Herpes Type 2 Test

Quick Guide

The HSV-2 test (herpes simplex virus type 2 test) is a blood test that detects type-specific IgG antibodies your body makes in response to an HSV-2 infection. It works with or without active symptoms, because it measures your immune response rather than the virus itself. A CLIA-certified (Clinical Laboratory Improvement Amendments) lab processes the results.

Detail	Value
Sample type	Blood
Collection method	In-person blood draw at a lab or clinic
Turnaround time	Typically one to three business days
Fasting required	No
Age requirement	Typically 18+

If you recently had unprotected sex or are concerned about your HSV-2 status, you don’t need to wait to get tested. The CDC’s STI Treatment Guidelines note that type-specific HSV-2 serologic assays are useful in several scenarios, including recurrent or atypical genital symptoms with a negative PCR or culture result, a clinical diagnosis without lab confirmation, and when a patient’s partner has genital herpes. Antibodies can take time to develop, and CDC advises repeat type-specific testing 12 weeks after the presumed time of acquisition when recent HSV-2 infection is suspected. A negative result within that window doesn’t rule out a very recent infection. If you had a confirmed exposure, retest after the window closes.

About the Herpes Type 2 Test (HSV-2)

Purpose of the test

The HSV-2 test detects past or current infection, with or without symptoms. Most people who have HSV-2 don’t know it. The virus spreads through asymptomatic shedding, so you can transmit it even when you feel fine and have no visible sores. Testing is the only reliable way to know your status.

The test helps confirm a diagnosis when symptoms like genital sores or tingling suggest HSV-2. It’s also used when a partner has a known HSV-2 diagnosis or when you want to know your status before a new relationship. HSV-2 is primarily responsible for genital herpes, though herpes simplex virus type 1 (HSV-1) can cause genital herpes through oral sex too.

There’s no cure, but antiviral medications reduce outbreak frequency and lower the chance of passing the virus to partners. Untreated HSV-2 raises susceptibility to HIV, as the CDC’s treatment guidelines note an increased risk for HIV acquisition among HSV-2 seropositive persons who are exposed to HIV. The virus can also be passed to a newborn during delivery, causing neonatal herpes, which is rare but serious.

The blood test detects HSV-2 IgG antibodies. It can’t tell you where the infection is located (oral vs. genital), whether you’re actively shedding the virus, or whether you have HSV-1. When an active sore is present, a swab-based test is preferred.

Providers order it for several reasons:

• Diagnosis: Symptoms like genital sores, tingling, or painful urination suggest HSV-2, or a prior clinical diagnosis was never confirmed by a lab.
• Screening: A partner has HSV-2, you have HIV, or you want to know your status before a new sexual relationship.
• Pregnancy planning: Assessing transmission risk when a partner has genital herpes.

What does the HSV-2 test measure?

One marker from a single blood sample, processed at a CLIA-certified lab.

• Herpes Simplex Virus Type 2 IgG Antibodies (HSV-2 IgG): Detects IgG antibodies your immune system produces in response to an HSV-2 infection.

The test uses an IgG immunoassay, most commonly the HerpeSelect assay or an equivalent. It’s type-specific, meaning it distinguishes HSV-2 from HSV-1. Cross-reactivity between the two can occur at low index values, which is one reason low-positive results sometimes need follow-up.

When an active sore is present, a swab-based method fits better than a blood antibody test. Here’s how the main methods compare:

• IgG immunoassay (HerpeSelect or equivalent): The standard blood test. Detects HSV-2 antibodies with or without symptoms.
• Western blot: The gold-standard confirmatory test. Used when an IgG result falls in the low-positive or equivocal range.
• Swab PCR (polymerase chain reaction): Preferred when an active sore is present. Detects viral DNA directly from lesion material.
• Viral culture: Grows HSV from a swab sample. Less sensitive than PCR but still used in some settings.

The CDC recommends herpes testing for people who have genital symptoms to confirm if they have it. The blood test can’t localize the infection. It detects antibodies in your bloodstream, not the virus at a specific site.

When should I get an HSV-2 test?

Consider testing if any of these apply:

• Genital sores, blisters, tingling, or burning that could be herpes
• A current pregnancy, especially with a partner who has HSV-2
• A desire to confirm status before a new relationship
• A prior STI (sexually transmitted infection) diagnosis or current HIV infection
• A sexual partner recently diagnosed with HSV-2 or genital herpes
• Painful urination or flu-like symptoms after sexual contact
• Unprotected sex with a new or unknown-status partner

For routine screening, the CDC’s herpes testing guidance recommends HSV-2 testing for:

• People with symptoms of genital herpes who’ve never had lab confirmation
• People with a known partner who has HSV-2
• People with HIV, at initial evaluation and as clinically indicated
• Pregnant people with a partner who has genital herpes

The U.S. Preventive Services Task Force recommends against routine serologic screening for genital HSV infection in asymptomatic adolescents and adults, including pregnant persons (D recommendation). The USPSTF found that screening is limited by the low predictive value of the widely available serologic screening tests and the expected high rate of false-positive results that is likely to occur with routine screening of asymptomatic people. A positive result in someone with no symptoms or exposure history is more likely to be wrong than right. If you have symptoms or a known exposure, the test is appropriate. If you don’t, talk with your provider about whether it makes sense for you.

How It Works

How to get tested

You can order the Herpes Type 2 Test (HSV-2) yourself online, with no doctor visit or referral needed. A licensed physician reviews and authorizes your order as part of the process. Most results are ready in one to three business days and appear in your secure online account.

Before the test

No fasting required. Eat and drink normally.

1. The IgG antibody test isn’t affected by food. No dietary restrictions apply.
2. You don’t need to stop any medications.
3. Bring a list of current medications in case your provider needs context.
4. Wear clothing that gives easy access to your arm.

If you were recently exposed to HSV-2, timing affects what a negative result means. Testing sooner is still worthwhile, but a negative result in that window may not reflect a very recent infection. This isn’t a reason to delay. It’s context for reading your result.

During the test

The blood draw takes a few minutes.

1. Check in at the lab and show your ID and order confirmation.
2. A phlebotomist (blood draw specialist) cleans a small area on your inner arm, usually near the elbow.
3. A needle goes in briefly. You’ll feel a pinch or mild pressure.
4. The phlebotomist removes the needle and covers the site with a small bandage.

No urine sample, no swab, no physical exam. The whole visit typically runs 15 to 30 minutes from check-in to leaving.

Minor bruising or soreness at the draw site is normal and clears within a day or two. Call your provider if you notice swelling, warmth, or signs of infection at the site.

After the test

Results are typically ready within one to three business days after the lab receives your sample, though timing can vary by lab. Some labs include a clinical review step before releasing results, which may add a day.

Your results appear in your secure online account.

What Do My Results Mean?

HSV-2 IgG results are reported based on an index value: negative, low-positive, or positive. Each outcome means something different. The low-positive range deserves careful attention before you draw any conclusions.

If your results are negative

No HSV-2 IgG antibodies were detected. For most people, this means no current or past HSV-2 infection.

But timing matters. The CDC does not recommend herpes testing for people without symptoms in most situations, because of the limits of a herpes blood test and the possibility of a wrong test result, with the chances of wrong results being higher for people at low risk of infection. Retest after the window closes if you had a confirmed exposure.

Symptoms despite a negative result? A swab PCR test from an active sore is the right next step. The blood test measures your immune response, so it won’t catch an infection too new to have triggered one. In rare cases, some people with HSV-2 may not produce detectable IgG antibodies. Ongoing symptoms warrant a conversation with your provider.

If your results are low-positive

Your lab report will likely list this result as positive, but with an index value in a gray zone, roughly 1.10 to 3.49 on the HerpeSelect immunoassay. This range has a well-documented high false-positive rate. A low-positive result doesn’t confirm HSV-2 infection.

Don’t assume you have HSV-2 based on this result alone. The recommended next step is a Western blot confirmatory test, which is more specific and can clarify whether the result reflects a true infection or a false positive. If your exposure was recent, retesting after 12 weeks may help too.

Talk with your provider before drawing conclusions. This index range is genuinely uncertain territory, and the Western blot exists precisely to resolve it.

If your results are positive

HSV-2 IgG antibodies were detected. This may indicate a current or past infection.

If your index value was between 1.10 and 6.00, the lab may automatically run a reflex confirmatory test (an HSV-2 IgG inhibition study) on the same sample. Ask your provider whether this was done and what it showed.

HSV-2 is a chronic, lifelong viral infection, as noted in the CDC’s STI treatment guidelines. Antiviral medications, including acyclovir, valacyclovir, and famciclovir, reduce outbreak frequency, shorten episodes, and lower the chance of passing the virus to partners. A positive result doesn’t tell you when you were infected, where the infection is, or whether you’re currently shedding.

Let recent sexual partners know so they can get tested. Your provider can help with disclosure conversations and next steps. If you’re pregnant, contact your OB-GYN promptly. The CDC’s treatment guidelines note that the risk for neonatal HSV is low except when genital herpes is acquired late in pregnancy or if prodrome or lesions are present at delivery.

Sources

1. CDC. Herpes, STI Treatment Guidelines. 2021.
2. CDC. Screening for Genital Herpes. 2024.
3. CDC. About Genital Herpes. 2024.
4. USPSTF. Serologic Screening for Genital Herpes Simplex Virus: Recommendation Statement. 2023.
5. MedlinePlus. Herpes Simplex Virus (HSV) Tests. 2023.
6. CDC. NHANES Data Brief: Prevalence of Herpes Simplex Virus Type 1 and Type 2 in Persons Aged 14 to 49. 2018.
7. NIH National Institute of Allergy and Infectious Diseases. Herpes.

Frequently Asked Questions

• What is the difference between HSV-1 and HSV-2?

  HSV-1 and HSV-2 are two distinct viruses. HSV-1 most often causes oral herpes (cold sores), while HSV-2 most often causes genital herpes. But HSV-1 can spread to the genitals through oral sex, so either virus can cause genital infection. The HSV-2 blood test is type-specific and won’t detect HSV-1.

• If I have HSV-1, can I test positive for HSV-2?

  Type-specific IgG tests are designed to tell the two viruses apart, but cross-reactivity can occur at low index values. This is one reason a low-positive HSV-2 result often warrants a Western blot before a diagnosis is made. A positive result at a high index value is much less likely to reflect HSV-1 cross-reactivity.

• What is the Western blot test for HSV-2, and when is it needed?

  The Western blot is the most accurate confirmatory test for HSV-2. It’s used when a standard IgG immunoassay result falls in the low-positive or equivocal range (roughly 1.10 to 3.49), because the immunoassay has a higher false-positive rate at those levels. The Western blot isn’t a routine first-line test. It’s ordered to confirm or rule out what the immunoassay found.

• Can the HSV-2 blood test tell me where my infection is located?

  No. The blood test detects antibodies in your bloodstream. It can’t tell you whether the infection is oral or genital. A swab-based test is preferred when active symptoms are present, consistent with CDC guidance that recommends herpes testing for people who have genital symptoms to confirm infection.

• I'm pregnant. Should I get tested for HSV-2?

  Yes, if you or your partner have a history of genital herpes or symptoms. HSV-2 can be passed to a newborn during delivery, causing neonatal herpes, which is rare but serious. The CDC’s STI treatment guidelines note that routine HSV-2 serologic screening of pregnant women is not recommended, but that women without known genital herpes should be counseled to abstain from vaginal intercourse during the third trimester with partners known to have or suspected of having genital herpes. Talk with your OB-GYN about testing and management options, including antiviral suppression therapy as your due date approaches.

• Does HSV-2 ever go away?

  No. HSV-2 stays in your body permanently. It cycles between active outbreaks and dormant phases. During dormant phases, the virus can still spread through asymptomatic shedding. According to the CDC’s STI treatment guidelines, episodic and suppressive antiviral therapies are used predominantly to treat recurrences, prevent recurrences, and prevent transmission to sex partners of persons with symptomatic HSV-2 infection.

• Can I have HSV-2 and still test negative on a blood test?

  Yes, in two scenarios. First, antibodies may not have fully developed if you test too soon after exposure, retesting after 12 weeks is advisable if an initial test is negative following a potential exposure. Second, in rare cases, some people with HSV-2 may not produce detectable IgG antibodies. If symptoms persist despite a negative result, a swab-based test is the right next step, in line with CDC guidance recommending herpes testing for people who have genital symptoms.

• Do I need to fast before this test?

  No. You can eat and drink normally before your appointment.

• Will anyone see my results besides me?

  No. Your results go to your secure online account and are not shared with anyone else. You can download or print them to share with your own doctor if you choose.

• Can I use insurance to pay for this test?

  We do not bill insurance directly, which keeps your testing and results private. You can pay with HSA or FSA funds, and we can provide an itemized receipt if you want to request reimbursement.

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