Q. If IgG is positive and IgM is negative, is the person positive or negative for HSV?

Hi doctor,

If the results of a laboratory blood test for HSV 1 and HSV 2 come back as follows. HSV 1: IgG is 40.3, and IgM is negative. HSV 2: IgG is 3.2, the supplemental reflex test is negative, and IgM is negative. Is this person positive or negative for the virus? Is the low positive for HSV 2 caused by cross-reactivity to the HSV 1 IgG? Is the supplemental reflex HSV 2 test "negative" the same level of "negative" as someone who tested lower (negative) on the first test? So, would this person say they are HSV 1 positive and HSV 2 negative? Kindly give your opinion.

Hi doctor,

Thank you. The patient never had any symptoms or outbreaks of genital herpes (has had cold sores on the lip in the past). The patient does not have any symptoms currently. The patient is under the following medications Adderall, Wellbutrin, A prescription blood thinner (not sure which) and A non-prescription probiotic. The patient has never had any HSV 2 symptoms. However, she had unprotected intercourse and felt discomfort in the genital area, so she went to the gynecologist. He swabbed her vaginal area and found it was bacterial vaginosis. But, the patient had been distressed and paranoid, so she got blood lab work to test for HSV 1 and 2. She was worried about the positive HSV 2 number in the initial test, even though the reflex test shows negative. After doing some research, I found that there are often false positives if the number is under 5.0. So a reflex or supplemental test was done to determine the actual result. Often if HSV 1 is positive due to cross-reactivity. Is she HSV 2 positive or negative? If she has a new sexual partner, does she say that she has tested positive for HSV 2 or negative? Please give your opinion.