EBV Test Result Interpretation?

[Dan_USAAZ]

For the last 10 years I have primarily focused on my elevated HHV-6 titers.

1:1280 Ref. <1:80

Over the last 20+ years I have also had abnormal EBV test results, but the doctors always stated that it is just a result of past infection, even though the interpretation on the lab report suggested that the result represented chronic or reactivated EBV.

A new doctor recently ordered EBV testing from ARUP and I was hoping to get opinions as to what they may indicate, based on our knowledge of viruses in ME/CFS.
I assume these results suggest a past infection (as opposed to the acute phase), but are the numbers suggestive of an over active immune response to EBV or are these tests not very meaningful? Thoughts?

@Hip I always appreciate your input on pathogen topics, if you have time.

Thanks!

Ebv Ab Vca, Igg >750.0 U/mL ref 0.0 - 21.9 U/mL H

INTERPRETIVE INFORMATION: Epstein-Barr Virus Antibody to Viral Capsid Antigen, IgG​

17.9 U/mL or less.......Not Detected​

18.0-21.9 U/mL..........Indeterminate - Repeat testing in 10-14 days may be helpful.​

22.0 U/mL or greater....Detected​

Ebv Ab Vca, Igm <10.0 U/mL ref 0.0 - 43.9 U/mL

INTERPRETIVE INFORMATION: Epstein-Barr Virus Antibody to Viral Capsid Antigen, IgM​

35.9 U/mL or less.......Not Detected​

36.0-43.9 U/mL..........Indeterminate - Repeat testing in 10-14 days may be helpful.​

44.0 U/mL or greater....Detected​

Ebv Na-Abs 355.0 U/mL ref 0.0 - 21.9 U/mL H

INTERPRETIVE INFORMATION: Epstein-Barr Virus Antibody to Nuclear Antigen, IgG​

17.9 U/mL or less.......Not Detected​

18.0-21.9 U/mL..........Indeterminate - Repeat testing in 10-14 days may be helpful.​

22.0 U/mL or greater....Detected​

Ebv Ea-Igg 24.9 U/mL ref 0.0 - 10.9 U/mL H

INTERPRETIVE INFORMATION: Epstein-Barr Virus Antibody to Early D Antigen (EA-D), IgG​

8.9 U/mL or less........Not Detected​

9.0-10.9 U/mL...........Indeterminate - Repeat testing in 10-14 days may be helpful.​

11.0 U/mL or greater....Detected​

 

[Hip]

The criteria Dr Lerner used to diagnose active EBV infection in ME/CFS was elevated VCA IgM and/or EA IgG diffuse (see this study).

You do not have high VCA IgM, and your EA IgG does not seem particularly high, so my guess is that you might be negative by Lerner's criteria.

Confusingly, Prof Montoya had his own EBV criteria, with active infection indicated by high VCA IgG and EA IgG (but he also required high HHV-6 IgG). Your VCA IgG is pretty high, so by Montoya's criteria, perhaps you might be positive. Refs: 1 2

Both used their respective criteria to recruit ME/CFS patients into studies to be treated with antiviral drugs (Valcyte and Valtrex).

 

[Dan_USAAZ]

Both used their respective criteria to recruit ME/CFS patients into studies to be treated with antiviral drugs (Valcyte and Valtrex).

Thanks for the links! I will be getting input from the doctor in the next couple weeks, after more test results come in. I will post any interesting points.
After my wife read your post, she reminded me that the doctor had made the comment that if Montoya saw these results, he would say I was positive.

I have been on long term treatments with both Valtrex and Valcyte over the last 15 years. I also threw in combo treatment with 2 ARVs and Famvir at various times. No cures. The best result came from Valcyte, but decided it would not be healthy to stay on it forever. It lowered my titer to 1:320 and reduced the cognitive fog. Six years was my limit. I felt as if it allowed me to win the battle, but I was losing the war. I was concerned about the possible long term negative affects of Valcyte.