With a full battery of titers, plus symptoms, inflammation markers, plus the development of POTS antibodies. I had no IgM but high IgGs, positive PCRs, and a very strange presentation of EBV as described in the attached deficient EBV response doc.
Both my top ME/CFS doctor and my primary doctor agree on my diagnosis, though I had other doctors dismiss my results as "past infections". My CFS doc said "I know what we were all taught in med school but its wrong.
Additionally, the tests for various infections seem to vary. That is, certain tests are better for certain viruses.
Since being treated for viruses, I've improved, while in the previous 18 months, of been going downhill, so I have no reason to doubt the diagnosis. I think a lot of patients may have chronic viruses that are missed and therefore don't get the treatment they need.
My CFS doc and the researchers at the Symposium both described how viruses, especially EBV, can push the immune system to create autoimmune antibodies. I didn't have POTS 2 years ago, but developed it during the time I was getting sicker before antiviral treatment.