Epstein Barr Virus

Do you have a fever, a sore throat, enlarged lymph nodes, and fatigue? 

The mononucleosis tests look for antibodies that indicate mono, usually caused by the Epstein-Barr virus (EBV). Order your EBV blood test from Ulta Lab Test and know if you are carrying the Epstein-Barr virus.

You could be infected with the Epstein-Barr Virus (EBV). Mononucleosis is caused by the Epstein-Barr Virus (EBV). Extreme fatigue, loss of appetite, weight loss, and other flu-like symptoms are signs of this virus. Symptoms usually develop four to six weeks after exposure to EBV; however, it might take up to three months or more for some persons. Although the virus remains in your body for the rest of your life, it does not usually create difficulties. In reality, most persons who have been infected with EBV are unaware of their infection since they have never experienced mono or any other EBV-related health problems. However, if you develop mono symptoms after being exposed to EBV, you should get tested for the virus because it can cause significant health concerns if left untreated. 
If you suspect you've been infected with EBV, we recommend being tested as soon as possible to see if your symptoms are due to the virus and to prevent potential complications in the future. 

If you want to learn more about Epstein-Barr Virus (EBV) and the lab tests that can help you, click on the title of the articles below.

You can order affordable mononucleosis tests and EBV lab tests online 24 hours a day, 7 days a week with Ulta Lab Tests, and we'll provide the doctor's authorization. We have a lab near you, with over 2100 locations around the country. Most tests processed by Quest Diagnostics get results in 24 to 48 hours, and our customer service is always courteous, friendly, and helpful.  

Take control of your health by ordering Epstein-Barr Virus (EBV) blood tests from the list below.


Name Matches

For the most comprehensive look at your biomarkers for Epstein-Barr (EBV), we recommend the Epstein-Barr (EBV) Comprehensive Panel, as only one may come out positive:

  • EBV-VCA IgG/IgM (viral capsid antigen): A positive IgG means you’ve had or currently have the infection; A positive IgM means the virus has been reactivated.
  • EBV-EBNA IgG (nuclear antigen): A positive test result is usually associated with past infections.
  • EBV-EA-D IgG (early antigen): A positive EA IgG may mean you have an active or reactivated infection.
  • The Epstein-Barr EBV Early Antigen D Ab IgG test that will let one know if the virus is actively replicating.

Epstein-Barr (EBV) is a virus that causes mononucleosis, also known as the kissing disease, is a viral infection that is thought to be transmitted through the saliva of those who are infected. The Epstein-Barr virus creates an inactive infection in the body where it lies dormant. It can awaken and reactivate itself, even many years after its initial activation.

The reactivated virus has the potential to induce many debilitating autoimmune symptoms. In some, the infection may not be adequately suppressed and may cause or exacerbate autoimmune diseases. 

The Epstein-Barr (EBV) tests are used to figure out if a person has a reactivated infection. 

Reference Range(s)

Epstein-Barr Virus VCA Antibody (IgM)

U/mLInterpretation

  • <36.00 Negative
  • 36.00-43.99 Equivocal
  • >43.99 Positive

Epstein-Barr Virus VCA Antibody (IgG)

U/mLInterpretation

  • <18.00 Negative
  • 18.00-21.99 Equivocal
  • >21.99 Positive


Epstein-Barr Virus Nuclear Antigen (EBNA) Antibody (IgG)

U/mLInterpretation

  • <18.00 Negative
  • 18.00-21.99 Equivocal
  • >21.99 Positive

Epstein-Barr Virus Early Antigen D Antibody (IgG)

U/mLInterpretation

  • <9.00 Negative
  • 9.00-10.99 Equivocal
  • >10.99 Positive

Epstein-Barr Viral Capsid Antigen (VCA) Antibody (IgA)

Clinical Significance

Epstein-Barr Viral Capsid Antigen (VCA) Antibody (IgA) - VCA IgA titers ≥1:80 are suggestive of chronic or reactivated EBV infection, whereas titer of 1:10, 1:20, or 1:40 typically indicate past infection.

 

Reference Range(s)

<1:10
Interpretive Criteria

  • <1:10Antibody not detected
  • 1:10-1:40Past infection
  • ≥1:80Chronic/Reactivated infection

Epstein-Barr Virus (EBV) Antibody Panel

Includes: Epstein-Barr Virus VCA Antibody (IgM), Epstein-Barr Virus VCA Antibody (IgG), Epstein-Barr Virus Nuclear Antigen (EBNA) Antibody (IgG)

Clinical Significance: Primary infection by EBV causes infectious mononucleosis, usually a self-limiting disease in children and young adults. Infection with EBV can cause lymphoproliferative disorders including tumors. VCA-IgM is typically detectable at clinical presentation, then declines to undetectable levels within a month in young children and within 3 months in other individuals. VCA-IgG is typically detectable at clinical presentation, and persists for life. EBNA IgG typically appears during convalescence (3-4 months after clinical presentation) and remains detectable for life.

EBV-VCA IgG/IgM (viral capsid antigen): A positive IgG means you’ve had or currently have the infection; A positive IgM means the virus has been reactivated.

EBV-EBNA IgG (nuclear antigen): A positive test result is usually associated with past infections.

Reference Range(s)

Epstein-Barr Virus VCA Antibody (IgM)

U/mLInterpretation

  • <36.00 Negative
  • 36.00-43.99Equivocal
  • >43.99Positive


Epstein-Barr Virus VCA Antibody (IgG)

U/mLInterpretation

  • <18.00 Negative
  • 18.00-21.99Equivocal
  • >21.99Positive


Epstein-Barr Virus Nuclear Antigen (EBNA) Antibody (IgG)

U/mLInterpretation

  • <18.00 Negative
  • 18.00-21.99Equivocal
  • >21.99Positive

Alternative Name(s)

EBV Comprehensive,Infectious Mononucleosis Panel

 


Epstein-Barr Virus DNA, Real-Time PCR is useful in assessing active disease. Central nervous system infections can be diagnosed with CSF specimens.

Clinical Significance

Primary infection by EBV causes infectious mononucleosis, usually a self-limiting disease in children and young adults. Infection with EBV can cause lymphoproliferative disorders including tumors. IgG recognizing Early Antigen D typically appears within a month after clinical presentation and is transient, lasting only 3-4 months. Persistently elevated levels suggest reactivation or persistence of EBV infection.

The Epstein-Barr EBV Early Antigen D Ab IgG test that will let one know if the virus is actively replicating.


Epstein-Barr Virus Nuclear Antigen (EBNA) Antibody (IgG)

Primary infection by EBV causes infectious mononucleosis, usually a self-limiting disease in children and young adults. Infection with EBV can cause lymphoproliferative disorders including tumors. VCA-IgG is typically detectable at clinical presentation, and persists for life. Absence of VCA-IgG usually indicates the patient is susceptible to EBV infection.

Primary infection by EBV causes infectious mononucleosis, usually a self-limiting disease in children and young adults. Infection with EBV can cause lymphoproliferative disorders including tumors. VCA-IgM is typically detectable at clinical presentation, then declines to undetectable levels within a month in young children and within 3 months in other individuals.

A Complete Blood Count (CBC) Panel is used as a screening test for various disease states including anemia, leukemia and inflammatory processes.

A CBC blood test includes the following biomarkers: WBC, RBC, Hemoglobin, Hematocrit, MCV, MCH, MCHC, RDW, Platelet count, Neutrophils, Lymphs, Monocytes, Eos, Basos, Neutrophils (Absolute), Lymphs (Absolute), Monocytes(Absolute), Eos (Absolute), Basos (Absolute), Immature Granulocytes, Immature Grans (Abs)

NOTE: Only measurable biomarkers will be reported.


Intrauterine or congenital CMV infections occur in 0.5 to 2.2% of all live births. Symptomatic congenital infections usually occur in infants born to nonimmune mothers who have primary infections during pregnancy. Latency and reactivation of CMV influence the interpretation of serological results. A single positive CMV IgG result is and indication of present or past infection. The presence of CMV IgM suggests a recent CMV exposure but does not differentiate between primary infection and reactivation.

CMV infections are common and usually asymptomatic. In patients who are immunocompromised, CMV may cause disseminated, severe disease. CMV may cause birth defects in a minority of infected newborns. Antibody IgG may represent prior exposure or recent infection if there is a significant change in titer between acute and convalescent specimens.

CMV infections are common and usually asymptomatic. In patients who are immunocompromised, CMV may cause disseminated, severe disease. CMV may cause birth defects in a minority of infected newborns.

Sera are intially screened for IgG and IgM antibodies recognizing and nucleocapsid protein common to all hantaviruses.


Hepatitis A IgM Antibody

This test is used to screen for recent exposure to the Hepatitis A virus.and to help diagnose a liver infection due to the Hepatitis A virus. There are several causes of hepatitis and the accompanying symptoms, so this test may be used to determine if the symptoms are due to Hepatitis A.

Hepatitis A IgM Antibody

The Hepatitis A IgM antibody test detects the first antibody produced by the body when it is exposed to Hepatitis A. This test is used to detect early or recent infections and to diagnose the disease in people with symptoms of acute hepatitis. IgM antibodies to Hepatitis A suggest a current, acute or recent Hepatitis A infection.

Results of this hepatitis testing may indicate the following:

  • If Hepatitis A IgM Antibody is positive the results indicate Acute or recent Hepatitis A virus infection.
  • If Hepatitis A IgM Antibody is negative and the Hepatitis A Antibody, Total is positive then the results indicate no active infection but previous Hepatitis A virus exposure; has developed immunity to Hepatitis A virus or recently vaccinated for Hepatitis A virus.
  • Dietary supplements containing biotin may interfere in assays and may skew analyte results to be either falsely high or falsely low. For patients receiving the recommended daily doses of biotin, draw samples at least 8 hours following the last biotin supplementation. For patients on mega-doses of biotin supplements, draw samples at least 72 hours following the last biotin supplementation.


Hepatitis B Surface Antibody, Qualitative  (anti-HBs)

Detects only the IgM antibody to the hepatitis B core antigen. Used to detect acute infections; sometimes present in chronic infections as well as used to detect previous exposure to HBV; it can also develop from successful vaccination so it is used to determine the need for vaccination (if anti-HBs is absent) or to determine if a person has recovered from an infection and is immune (cannot get the infection again).

Clinical Significance

The detection of anti-HBs is indicative of a prior immunologic exposure to the antigen or vaccine. To determine immune status as ≥10 mIU/mL as per CDC guidelines, please order Hepatitis B Surface Antibody, Quantitative.


Hepatitis B Surface Antibody, Quantitative (anti-HBs

Detects antibody produced in response to HBV surface antigen. It is used to detect previous exposure to HBV; it can also develop from successful vaccination so it is used to determine the need for vaccination (if anti-HBs is absent) or to determine if a person has recovered from an infection and is immune (cannot get the infection again).

Clinical Significance

This assay is used to determine immune status for Hepatitis B as ≥10 mIU/mL as per CDC Guidelines.


Hepatitis B Surface Antigen with Reflex Confirmation: Positive samples will be confirmed

IMPORTANT:  NOTE THIS IS A REFLUX TEST - The price charged for this test is only for the Hepatitis B Surface Antigen. ADDITIONAL CHARGES WILL OCCUR FOR THE REFLUX CONFIRMATION if the Hepatitis B Surface Antigen is positive.

Hepatitis B surface antigen (HBsAG) Detects protein that is present on the surface of the virus.  It is used to screen for, detect, and help diagnose acute and chronic hepatitis B virus (HBV) infections; earliest routine indicator of acute hepatitis B and frequently identifies infected people before symptoms appear; undetectable in the blood during the recovery period; it is the primary way of identifying those with chronic infections, including "hepatitis B virus (HBV) carrier" state.

Clinical Significance

Surface antigen usually appears in the serum after an incubation period of 1 to 6 months following exposure to Hepatitis B virus and peaks shortly after onset of symptoms. It typically disappears within 1 to 3 months. Persistence of Hepatitis B surface antigen for greater than 6 months is a prognostic indicator of chronic Hepatitis B infection.


Hepatitis C AB with reflex to HCV RNA, QN, PCR

IMPORTANT - THIS IS A REFLEX TEST AND AN ADDITIONAL CHARGE OF $129 WILL BE APPLIED IF THE Hepatitis C Antibody is reactive.

If Hepatitis C Antibody is reactive, then Hepatitis C Viral RNA, Quantitative, Real-Time PCR will be performed at an additional charge of $129.00

For the detection of active HCV infection in HCV antibody positive individuals.

Clinical Significance

Hepatitis C Virus (HCV) is a major cause of hepatitis. The clinical symptoms of an HCV infection are variable. Infection with HCV results in a chronic infection in 50 to 80% of cases. The "window" between HCV acquisition and seroreactivity is highly variable; up to six months.

 


Includes

Hepatitis A Antibody, Total; Hepatitis B Surface Antibody, Qualitative; Hepatitis B Surface Antigen with Reflex Confirmation; Hepatitis B Core Antibody, Total; Hepatitis C Antibody with Reflex to HCV, RNA, Quantitative, Real-Time PCR

Hepatitis B Surface Antigen with Reflex Confirmation: Positive samples will be confirmed based on the manufacturer's FDA approved recommendations at an additional charge (CPT code(s): 87341).


If Hepatitis C Antibody is reactive, Hepatitis C Viral RNA, Quantitative, Real-Time PCR will be performed at an additional charge (CPT code(s): 87522).


Herpes Simplex Virus 1/2 (IgG), Type-Specific Antibodies (HerpeSelect®) 

  1. HSV 1 IGG, TYPE SPECIFIC AB
  2. HSV 2 IGG, TYPE SPECIFIC AB

Diagnose HSV infection when lesions are absent; determine HSV type

Reference Range(s)

Index Interpretation

  • <0.90 Negative
  • 0.90-1.09 Equivocal
  • >1.09 Positive

This assay utilizes recombinant type-specific antigens to differentiate HSV-1 from HSV-2 infections. A index positive result cannot distinguish between recent and past infection. If recent HSV infection is suspected but the results are negative or equivocal, the assay should be repeated in 4-6 weeks. The performance index characteristics of the assay have not been established for pediatric populations, immunocompromised patients, or neonatal screening.

Limitations

Individuals infected with HSV may not exhibit detectable IgG antibody in the early stages of infection.

Clinical Significance

Herpes Simplex Virus (HSV) is responsible for several clinically significant human viral diseases, with severity ranging from inapparent to fatal. Clinical manifestations include genital tract infections, neonatal herpes, meningoencephalitis, keratoconjunctivitis, and gingivostomatitis. There are two HSV serotypes that are closely related antigenically. HSV Type 2 is more commonly associated with genital tract and neonatal infections, while HSV Type 1 is more commonly associated with infections of non-genital sites. Specific typing is not usually required for diagnosis or treatment. The mean time to seroconversion using the type specific assay is 25 days. The performance of this assay has not been established for use in a pediatric population, for neonatal screening, or for testing of immunocompromised patients.


Heterophile antibodies, in patients with infectious mononucleosis, may be present as early as the fourth day of illness, and by the twenty-first day of illness, 90% of patients will exhibit a positive test. The Epstein-Barr virus causes infectious mononucleosis.

Rubella is an acute exanthematous viral infection of children and adults. Rash, fever and lymphadenopathy characterize the illness. While many infections are subclinical, this virus has the potential to cause fetal infection with resultant birth defects. Diagnosis of a Rubella infection is best made serologically. In the absence of a current or recent infection, a demonstration of specific IgG on a serum sample is evident of immunity to Rubella.

Rubella is an acute exanthematous viral infection of children and adults. Rash, fever and lymphadenopathy characterize the illness. While many infections are subclinical, this virus has the potential to cause fetal infection with resultant birth defects. In the absence of a current or recent infection, a demonstration of specific IgG on a serum sample is evidence of immunity to rubella. A positive rubella IgM result does not necessarily indicate current or recent infection. Without a history of exposure to rubella or symptoms consistent with rubella, the IgM result may be difficult to interpret. Rubella IgM can be false positive due to other causes (e.g., parvovirus, rheumatoid factor, cytomegalovirus). Rubella IgM may also persist for more than 12 months after vaccination or natural infection. For a serologic diagnosis of congenital rubella in the neonatal period, antibody to rubella virus should be measured in both infant and maternal sera. If IgM is detected in a newborn infants serum, it is probable that transplacental rubella infection has occurred.

Rubella is an acute exanthematous viral infection of children and adults. Rash, fever and lymphadenopathy characterize the illness. While many infections are subclinical, this virus has the potential to cause fetal infection with resultant birth defects. Diagnosis of a Rubella infection is best made serologically. In the absence of a current or recent infection, a demonstration of specific IgG on a serum sample is evidence of immunity to Rubella.


No doubt you've heard about mononucleosis before. You've probably heard it called the "kissing disease" when you were young. 

But this kissing disease is much more than that. The Epstein Barr Virus EBV actually causes it, and it's more common than people realize. In the US alone, over 95% of adults and 50% of children have had EBV.

You're in the right place if you have EBV and are looking for more information about the Epstein Barr Virus and Epstein Barr virus lab tests.

EBV infects your blood and causes your immune system to react. The Epstein Barr virus lab test can detect this reaction by detecting the antibodies produced. Keep reading to find out all about EBV and blood tests.

What Is the Epstein Barr Virus?

The Epstein Barr Virus EBV is actually a herpes virus that infects humans. EBV infections are common, and most of the time, you'll never know you had the virus in the first place.

You might automatically associate the Epstein Barr Virus with mononucleosis (mono), but the truth is EBV doesn't always result in infectious mononucleosis. This is because so many people can test positive for the EBV virus even when they've never had infectious mononucleosis before.

Risk Factors for Epstein Barr Virus

Risk factors include having close contact with another person's bodily secretions like sexual intercourse and kissing. 

Young children and teenagers sharing toys, toothbrushes, cell phones, or food are also at increased risk.

If you've received an organ transplant or blood transfusion, you have a slight risk of getting EBV from the donor.

Cause of Epstein Barr Virus and Mono

An EBV infection occurs when your B cells become infected with EBV. Once your B cells are infected, the infection travels through your liver, spleen, and lymph nodes.

If your body responds enough to the presence of EBV, you'll develop symptoms of infectious mononucleosis.

How Do You Get EBV

EBV is spread around by bodily fluids, mainly your saliva, which explains the term kissing disease. You can also get EBV by sharing things like your toothbrush, eating utensils, or a drink. EBV is also spread by blood and semen.

You can infect other people with EBV from the very moment you get infected. And you don't need to have symptoms of EBV to pass it on to other people. You're contagious for as long as the virus is active in your body.

Signs and Symptoms of the Epstein Barr Virus

EBV infections are more likely to cause infections in teenagers and adults than in children. When EBV develops into mononucleosis (mono) infection, you'll notice symptoms like:

  • Fevers
  • Extreme fatigue
  • Headache
  • Sore throat
  • Swollen lymph nodes
  • Swollen tonsils
  • Enlarged spleen
  • Rash

Unfortunately, symptoms can be severe and last up to a month. And feelings of fatigue tend to linger on much longer.

EBV Reactivation

Once you get infected with the EBV virus, it remains inactive in your body for the rest of your life. Sometimes the virus can reactivate in your body but cause no symptoms.

However, EBV can reactivate and cause symptoms similar to mono if you have a weakened immune system.

EBV Complications

Usually, your body takes care of EBV with no issues. But sometimes, complications can occur. Complications include:

  • Anemia
  • Low levels of platelets
  • A ruptured spleen
  • Inflammation of the heart muscle

EBV can also cause nervous system conditions like Guillain-Barre syndrome, meningitis, and encephalitis

EBV is thought to be linked with certain autoimmune disorders. This is because EBV appears to change how some of our genes are expressed, which sometimes leads to an increased risk of developing an autoimmune disorder. Autoimmune conditions linked to EBV are:

  • Type 1 diabetes
  • Rheumatoid arthritis
  • Multiple sclerosis
  • Celiac disease
  • Graves disease
  • Inflammatory bowel disease
  • Hashimoto's thyroiditis

EBV Cancers

Another vital thing to know about EBV is that it can increase your risk of developing certain types of cancers, including:

  • Hodgkin Lymphoma
  • Burkitt Lymphoma
  • Nasopharyngeal cancer
  • Stomach cancer

Cancers linked to EBV aren't common in North America but still do occur. You'll mostly find EBV cancers in Africa and parts of Southeast Asia. It's estimated that EBV contributes to approximately 1.5% of all human cancer cases worldwide.

Scientists are still studying how viral proteins, RNA, and the overall understanding of viruses to understand the link to cancer better. Cell mutations from EBV can eventually lead to cancerous changes in your cells.

Epstein Barr Virus Lab Test

A blood test is helpful to distinguish between mono, EBV, or some other illness. Some people may want to get tested because they have a compromised immune system; other people may be looking to explain their symptoms.

Also, if you're pregnant or breastfeeding, it's even more important to understand the cause of the symptoms you're having.

Whatever the case, both mononucleosis tests and an EBV blood test are excellent diagnostic tools.

You'll want to find a comprehensive EBV panel at Ulta Lab Tests. A complete look at your EBV biomarkers will better determine your infection state, whether past or present.

It's important to know there is more than one EBV antibody test. And not all EBV antibody tests will show antibodies to EBV.

Standard laboratory tests in this panel include:

First, the EBV-VCA IgG/IgM test (viral capsid antigen VCA). If this is positive, it means you're currently infected, or you've been infected in the past.

A positive EBV-EBNA IgG (nuclear antigen) or an antibody to EBNA means you've had past infections.

A positive EBV-EA-D IgG (early antigen) means you may have either an active or reactive EBV infection.

The EBV antibody test or Epstein Barr, EBV Early Antigen test will let you know if your EBV virus is active.

The Monospot Test

heterophile antibody test or a Monospot test is one of the best initial tests to diagnose a mono infection. Heterophile antibody testing is excellent because heterophile antibodies can be present in the first five days of illness from infectious mononucleosis.

Heterophile antibody tests are quick, inexpensive, and easy to use. A positive heterophile antibody test should be followed with more antibody testing.

Be sure to discuss your test results with your doctor or infectious disease specialist to get the best interpretation and course of action based on your results.

EBV Treatment

EBV doesn't have any specific treatment or even a vaccine. And since a virus causes EBV, antibiotics won't do the trick. Your best course of action in managing symptoms of EBV include:

  • Getting plenty of rest
  • Drinking lots of fluids
  • Taking Tylenol or Advil to relieve pain and fever
  • Avoid heavy lifting
  • Avoid extreme physical activity 

Sometimes doctors might prescribe steroid treatment for severe symptoms like throat and spleen inflammation.

Children with EBV and infectious mononucleosis should stay home from school for at least 2 to 4 weeks or attend half days or until their symptoms of fatigue have improved. Children also need to avoid contact sports for up to a month or until cleared by their doctor. 

Frequently Asked Questions 

Never be afraid to find the answers to your questions. Even though EBV and mononucleosis are common worldwide, many people are unaware of the details.

Chances are, many other people have the same questions you do. Let's take a look at some FAQs now to get you started. 

  • Infectious mononucleosis mainly occurs between 15 and 24 years old
  • False-negative test rates occur almost 25% of the time in the first week 
  • You can be contagious for up to a year after getting EBV
  • You usually don't get mono a second time
  • There is no cure for mono
  • You can have mono and not realize it if you have mild symptoms

More Interesting EBV Facts

Symptoms of mono don't start straight away and often take 4 to 6 weeks to show up after you're exposed. 

College students and people serving in the military are among the most common groups of people to get mono.

Adults are rarely infected with mono because they usually get it as a child. But when adults do get mono, they tend to have less lymph node swelling and throat pain and more liver enlargement, and even jaundice.

The term infectious mononucleosis was coined in 1920 to describe the specific collection of symptoms doctors would often find.

Your EBV Blood Test

Your health is essential, so choose Ulta Lab Tests for your Epstein Barr Virus lab test. Ulta Lab Tests are highly accurate, reliable, and affordable.

The best part is you don't need a referral or insurance coverage. Your results are kept secure and confidential. And you'll typically receive your result in just 24 to 48 hours for most tests.

So take charge of your health today and get tested with Ulta Lab Tests.

Typically, the Epstein-Barr virus (EBV) causes mild to moderate illnesses. Epstein-Barr virus blood tests detect antibodies for EBV within the blood and help to establish an EBV infection diagnosis.

The Epstein-Barr virus is a very common infection. The Centers for Disease Control and Prevention (CDC) reports that most individuals in the United States at some point within their lives are infected with EBV. It is a very contagious virus and passes from one person to the next easily. Infected individuals have the virus in their saliva, and it may be spread via close contact like sharing cups or utensils or through kissing.

After being initially exposed to Epstein-Barr Virus, there is a several week time period before the associated symptoms start to appear, which is referred to as the incubation period. Throughout the acute primary infection phase, the virus continues to multiply. That is followed by a reduction in viral numbers and symptoms being resolved. However, the virus never disappears completely. Latent EBV stays inside people’s bodies for the rest of their lives and might reactivate but normally does not cause too many problems unless a person has a significantly weakened immune system. 

Most individuals are infected by Epstein-Barr Virus when they are children and experience no or few symptoms. However, whenever the initial infection takes place in adolescence, it might cause infectious mononucleosis, which is commonly referred to as mon. This condition is associated with an enlarged spleen, swollen lymph nodes, sore throat, fever, fatigue, and an enlarged liver at times. Those symptoms arise in around 25% of infected young adults and teenagers and normally are resolved within a few months. 

People who have mono are usually diagnosed based on their symptoms and the results from a mono test (that tests for a heterophile antibody) and complete blood count (CBC). Around 25% of individuals with mononucleosis do not produce any heterophile antibodies and end up with a negative mono test. That is particularly true for children. EBV antibody tests may be used to determine whether a current EBV virus infection is causing the symptoms that individuals are experiencing.

The most common cause of mononucleosis is EBV. The CDC reports that examples of other mono causes include toxoplasmosis, rubella, hepatitis C, hepatitis B, hepatitis A, and cytomegalovirus (CMV). 

It can sometimes be important to be able to distinguish EBV from those other illnesses. For example, in pregnant women, it might be important to diagnose the causes of viral illness symptoms. Testing may help with distinguishing a primary EBV infection, which hasn’t been shown that it affects a developing infant, from toxoplasmosis infection, herpes simplex virus, or CMV, since those illnesses might cause complications while a woman is pregnant and harm the fetus.

It might also be important to rule an Epstein-Barr Virus infection out and search for other issues that are causing the symptoms. For example, for a person with strep throat, which is an infection that group A streptococcus causes, needs to be identified and then treated using antibiotics. An individual might have strep throat rather than mononucleosis or might have both conditions simultaneously.

Several tests are available for different classes and types of Epstein-Barr Virusantibodies. These antibodies are proteins that are produced by the human body as an immune response to several Epstein-Barr virus antigens. Throughout a primary EBV infection, the levels of the EBV antibodies rise and fall at different times as the infection continues to progress. Measuring the antibodies within the blood can help with diagnosis and usually provide the healthcare professional with information on the stage of the infection and whether the infection is past, recent, or current. 

  • Antibody – Timing of when an antibody is usually detected within the blood
  • Viral Capsid Antigen (VCA)-IgM Antibody – First appears after being exposed to the virus and then after around 4 to 6 weeks tends to disappear.
  • VCA-IgG antibody – Arises during acute infection. The level is highest at 2-4 weeks, and then sees a slight drop, stabilizes, and then remains present in the person’s body for the rest of their life.   
  • Early Antigen (EA-D) antibody – Arises during an acute infection phase. It then tends to go away. Around 20% of people who are infected will continue having quantities that are detectable for several years once the EBV infection is resolved.
  • Epstein-Barr Nuclear Antigen (EBNA) antibody – Normally does not arise until after the acute infection is resolved. It starts to develop around 2-4 months following the initial infection and is present for life after that.

How are the tests used?

Epstein-Barr virus (EBV) antibody blood tests are used to assist with diagnosing EBV infection, which is the most common cause of mono (infectious mononucleosis) if an individual is symptomatic, but their mono test is negative.

In pregnant women who have viral illness symptoms one or several EBV antibody tests might be ordered in addition to tests for toxoplasmosis, cytomegalovirus (CMV), and other infections (that are sometimes part of the TORCH screen) to assist with distinguishing between EBV and other conditions that might result in similar symptoms.

Those tests might be ordered if an asymptomatic individual has been exposed to EBV previously or is susceptible to developing a primary EBV infection. It is not performed routinely but might be ordered when a person, such as an immunocompromised individual or an adolescent, has come into close contact with someone who has mononucleosis. 

It is recommended by the Centers for Disease Control and Prevention (CDC) that several tests be ordered to help determine whether an individual is susceptive to EBV or for detecting a reactivated EBV infection, prior infection, or recent infection.

Those tests include the following:

When are the tests ordered?

EBV antibody tests can be ordered whenever a person has symptoms that suggest mono but where the mono test comes back negative and whenever a pregnant woman exhibits flu-like symptoms. The healthcare provider would like to determine whether her symptoms are being caused by EBV or another type of microbe.

Some symptoms and signs that are associated with mononucleosis include the following:

  • Swollen lymph glands in the armpits and/or neck
  • Sore throat
  • Headache
  • Fever
  • Extreme fatigue or weakness
  • Enlarged liver and/or spleen (sometimes)

Testing might be ordered whenever a healthcare professional is looking to establish prior exposure to EBV. Also, testing might be repeated occasionally whenever the healthcare provider wants to track concentrations (titers) of antibodies and/or whenever the initial test is negative, but the healthcare provider still suspects that EBV is causing the individual’s symptoms.

What do the test results mean?

Care needs to be taken whenever EBV antibody testing results are interpreted. The symptoms and signs, in addition to the medical history of the individual who is being tested, need to be factored in. A healthcare practitioner might consult with an infectious disease specialist, specifically one who has experience with EBV testing.  

If a person tests positive for VCA-IgM antibodies, most likely, the individual does have an EBV infection, and it might be early in the overall course of the illness. If the person has symptoms that are associated with mono as well, then most likely, the individual will be diagnosed with having mononucleosis, even if their mono test results were negative.

  • If a person has positive EA-D IgG and VCA-IgG tests, then it is very likely that the individual has a recent or current EBV infection.
  • If the EBNA and VCA-IgG are positive, but the VCA-IgM is negative, then most likely, the individual who has been tested had an EBV infection in the past.
  • If a person is asymptomatic and tests negative for VCA-IgG, then most likely, the person has not been exposed to EBV previously and is vulnerable to the infection.

Increasing VCA-IgG levels tend to indicate that the person has an active EBV infection. On the other hand, decreasing concentrations tend to indicate an EBV infection that is recent and resolving. However, a practitioner needs to be careful when they are interpreting concentrations of EBV antibodies since the amount of antibody that is present doesn’t correlate with how severe the infection is or how long it is going to last. High VCA-IgG levels might be present and continue to persist at this concentration for the rest of the individual’s life.

Is there anything else that is important for me to know?

A ruptured spleen is the most type of mono complication. Other EBV infection complications that may occur include having difficulty breathing due to having a swollen throat, and, rarely, encephalitis, seizures, pancreatitis, skin rashes, and/or jaundice. EBV also is associated with and might play a role in several rare types of cancer, including nasopharyngeal carcinoma, Hodgkin lymphoma, and Burkitt’s lymphoma, in addition to fibromyalgia and multiple sclerosis.

Rarely is the reactivation of the virus a health concern unless the individual is persistently and significantly immunocompromised, as can happen in organ transplant recipients or those with HIV/AIDS. Primary infections in those individuals might be more serious, and some might suffer chronic EBV-related symptoms.