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EBV titers

Discussion in 'Diagnostic Guidelines and Laboratory Testing' started by powertool4, Feb 9, 2010.

  1. powertool4

    powertool4

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    Hi,

    about 6 months ago when i got really ill, a doctor checked my EBV VCA IgG levels and they were in the 1000's, ref range is less than 100. He said all my symptoms were from mono, even though i didn't have a sore throat, i didn't have the flu etc. In fact, my symptoms at the time were anxiety, paranoia, psychiatic issues that were brought on my surgery and antibiotics. I just recently checked my EBV VCA IgM and they came back negative..

    does anyone know what this means? any way of finding out where my issues are viral or not?
  2. cfs since 1998

    cfs since 1998 *****

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    The use of antibodies to diagnose ongoing chronic EBV infection is controversial.

    Dr. Martin Lerner is one of the most prominent physicians treating chronic herpes viruses with antivirals. He uses EBV VCA (Viral Capsid Antigen) IgM and EBV EA (Early Antigen) antibodies. He does not use VCA IgG. The Early Antigen is probably more important because he believes the virus does not replicate fully.

    I think most people with ME/CFS probably have active herpes virus infections because of the immune dysregulation we have, possibly caused by XMRV.
  3. Kati

    Kati Patient in training

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    Thank you for the answer CFS since... so what are the right tests to be done to assess herpes viruses activity? I understand Dr Lerners uses titers to assess response to antivirals.

    Thanks, Kati
  4. cfs since 1998

    cfs since 1998 *****

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    Dr. Lerner recently posted the tests he uses at his website. I think different doctors use different tests, but he seems to be the most experienced, and I believe he was an infectious disease specialist from the get-go so that helps. He doesn't explain why he uses a lab in Minnesota for some tests as these should be available at LabCorp as well. Maybe he thinks they are more accurate or maybe it's for financial reasons.
    http://www.cfsviraltreatment.com/FAQ/index.html#Tests
  5. powertool4

    powertool4

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    Very interesting. I should have done the early antigen test as well. My IgM was normal though.. so not really sure.

    So, i'm new to CFS but there are many CAUSES of CFS right, i mean it's not like everyone that is diagnosed with CFS or ME is going to have high viral counts, or have gut issues with d-lactate problems, parasites, etc. but they CAN overlap but not always the same for everyone?

    Do most doctors of CFS also accept adrenal fatigue as a legitimate cause or factor in treatment?
  6. Dr. Yes

    Dr. Yes Shame on You

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    powertool4, elevated IgM generally reflects a currently active infection being engaged by the immune system, so it would not be surprising that your IgM is now negative. IgG titers would be more helpful, though they are difficult to read in the case of chronic/low-level infections. I too have heard that the IgG Early Antigen test is probably more reliable. High (or very high, in your case) IgG titers don't always mean too much to doctors who lack experience in these areas, but specialists think (if accompanied by symptoms) they may indicate a 'smoldering' infection, or one that has gone largely undetected or otherwise undeterred by the immune system. So.. did you have any CFS-type symptoms when your EBV was that high? (Exhaustion/drowsiness, PEM, weakness, dizziness, etc)?
  7. FernRhizome

    FernRhizome Senior Member

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    Can anyone tell me the criteria for the early antigen antibodies, like what is "high" and what is "low". Someone told me 4 is considered super high. Is that right?
  8. Anika

    Anika Senior Member

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    Viral Antibodies - Different Measures

    I find the measures for viral antibodies confusing, also. I do remember two key points.

    One, is that there are different ways of testing for the antibodies - the tests themselves are of different types.

    Two, is that even for the same general type of tests/measures, the results that are reported are in different ranges for different labs. I think labs have to validate their reference ranges in some way.

    So, the bottom line, is that to interpret the result, you have to know the lab and its reference ranges. The type of test might affect the general types of numbers reported.

    Titers - I've had some antibody tests (not just viral - I think autoimmune tests are often run this way) reported in titers - and they were all in multiples that doubled - like 40, 80, 160, 320, 640, etc. But I hear some people reporting titers that don't follow this "rule."

    Other antibody tests are reported in decimals, like 2.7, 3.5, etc., or round numbers. Depending on the test, a positive or "high"result could be over 1, over 10, 100, 1000, or pick some other number.

    So, Fern, if you have a result, I think you need to know the lab ranges, and also have your doctor help explain "how high is high?". I'm always interested in what people have to report based on what their doctors use.

    One reason why Lerner may use that particular lab, is that he knows its method well, has high confidence in their testing process, and using it consistently means the results are comparable. If he got a lab result from another lab, he couldn't necessarily compare it directly.

    Anika
  9. alice1

    alice1 Senior Member

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    We may have had the same type of test powertool4.When I was tested for EBV it was also about 2000 when the norm was <200.
    I've just recently had tubes and tubes of blood work done,it'll be interesting to see what comes up.
    This was at Dr. Klimas's clinic.
  10. consuegra

    consuegra Senior Member

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    EBV antibody testing

    This is a confusing subject. I have read that elevated EBV IgG antibodies over a long period of time are suspect. For instance if you have sustained eleveated IgG EBV antibodies that do not diminish in time, perhaps there is viral involvement. I have also heard from Dr. Lerner himself that IgG EBV antibody readings are "worthless". Dr. Lerner himself uses an EBV test that was designed and marketed by Diasorin corp in Stillwater, MN. This test is done at ARUP in Salt Lake and perhaps at other labs. Dr. Lerner uses elevated IgM and early antigen as diagnostic markers, along with other measurements. Others are not so prissy and realize that there might be various viruses involved and the proof comes in the pudding: through antiviral therapy and patient improvement. This is particularly important when symptoms and history point to viral involvement. Dr. Guyer uses various anti-virals, often in combinations, increasing dosage slowly, with the idea that we really do not know which antivirals is pushing back on which virus, and that maybe there are unknown viruses that are being inhibited. So I invite you, with this information, to come to your own conclusions.

    Chris

    http://cfspatientadvocate.blogspot.com
  11. August59

    August59 Daughters High School Graduation

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    My bloodwork was done through Labcorp. Anything that Labcorp runs and returns a value above normal is sent to the lab in Minnesota. Hunter Hopkins did my labwork and they are mixed in how rhey interpret the labwork. If it is Early Antigen or Viral Capsule Antigen they will take note of IgG levels, especially the Early Antigen, which I think is suppose to come before Viral Capsule Antigen. The EBNA level, whether it is IgM or IgG they don't give much thought of. The IgM is by far the most indicative of a present infection. An EBV EA IgG that is very high is an indicator of an infection within the last 6 - 12 weeks, but in my case I had been the same for 6 months or more. Some thought was given to "What is CFS doing to the immune system to cause Early Antigen IgG to be this high and not have had an active infection in at least 6 months. The impression that I got was that the entire EBV titer test is of no use in diagnosing EBV (Mono) for someone that has CFS. The virus will not follow its normal transformation (probably not the right term) if someone has CFS. I got the impression that Dr. Lapp and Dr. Black felt like EBV was opportunistic with someone with CFS and not the cause of it. I believe this as well because I have never had mono as long as I remember and most people don't know it because they are expose when young and build antibodies then.

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