What does HSV 1 greater than 62.2 and HSV 2 in STD panel indicate?

Hello,

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I understand from the reports you have sent me that stating HSV 1 (herpes simplex virus) serology is positive (attachment removed to protect patient identity). I will need a bit more information before I can advise you how to proceed further.

A. Is this HSV 1 IgG or IgM serology?

B. Do you have a history of recurrent oral or genital painful vesicles or ulcers?

C. If yes, how many episodes and how frequently do you have those episodes?

If only the serology of HSV 1 is positive without any clinical symptoms before, you do not require any treatment as it can happen in any past clinical or subclinical herpes infection. HSV 1 serology has no relation with varicella (chicken pox). They are caused by different viruses.

Hello,

Welcome to icliniq.com.

IgG HSV1 only indicates that you had that infection in the past. It might be subclinical that is without any visible ulcers. And it can be without sexual activity also. In any case, you do not need any treatment for this as it can remain positive indefinitely but no active intervention is needed.

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Overall about 50 to 75 % population has seropositivity in different titer to HSV 1. There have been studies regarding the transmission of HSV 2 and very few regarding HSV 1 when there is no active herpes. But in all those studies patients had previous episodes of herpes ulcers or oral herpes. Even in those cases shedding is too infrequent but can be the source of transmission. Treatment is not recommended for the persons who have no history of active herpes infection in the near past only on the basis of seropositivity.

In short, you do not need any treatment for this right now and you are only as much contagious as those 75 percent people who have seropositivity to HSV 1. So my advice is not to worry about it unless you get active herpes breakouts.

Hi,

Welcome back to icliniq.com.

Yes, it is on the higher side only but it can happen as I told you in the case of previous clinical or subclinical (in your case subclinical) herpes infection. IgG once positive can remain positive in varying titers indefinitely.

You definitely do not require treatment for this and it is not recommended according to any international treatment guidelines for herpes treatment. You should just abide by safe sexual practices if you are sexually active. HSV 2 is the most common cause of the genital herpes ulcers, not HSV 1, that is the reason some STD panels might not include it.

HSV 1 is more commonly involved in herpes of oral mucosa and lips. But HSV 1 though less commonly but can be a causative factor in genital herpes as in the case of oro-genital sexual activity. There is no point retesting it as it will again be positive, maybe in different titer. Raised titer does not warrant treatment unless there is a history of any active episodes.