perinatal transmission. Type 1 sheds asymptomatically orally with a high frequency in sufficient amount for transmission (http://www.ncbi.nlm.nih.gov/m/pubmed/17703961/?i=6&from=/11154417/related). Type 1 carries a greater risk for ocular herpes which can be serious even in adults. Accordingly, the medical community is increasingly concerned about a projected type 1 genital epidemic, http://m.jid.oxfordjournals.org/content/209/3/325.long?view=long&pmid=24136792#ref-13.

    We all need to stop blaming the other type as somehow worse than our own type, and accept that we have been living with herpes as a parasite on out nervous system since we were chimps. And pray the vaccine comes out soon (http://acsh.org/news/2016/03/10/a-vaccine-for-herpes-erupts-in-the-news/ Maybe type 2 carriers are more lucky because we are closer to having a vaccine for 2 than 1!). Take medication if you or your partner has bothersome symptoms, and AVOID CASUAL SEX. Herpes is one big reason to limit the # of sexual partners in a lifetime and not have sex unless you are serious about someone. Condoms do not protect fully against herpes and no one uses them for kissing or oral sex.

    Finally, anyone receiving a low positive for type 2 by ELISA (index up to around 5.0) should get confirmation via western blot. The commonly used ELISA has been improved but still suffers from too many false positives. You have to send your sample to University of Washington for the western blot, by your doctor should be willing to order it. See http://depts.washington.edu/rspvirus/documents/hsv_western_blot.pdf

    Posted by Andrew | August 5, 2016, 7:23 am
  42. Hello,
    Today I received my test results back for my HSV 1-2 IGG for my (1) my result was 4.99 and (2) my result was 4.97 dies this mean I’m positve for herpes. I’ve never had any type of break out and 1 week after this blood work I had a pep smear done. I receives those results and my cultures came back negative for all including HPV….Wouldn’t something have shown up before with my previous peps far as any warts. I’ve never had any type of cold sore or warts appear and I’m clueless to this results
    Because according to the guidelines. 0.90 is negative, 0.09-1.10 Equivocal and > 1.10 Positive so I’m thinking 1.10 and above is definitely positve and I’m scared.

    Posted by Kay | August 22, 2016, 11:55 am
  43. So now I’m confused. I was tested for both HSV-1 and 2 in Sept of last year because I was pregnant. HSV-1 came back positive with no symptoms my entire life. HSV-2 was negative. My husband and I have been married 2 years. I am again pregnant and this year the test came back negative with absolutely no markers at all. How is that even possible?? If his ex had HSV-2 does that mean he’s infected even with no symptoms or positive tests?

    Posted by jennifer | August 27, 2016, 10:23 am
  44. Hello,
    Thank you for your informative post.
    My three month old son was recently exposed to hsv1 (kiss on the cheeks from someone with active ulcer on lips). I am terrified about the dangers of CNS infection. He is asymptotic at the moment. Would you recommend any antibodies check or wait for the 14 week window and check for IGG?
    Thank you in advance

    Posted by Eleni | November 7, 2016, 9:48 am
  45. I’ve had HSV since 1978. Before starting a sexual relationship with my current man, I informed him of this. He said his previous gf of three years also had it. But chose to have unprotected sex as he had done with her for years earlier.

    Then he says he’s having tingling symptoms and goes and gets tests. Now, I am concerned I’ll be blamed for this if it comes out positive, but couldn’t he already have it from being exposed before?

    Posted by Stella | November 7, 2016, 4:09 pm
  46. Hi, I just went to the doctor to get my blood test results and she explained to me that it shows that my body recognizes herpes but I kept asking her if I have it and she was going around the bushes on me. So my question to you is exactly that. Does that mean I do have it or not? please help me

    Posted by vanessa | December 12, 2016, 6:55 pm
  47. Informative …. Just one question that I can’t see an answer for. The window period is 3-6 months …. Is that after intercourse or from first outbreak if that occurred… I.e when do the antibodies start getting produced ? Do the body fight infection instantly or only when it becomes non-dormant ?

    Thanks

    Posted by Steve | December 15, 2016, 5:41 am
  48. My girlfriend had some odd bumps on her vagina and had a blood test which came back “Dubious” I’ve never heard of a test result like that . We live in Belgium and i went for a blood test also, my doctor said i have hsv anti bodies. I asked how many and he replied 4125. i asked if that was high and he replied yes very. Normal is 250

    I’ve done some research and nobody seems to have results like we have (I’ve tried scanning Google for results similar). WTH??

    none of our tests were type specific IgG

    Am i going crazy here or does it seem that the tests here are ridiculous and we should get re-tested??

    Posted by howusewordpress | January 14, 2017, 1:05 pm

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