How to Read Epstein Barr Virus Test Results
At a Glance
Why Become Tested?
To assistance diagnose infectious mononucleosis (mono); to distinguish between an Epstein-Barr virus (EBV) infection and another affliction with similar symptoms; to help evaluate susceptibility to EBV
When To Get Tested?
When you accept symptoms of mono but a negative mono test; when a pregnant woman has flu-like symptoms; occasionally when an asymptomatic person has been exposed to someone with mono; or mayhap as a means to bank check allowed organization role
Sample Required?
A blood sample fatigued from a vein in your arm
Test Preparation Needed?
None
What is existence tested?
Epstein-Barr virus (EBV) is a virus that typically causes a mild to moderate disease. Blood tests for Epstein-Barr virus observe antibodies to EBV in the blood and assist plant a diagnosis of EBV infection.
Epstein-Barr virus causes an infection that is very mutual. According to the Centers for Disease Control and Prevention (CDC), near people in the United states are infected by EBV at some point in their lives. The virus is very contagious and easily passed from person to person. Information technology is present in the saliva of infected individuals and tin can exist spread through close contact such as kissing and through sharing utensils or cups.
Afterward initial exposure to EBV, there is a flow of several weeks earlier associated symptoms may appear, called the incubation menses. During the acute primary infection, the virus multiplies in number. This is followed by a decrease in viral numbers and resolution of symptoms, only the virus never completely goes away. Latent EBV remains in the person's trunk for the rest of that person's life and may reactivate but normally causes few problems unless the person'due south immune system is significantly weakened.
Virtually people are infected past EBV in childhood and experience few or no symptoms. However, when the initial infection occurs in adolescence, it can cause infectious mononucleosis, commonly chosen mono, a status associated with fatigue, fever, sore pharynx, swollen lymph nodes, an enlarged spleen, and sometimes an enlarged liver. These symptoms occur in about 25% of infected teens and young adults and commonly resolve inside a calendar month or two.
People with mono are typically diagnosed by their symptoms and the findings from a complete blood count (CBC) and a mono test (which tests for a heterophile antibody). About 25% of those with mono practice not produce heterophile antibodies and will have a negative mono test; this is peculiarly truthful with children. Tests for EBV antibodies tin be used to determine whether or non the symptoms these people are experiencing are due to a current infection with the EBV virus.
EBV is the most common crusade of mono. According to the CDC, examples of other causes of mono include cytomegalovirus (CMV), hepatitis A, hepatitis B or hepatitis C, rubella, and toxoplasmosis. Sometimes, information technology tin can be important to distinguish EBV from these other illnesses. For instance, it may exist important to diagnose the cause of symptoms of a viral illness in a pregnant woman. Testing can help to distinguish a master EBV infection, which has not been shown to touch on a developing baby, from a CMV, herpes simplex virus, or toxoplasmosis infection, as these illnesses can crusade complications during the pregnancy and may harm the fetus.
It can too be important to rule out EBV infection and to wait for other causes of the symptoms. Those with strep throat, an infection caused past group A streptococcus, for instance, need to exist identified and treated with antibiotics. A person may accept strep throat instead of mono or may accept both conditions at the same time.
Several tests for different types and classes of EBV antibodies are available. The antibodies are proteins produced by the body in an allowed response to several unlike Epstein-Barr virus antigens. During a primary EBV infection, the level of each of these EBV antibodies rises and falls at various times as the infection progresses. Measurement of these antibodies in the blood can aid in diagnosis and typically provides the healthcare practitioner with data most the stage of infection and whether it is a electric current, recent, or by infection.
| Antibody | Timing of when the antibody is typically detected in the claret |
| Viral Capsid Antigen (VCA)-IgM antibody | Appears offset after exposure to the virus and then tends to disappear afterwards about 4 to 6 weeks |
| VCA-IgG antibody | Emerges during acute infection with the highest level at 2 to iv weeks, then drops slightly, stabilizes, and is present for life |
| Early Antigen (EA-D) antibiotic | Appears during the acute infection phase and then tends to disappear; about 20% of those infected will continue to have detectable quantities for several years afterwards the EBV infection has resolved. |
| Epstein-Barr Nuclear Antigen (EBNA) antibiotic | Does not usually appear until the astute infection has resolved; it develops most 2 to iv months after the initial infection and is then is nowadays for life. |
Common Questions
How is the test used?
Claret tests for Epstein-Barr virus (EBV) antibodies are used to help diagnose EBV infection, the near mutual cause of infectious mononucleosis (mono), if a person is symptomatic but has a negative mono test.
In pregnant women with symptoms of a viral disease, ane or more EBV antibody tests may be ordered along with tests for cytomegalovirus (CMV), toxoplasmosis, and other infections (sometimes as part of a TORCH screen) to help distinguish between EBV and conditions that may cause similar symptoms.
These tests may be ordered for an asymptomatic person to see if that person has been previously exposed to EBV or is susceptible to a chief EBV infection. This is not routinely done, just information technology may be ordered when someone, such as an adolescent or an immunocompromised person, has been in close contact with a person who has mono.
The Centers for Disease Control and Prevention (CDC) recommend ordering several tests to assistance make up one's mind whether a person is susceptible to EBV or to find a recent infection or a prior infection, or a reactivated EBV infection. These tests include:
- Viral capsid antigen (VCA)-IgM
- VCA-IgG
- D early antigen (EA-D)
- Epstein Barr nuclear antigen (EBNA)
When is it ordered?
EBV antibiotic tests may be ordered when someone has symptoms suggesting mono only a negative mono examination and when a pregnant woman has flu-similar symptoms and her healthcare provider wants to determine whether the symptoms are due to EBV or another microbe. Some signs and symptoms associated with mono include:
- Farthermost weakness or fatigue
- Fever
- Headache
- Sore throat
- Swollen lymph glands in the neck and/or armpits
- Enlarged spleen and/or liver (sometimes)
Testing may be ordered when a healthcare practitioner wants to establish previous exposure to EBV. Testing may occasionally exist repeated when the healthcare provider wants to rail antibody concentrations (titers) and/or when the commencement examination was negative but the healthcare practitioner still suspects that the person'southward symptoms are due to EBV.
What does the test result mean?
Care must be taken when interpreting results of EBV antibody testing. The signs and symptoms as well as the medical history of the person tested must be taken into account. A healthcare practitioner may consult a specialist in infectious diseases, specifically one who is experienced with EBV testing.
If someone is positive for VCA-IgM antibodies, then it is likely that the person has an EBV infection and it may exist early on in the form of the illness. If the individual besides has symptoms associated with mono, so information technology is nearly likely that the person will be diagnosed with mono, even if the mono exam was negative.
If someone has positive VCA-IgG and EA-D IgG tests, so it is highly probable that the person has a current or recent EBV infection.
If the VCA-IgM is negative but VCA-IgG and an EBNA antibody are positive, then it is probable that the person tested had a previous EBV infection.
If an individual is asymptomatic and negative for VCA-IgG, and so that person has likely not been previously exposed to EBV and is vulnerable to infection.
In general, rising VCA-IgG levels tend to point an active EBV infection, while falling concentrations tend to indicate a recent EBV infection that is resolving. However, care must exist taken with interpreting EBV antibody concentrations because the amount of antibody present does not correlate with the severity of the infection or with the length of time information technology will last. High levels of VCA-IgG may be present and may persist at that concentration for the rest of a person's life.
Below, examples of some results are provided in table class.
| VCA-IgM | VCA-IgG | EA-D, IgG | EBNA, IgG | Possible Interpretation |
| Negative | Negative | Negative | Negative | No infection, symptoms due to another cause, susceptible to EBV infection |
| Positive | Positive | Negative | Negative | Early on, master infection |
| Negative or positive | Positive | Positive | Negative | Active infection, though EA-D IgG may persist for life in virtually 20% of people |
| Negative | Positive | Negative | Positive | Past infection |
| Negative | Positive | Positive | Positive | May indicate reactivation of virus |
Is in that location annihilation else I should know?
The most common complication of mono is a ruptured spleen. Other complications of EBV infection that tin can occur include trouble breathing due to a swollen throat and, rarely, jaundice, skin rashes, pancreatitis, seizures, and/or encephalitis. EBV is as well associated with, and may play a role in, several rare forms of cancer, including Burkitt'southward lymphoma, Hodgkin lymphoma, and nasopharyngeal carcinoma, every bit well as multiple sclerosis and fibromyalgia.
Reactivation of the virus is rarely a health concern unless the person is significantly and persistently immunocompromised, as may happen in those who have HIV/AIDS or organ transplant recipients. Main infections in these people can be more astringent, and some may experience chronic EBV-related symptoms.
How is Epstein-Barr virus (EBV) infection or infectious mononucleosis (mono) treated?
Care is largely supportive and typically includes plenty of residue and fluids equally well as handling of the symptoms. Avoiding any contact sports or heavy lifting for several weeks to months may be recommended to avoid spleen rupture. At that place are no anti-viral medications available to speed healing; however, anti-virals and steroids can be used to treat symptoms in astringent cases. At present, at that place is no vaccine for EBV, just clinical trials are underway.
Practice adults get mono?
They exercise, but it is rare because about have already been infected with EBV at an earlier age. When they practice, they tend to take less lymph node swelling and sore throat and more than liver enlargement and jaundice.
Do EBV infection and mono occur throughout the world?
Yes. In emerging nations, however, mono is non as common because virtually of the population is infected with EBV earlier in life when symptoms are minimal.
If I have had EBV infection, tin I still become mono?
No. One time you have had an EBV infection, yous volition not go mono. You could, even so, feel similar symptoms from another viral illness. In individuals with weakened immune systems, the virus can reactivate and cause affliction.
Why is mono sometimes called "the kissing disease"?
This is considering EBV is present in the saliva of an infected private and is commonly spread through kissing. It can also be spread, especially in the example of children, through saliva transfer to hands and/or toys and by sharing utensils or cups.
Are there other types of tests available for EBV?
Yes. There are molecular tests that tin can detect and measure EBV Dna.
Wellness Professionals – LOINC
LOINC Observation Identifiers Names and Codes (LOINC®) is the international standard for identifying health measurements, observations, and documents. It provides a common language to unambiguously place things yous tin measure out or observe that enables the exchange and aggregation of clinical results for care delivery, outcomes management, and research. Learn More.
Listed in the tabular array beneath are the LOINC with links to the LOINC particular pages. Please note when y'all click on the hyperlinked code, you are leaving Testing.com and accessing Loinc.org.
| LOINC | LOINC Brandish Proper name |
|---|---|
| 31372-vi | EBV nuclear Ab Qn (Southward) |
| 22296-8 | EBV nuclear Ab Ql (Due south) |
| 20432-one | EBV nuclear Ab IF Ql (S) |
| 22297-half-dozen | EBV nuclear Ab (South) [Titer] |
| 21260-5 | EBV nuclear Ab IF (Due south) [Titer] |
| 31374-2 | EBV nuclear IgG Qn (S) |
| 30083-0 | EBV nuclear IgG IA Qn (S) |
| 40753-6 | EBV nuclear IgG IF Qn (S) |
| 7883-two | EBV nuclear IgG Ql (Due south) |
| 5156-v | EBV nuclear IgG IA Ql (Due south) |
| 5155-7 | EBV nuclear IgG IF Ql (Southward) |
| 22298-four | EBV nuclear IgG (Southward) [Titer] |
| 12212-7 | EBV nuclear IgG IF (S) [Titer] |
| 24007-7 | EBV early IgG Qn (S) |
| 22295-0 | EBV early IgG Ql (S) |
| 40752-eight | EBV early IgG IA Ql (Due south) |
| 6814-viii | EBV early IgG IF Ql (S) |
| 23971-five | EBV early IgG (S) [Titer] |
| 23995-four | EBV early IgG IF (Southward) [Titer] |
| 22293-v | EBV early Ab Qn (South) |
| 16823-7 | EBV early Ab IA Qn (Southward) |
| 7882-4 | EBV early on Ab Ql (Southward) |
| 5153-2 | EBV early on Ab IA Ql (S) |
| 5154-0 | EBV early on Ab IF Ql (Due south) |
| 22294-3 | EBV early on Ab (Due south) [Titer] |
| 14083-0 | EBV early Ab IF (South) [Titer] |
| 50969-5 | EBV early diffuse IgG Qn (S) |
| 59183-4 | EBV early lengthened IgG Ql (Due south) |
| 47434-six | EBV early diffuse Ab Ql (S) |
| 13236-5 | EBV early on diffuse Ab IF Ql (S) |
| 30137-iv | EBV capsid IgM spec 2 Ql (S) |
| 7886-five | EBV capsid IgM Qn (S) |
| 5159-nine | EBV capsid IgM IA Qn (South) |
| 30340-4 | EBV capsid IgM Ql (S) |
| 24115-eight | EBV capsid IgM IA Ql (S) |
| 40751-0 | EBV capsid IgM IF Ql (S) |
| 20491-vii | EBV capsid IgM (S) [Titer] |
| 5160-7 | EBV capsid IgM IF (S) [Titer] |
| 32843-5 | EBV capsid IgG spec 1 Qn (S) |
| 32828-6 | EBV capsid IgG spec one IA Qn (S) |
| 32845-0 | EBV capsid IgG 1st specimen/2nd specimen (S) [Ratio] |
| 32830-2 | EBV capsid IgG 1st specimen/2nd specimen IA (S) [Ratio] |
| 32844-3 | EBV capsid IgG spec ii Qn (South) |
| 32829-iv | EBV capsid IgG spec 2 IA Qn (S) |
| 30136-vi | EBV capsid IgG spec 2 Ql (S) |
| 69949-6 | EBV capsid IgG avidity IA Ql (S) |
| 81119-0 | EBV capsid IgG avidity IA (South) [Ratio] |
| 7885-7 | EBV capsid IgG Qn (S) |
| 5157-iii | EBV capsid IgG IA Qn (S) |
| 30339-half-dozen | EBV capsid IgG Ql (S) |
| 24114-ane | EBV capsid IgG IA Ql (S) |
| 40750-2 | EBV capsid IgG IF Ql (South) |
| 20490-9 | EBV capsid IgG (S) [Titer] |
| 5158-1 | EBV capsid IgG IF (South) [Titer] |
View Sources
Sources Used in Current Review
(April 2011) Su-Mei Cao, et al. Fluctuations of Epstein-Barr Virus Serological Antibodies and Take a chance for Nasopharyngeal Carcinoma: A Prospective Screening Study with a twenty-Year Follow-Upward. PLOS One. Available online at http://journals.plos.org/plosone/commodity?id=10.1371/journal.pone.0019100. Accessed June 12, 2016.
(Jan 2014) Centers for Illness Control and Prevention. Epstein-Barr Virus and Infectious Mononucleosis. Available online at http://world wide web.cdc.gov/epstein-barr/laboratory-testing.html. Accessed June 11, 2016.
(Oct 2015) Cunha, B.A., et al. Infectious Mononucleosis Workup. Medscape. Available online at http://emedicine.medscape.com/article/222040-workup. Accessed June 13, 2016.
(Aug 2004) Hess, R. Routine Epstein-Barr Virus Diagnostics from the Laboratory Perspective: Still Challenging afterward 35 Years. Periodical of Clinical Microbiology. Available online at http://world wide web.ncbi.nlm.nih.gov/pmc/articles/PMC497621/. Accessed June xi, 2016.
(2015) Reshkova, V. et al. Evaluation of Antiviral Antibodies against Epstein-Barr Virus and Neurotransmitters in Patients with Fibromyalgia. Journal of Neurology and Neuroscience. Bachelor online at http://www.jneuro.com/neurology-neuroscience/evaluation-of-antiviral-antibodies-against-epsteinbarr-virus-and-neurotransmitters-in-patients-with-fibromyalgia.php?aid=7360. Accessed June 11, 2016.
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