How Do You Know When EBV Is Active?
Published 2020-12-03
We will look at how testing can differentiate EBV that is a current active infection, a reactivated or latent infection or dormant past infection. There are different antibodies tests and levels of positivity for each of the tests.
Reference article: www.ncbi.nlm.nih.gov/pmc/articles/PMC3782265/
Epstein-Barr is known also as EBV and is a virus in the human herpes virus family. It is responsible for Mono or Mononucleosis. Mononucleosis occurs when there's an initial acute infection with EBV or the Epstein-Barr virus. You will know you have active Epstein-Barr, if you've been diagnosed with Mono recently. Once a person recovers from this virus it always going to live in your body. This is true of al herpes viruses. These people can go on to get a resurgence of symptoms months or even years later. This is called latent or reactivation of Epstein-Barr virus. When you have a latent or reactivation of Epstein-Barr virus sometimes it is also referred to as active Epstein-Barr Virus. Really it should be referred to as reactivated.
IN addition, some people initially contract Epstein-Barr Virus and they never really get sick with classic Mono symptoms. Some don't have any symptoms. In these cases they were just exposed and their immune system like fought it off. However, even if you were exposed without full-blown Mono or other symptoms, you can still get latent, reactivation, or active Epstein-Barr later on. Like Mono the symptoms associated with active or reactivation of Epstein-Barr Virus are fatigue most common. Since fatigue can have many different causes, it's important to test and see how likely your fatigue is coming from the EBV. So the testing can be a little tricky. With testing though we can distinguish between initial active Epstein-Barr virus that would be commonly associated with Mono, reactivation, or dormant Epstein-Barr. The challenging part of testing is distinguishing a reactivation versus a dormant infection.
so how do You know when EBV is active requires a deeper understanding of antibodies and how your immune system makes these antibodies a virus like EBV. So let's look at some of that. The initial infection is straightforward to detect and look at. However we need a little bit more understanding of how your immune system makes antibodies. When your immune system sees the Epstein-Barr Virus proteins, it is able to recognize that those proteins are foreign and different than self. It starts to make antibodies against them. These initial antibodies are going to be in the IgM category. For EBV these IgM antibodies will fade fairly quickly after the initial infection. As they fade they are replaced by a different type of antibody called IgG antibody.
So you will know if epsilon bar virus is active when you check your blood and you see these antibodies. If you have any of the IgM antibodies then you have an active infection. Some people have IgM antibodies for longer than we would typically expect. Most people will not have the IgM antibodies after about four months or so. However, it can happen.
All Comments (21)
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It is so sad and frustrating that doctors on my insurance plan do not test for reactivated EBV. I needed to go out of network to a specialist to finally figure out what was causing this extreme fatigue and pain. I think that’s criminal - or it should be.
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you feel like death , sneezing, sore throat , runny eyes , nose , sneezing , fatigue , neck pain , sleeping ....all the time . bumps /rash on upper back and back of arms ... for EIGHT MONTHS .my Dr. Told me I needed to see a physchiatrist and gave me a paper with neck exercise s on it. I went and paid for my own EBV test ordered by my nurse practitioner and am on a months supply of Doxy 200 mg a day and feeling SO much better . my numbers were 600plus twice
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Im so frustated at this point in my journey. I saw an ID specialist last July, 2022. I tested positive for EBV but my early antigen is negative. IGM is high, IGG is high the only test that was negative was early antigen. He said there is nothing we can do for you, get rest and it should go away after a couple weeks to a couple months. I have had my PCP test me every 3 months since then and all my labs continue to rise. I still have EBV, I was just tested September 11th and it was higher than July of 2022! He said there is no cure and to forget I even have EBV because there is nothing he can do for me. I have swollen lymphadenopathy throughout my body. All reactive. I'm exhausted and in so much pain. Thank you for this video. It explains that I'm in CAEBV mode.
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My VCA IgG was 744 three years ago, dropped to around 600 and held steady until they ran it again Friday and it jumped back up to 746 U/mL my dr ordered an ultrasound of my spleen and was asking more questions about the pains I’ve been having in my joints which concerns me a bit. The other two (VCA IgM & EBNA-1 IgG are negative, they’ve never shown positive.) I don’t see my doctor again until after I do the ultrasound so I’m stressing about it. Any idea what this could possibly mean?
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Thank you for doing this very informative video. So if you get the EBV IGM, THE EARLY ANTIGEN ab, igG, and ab VCA, IgG, and nuclear antigen Ab, IgG and they are all flagged as High on the test what does this mean? I'm looking at the Ab,VCA IgG and it says 409. and the nuclear antigen Ab, IgG says 512. I think it is a reactivation?
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I’m new to researching this, I got some tests done recently and my Hsv 1 was SUPER high at like 21.70 on the index, then I started feeling these symptoms. Can HSV trigger EBV ?
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It has been 5 months since I was diagnosed with mono. I had fully recovered physically (aside from fatigue), but after some recent blood tests, my VCA IgM was high and VCA IgG was high, but EBNA-1 IgG was still low. I'm very confused on what this means. Would it be a reactivation? Or could it mean I have chronic EBV? It has been scaring me since I saw it
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I’ve had chronic active ebv for 8 years. Do you have any suggestions for how I can fight this off? I got high readings in IGM, IGG & EBNA.. and am so tired I cannot work anymore. Please advise. 😿
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I had a positive antibody test at really high levels showing I previously had Mono in 2021. I haven't felt okay since then having all the symptoms of active Mono. I had a monospot test recently come back negative so they are now shotgunning tests for various things. Can active EBV evade tests?
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Sir i have sore throat continus 2 months but no tonsillitis, can do all patients with mono have tonsillitis ?
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I recently had an ebv test. I diagnosed with mono in 1999. The recent results are ea-d 10.30, vca igm <36.00, NA igg 381.00, and vca igg 399.00 This means past infection correct? Or is it reactivation?
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Feeling bad from 8 months, extreme fatigue and my pulse is fast, before 2 years i had mono. Now i got tested for VCA IgM was negative and EBNA - 1 IGG was positive. Thats mean i dont have reactivation right?
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Idea! After a botched vein surgery for venous insufficiency my leg seizes up at night, left side (higher grade vein issue) it started doing that 3 weeks after surgery before I found out it opened and surgery was not successful. It gives me the heads up by being dehydrated eventhough drinking is maintained. With vitamins kept it away for year then went on keto and it came back. I do load up on electrolyte, magnesium and sea salt. Haaaalp! And yes working on correcting insulin resistance. Thank you!
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I tested for active EBV from April 2021 to October 2022 and now again I’m positive again and have had symptoms both times. I have seen several doctors with no answers why I continue to reactivate. Is it normal to have reactive EBV so much for so long?
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For the PCR test, the sample source MATTERS, whether whole blood or plasma/serum. When whole blood is processed into plasma/serum, cells infected with EBV are removed from the sample, so the results could be negative even though the subject has an active and possibly chronic EBV infection. When EBV DNA is found in plasma/serum - "cell-free DNA/virus" - that's typically an indicator of more serious illnesses; cell destruction, cancer. Two simultaneous PCR tests, one using whole blood and the other using plasma/serum may indicate the nature and degree of EBV-related diseases. Some labs process all samples into plasma/serum before testing, some test whatever they were sent, and some (Labcorp for example) offer sample-specific tests. (Labcorp offers whole blood, serum, and tissue.) And, some labs don't even report which they tested. If my opinion (based upon 21 years of suffering CAEBV) matters, simultaneously test BOTH whole blood and plasma/serum. Some medical articles explain the correlation between viral load and (whole blood/serum) ratio and EBV-related illnesses. In my case, every PCR that used whole blood was positive, in the 1000 to 9999 range, and every PCR that used plasma/serum was negative. Though this is a good thing, it doesn't reflect very nasty illness, it leaves me with doctors in chronic EBV denial and their refusal to diagnose and treat. (Despite EBNA never being positive, and VCA-IgG always being greater than 750, and EA-D often being positive, plus all the chronic myalgia, malaise, and other abnormal labs.)
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So I’m in my 40s and have undifferentiated connective tissue dz and a high rf , high protein in spinal fluid, lots of balls in the air. I had mono like 30 yrs ago. During a shingles outbreak in my 20s this was mentioned. Should I maybe see an immunologist?
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My IGM is negative, but I have tested equivocal twice for early antigen. The first time 9.23 and 6 weeks later 10.8. 10.9 is considered positive. EBNA >600 and IGG 350. I also have 4 strains of bartonella and I can't figure out if my symptoms are from EBV or chronic bartonella infection.
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I’ve had IgM active almost always since 2012. Does that mean it’s always reactivating? I have mental cognitive brain fog and fatigue
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If someone have lymphoma so how can we treat for ebv
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Hello doctor can u plz suggest me i had a vitamin d deficiency 5.10 i had heartburn palpitations gerd during ngt time is tat related to vitamin d plz sir help me
