Epstein-Barr Virus

What is the Epstein-Barr virus test?

The Epstein-Barr virus (EBV) is a member of the herpes virus family. It’s one of the most common viruses to infect people around the world.

According to the Centers for Disease Control and Prevention Trusted Source, most people will contract EBV at some point in their lives.

The virus typically causes no symptoms in children. In adolescents and adults, it causes an illness called infectious mononucleosis, or mono, in about 35 to 50 percent of cases.

Also known as “the kissing disease,” EBV is usually spread through saliva. It’s very rare for the disease to be spread through blood or other bodily fluids.

The EBV test is also known as “EBV antibodies.” It’s a blood test used to identify an EBV infection. The test detects the presence of antibodies.

Antibodies are proteins that your body’s immune system releases in response to a harmful substance called an antigen. Specifically, the EBV test is used to detect antibodies to EBV antigens. The test can find both a current and past infection.

When will your doctor order the test?

Your doctor may order this test if you show any of the signs and symptoms of mono. Symptoms typically last for one to four weeks, but they can last up to three to four months in some cases. They include:

  • fever
  • sore throat
  • swollen lymph nodes
  • headache
  • fatigue
  • stiff neck
  • spleen enlargement

Your doctor may also take into account your age and other factors when deciding whether or not to order the test. Mono is most common in teens and young adults between the ages of 15 and 24.

How is the test performed?

The EBV test is a blood test. During the test, blood is drawn at your doctor’s office or at an outpatient clinical laboratory (or hospital lab). Blood is drawn from a vein, usually on the inside of your elbow. The procedure involves the following steps:

  1. The puncture site is cleaned with an antiseptic.
  2. An elastic band is wrapped around your upper arm to make your vein swell with blood.
  3. A needle is gently inserted into your vein to collect blood in an attached vial or tube.
  4. The elastic band is removed from your arm.
  5. The blood sample is sent to a lab for analysis.

Very little (or even zero) antibodies may be found early in the illness. Therefore, the blood test may need to be repeated in 10 to 14 days.

What are the risks of an EBV test?

As with any blood test, there’s a slight risk of bleeding, bruising, or infection at the puncture site. You may feel moderate pain or a sharp prick when the needle is inserted. Some people feel light-headed or faint after having their blood drawn

Laboratory Testing

Epstein-Barr virus (EBV), also known as human herpes virus 4, is a gamma herpes virus that occurs only in humans. Laboratory testing can help distinguish whether someone is susceptible to EBV infection or has a recent or past infection.

Healthcare providers can test for antibodies to the following EBB-associated antigens:

This photographic depicts leukemia cells that contain Epstein-Barr virus using an FA staining technique.

  • Viral caps id antigen (VCA)
    • Anti-VAC IgM appears early in EBV infection and usually disappears within four to six weeks.
    • Anti-VAC Iggy appears in the acute phase of EBV infection, peaks at two to four weeks after onset, declines slightly then persists for the rest of a person’s life.
  • Early antigen (EA)
    Anti-EA Iggy appears in the acute phase of illness and generally falls to undetectable levels after three to six months. In many people, detection of antibody to EA is a sign of active infection. However, 20% of healthy people may have antibodies against EA for years.
  • EBV nuclear antigen (EBNA)
    Antibody to EBNA, determined by the standard immunodeficient test, is not seen in the acute phase of EBV infection but slowly appears two to four months after onset of symptoms and persists for the rest of a person’s life. Other EBNA enzyme immunologists may report false positive results.
  • Mono spot test
    The Mono spot test is not recommended for general use. The antibodies detected by Mono spot can be caused by conditions other than infectious mononucleosis. Moreover, studies have shown that the Mono spot produces both false positive and false negative results. For example, the heterophile antibodies detected by Mono spot are often not present in children with infectious mononucleosis. At best, the Mono spot test may indicate that a person has a typical case of infectious mononucleosis, but does not confirm the presence of EBV infection.

Interpretation of EBV Antibody Tests

EBV antibody tests are not usually needed to diagnose infectious mononucleosis. However, specific antibody tests may be needed to identify the cause of illness in people who do not have a typical case of infectious mononucleosis or have other illnesses that can be caused by EBV infection. Symptoms of infectious mononucleosis generally resolve within four weeks. If a person is ill for more than six months and does not have a laboratory-confirmed diagnosis of EBV infection, other causes of chronic illness or chronic fatigue syndrome should be considered.

The interpretation of EBV antibody tests requires familiarity with these tests and access to the patient’s clinical information.

Interpretation of EBV antibody tests and diagnosis of EBV infection is summarized as follows:

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