Epstein-Barr Virus (EBV) is a widespread human virus belonging to the herpesvirus family. Most individuals encounter EBV at some point in their lives, often without realizing they were infected. It typically spreads through bodily fluids, particularly saliva, which is why it is sometimes referred to as the “kissing disease.”
Interpreting a Positive Test Result
A positive EBV test indicates that you have been infected with the virus. The specific interpretation depends on the types of antibodies detected in your blood. Laboratories test for several antibodies to determine if an infection is current, recent, or from the past.
Viral capsid antigen (VCA) IgM antibodies are present during an acute or very recent EBV infection and disappear within a few months. VCA IgG antibodies develop shortly after VCA IgM appears and persist for life, indicating a past infection and immunity.
Epstein-Barr nuclear antigen (EBNA) IgG antibodies emerge later, about 2 to 4 months after the initial infection, and remain detectable indefinitely. Early antigen (EA-D) IgG antibodies can be tested; their presence suggests an active infection and they fade within a few months.
A common pattern for an acute infection is positive VCA IgM and VCA IgG, but negative EBNA IgG. If VCA IgG and EBNA IgG are both positive, while VCA IgM is negative, this signifies a past infection. Most adults will have positive VCA IgG and EBNA IgG, reflecting a prior exposure that may have been asymptomatic.
Typical Symptoms and Infection Course
When a primary EBV infection causes symptoms, it presents as infectious mononucleosis, commonly known as “mono” or “glandular fever.” The incubation period, the time between exposure to the virus and the onset of symptoms, ranges from 4 to 6 weeks.
Initial symptoms may be mild and resemble a common cold or flu, including fatigue, feeling unwell, and a low-grade fever. As the infection progresses into its acute stage, pronounced symptoms emerge. These can include profound fatigue, a fever that can reach up to 104°F, a severe sore throat, and swollen lymph nodes.
Some individuals may experience headaches, muscle aches, decreased appetite, and abdominal discomfort. The spleen or liver may become enlarged. While the acute symptoms last for 2 to 4 weeks, the fatigue can linger for several weeks or even months.
Treatment and Recovery
There is no specific antiviral medication that treats EBV directly; management focuses on supportive care to alleviate symptoms. Rest is recommended to help the body recover. Staying well-hydrated by drinking plenty of fluids like water and soups is beneficial.
Over-the-counter pain relievers can help manage fever, sore throat, and headaches. If the spleen is enlarged, it is important to avoid strenuous physical activities for several weeks or months to prevent the risk of splenic rupture.
While most people recover fully from an EBV infection, some may experience persistent fatigue for weeks or even months after the acute symptoms subside. After recovery, the virus remains dormant within the body for life, meaning it is not eliminated but becomes inactive.