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Q. My HSV 1 IgG value is 49. 20. Why is it so high?

Answered by
Dr. Sadaf Mustafa
and medically reviewed by Dr.Nithila A
This is a premium question & answer published on May 05, 2019

Hello doctor,

I took an STD panel test and got a positive result for HSV-1 IgG Ab test. My result was 49.20, but the reference range was 0.91 for negative and anything over 1.09 as positive. Does my 49.20 mean the infection is a very recent one because it is so high? I am confused about why it is so very high. Should it go down over time?

I have also heard that a high IgG could be related to HIV, as I was tested negative for it at day 105 after potential exposure (the last sexual encounter I had was three and a half months ago). Does an HSV IgG antibody test measure for antibodies that are only relevant to HSV, or should I be worried about HIV?

Dr. Sadaf Mustafa

General Medicine Internal Medicine


Welcome to

HSV (herpes simplex virus) IgG (immunoglobulin G) antibodies indicate previous exposure and HSV IgM (immunoglobulin M) indicates current disease. The positive IgG can become significant only if you have active lesions.

The type one usually causes oral lesions which look like small blisters. The HIV testing recommended post exposure is the PCR (polymerase chain reaction) or the fourth generation. Which testing did you get? If the antibodies are negative for three months out it is a good sign. But I would be satisfied if HIV by PCR is obtained. I hope I have answered your questions.

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Thank you doctor,

For HIV testing, I got a fourth generation test. Is it normal for someone who has had a past exposure to HSV-1 to have 49.20 was much higher than the reference range? Does this mean that the infection was there for a long time, or is it recent, or if other medical issues are causing the high number?

Dr. Sadaf Mustafa

General Medicine Internal Medicine


Welcome back to

No, you do not need to have an underlying infection for the HSV titers to go up. It can remain high and positive for years after the initial exposure. You may not even recall having a blister or a disease. The fourth generation HIV test is a good test, and it has both antigen and antibody testing.

Sometimes the HSV-1 can be acquired through sexual interaction, but mostly it is a non-sexual interaction. Like an affectionate mother kissing her child (who has HSV-1) having said that it could still happen. I would not worry much about the titers if you do not have active lesions both genital and oral. The HSV-2 is mostly sexually transmitted. I hope I have answered your questions. Take care

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