EBV Titers

[Springbok1988]

Hello, everyone!
Every blood test I’ve had has come back normal except the Epstein-Barr Virus panel. In July, my results showed:

VCA Ab IgM: <36 U/mL
<36 = Negative
VCA Ab IgG: 485 U/mL
>21.99 = Positive
EBNA Ab IgG: >600 U/mL
>21.99 = Positive

A negative result on the VCA IgM would indicate that I am not currently experiencing a primary EBV infection. Because they other titers were so high, I requested an EA-D IgG test. The lab messed up and ran the same panel again. In September, VCA IgM was still negative and EBNA IgG was still above 600. The VCA IgG result had increased 110 U/mL to 595 U/mL. When I went in again and finally got the EA-D IgG, it was negative. That would seem to indicate that I also don’t have a reactivation of the virus, either. Without a primary infection or reactivation, why would the capsid IgG have increased so much?

The doctors I’ve been to can’t explain the increase of that titer value or why those two titers are so high without an active infection.

I do have a recurring sore throat and the lymph nodes in my neck have been constantly swollen for a few years now. Thanks for taking the time to read this. I hope everything is going well on your end in this crazy world.

 

[Hip]

Every blood test I’ve had has come back normal except the Epstein-Barr Virus panel.

Have you been tested for coxsackievirus B and echovirus by an antibody test which uses the neutralization method (rather than the ELISA, IFA or CFT methods)?

Dr Chia found that only the neutralization method was sensitive enough to reliably detect the chronic low-level enterovirus infections found in ME/CFS.

VCA Ab IgG: 485 U/mL
>21.99 = Positive

Dr Lerner's and Prof Montoya's criteria for active EBV infection in ME/CFS are slightly different:

Lerner says active EBV infection = high VCA IgM and/or high EA IgG diffuse. Refs: 1 2

Prof Montoya had his own EBV criteria, with active infection indicated by high EBV VCA IgG and EBV EA IgG (but he also required high HHV-6 IgG). Refs: 1 2


Thus by Montoya's criteria, you might be positive for active EBV.

 

[Springbok1988]

I just had my blood drawn to test for coxsackievirus B and echovirus last Thursday. I had the lab send it to ARUP for a neutralization assay.
Thank you for the sources about EBV titers! It’s interesting information. I’ll have to look into it more.

 

[Springbok1988]

Do you know if a PCR for EBV would be helpful?

 

[Hip]

I just had my blood drawn to test for coxsackievirus B and echovirus last Thursday. I had the lab send it to ARUP for a neutralization assay.

When you get your results, do check on the results page that it says ARUP, because LabCorp and Quest frequently make errors, and perform these CVB and echovirus tests in-house, rather than sending the blood samples out to ARUP. Their in-house tests are not neutralization tests, and thus not sensitive enough.

 

[sometexan84]

The VCA IgG result had increased 110 U/mL to 595 U/mL. When I went in again and finally got the EA-D IgG, it was negative.

That doesn't make sense to me.

My first thought was that I'd want to see the actual test results, not that I don't believe you. Another thought is that maybe it was just normal fluctuation from the labs. Maybe if you took it again, VCA would be lower than 585.

 

[Springbok1988]

I’ve attached the labs below. They are a different format because my doctor’s office changed their patient portal. It was the same lab that processed both samples.
I think fluctuations between labs wouldn’t be that large. If so, there would be a lot of false negatives and positives. Thanks for taking a look!

 

[Springbok1988]

I forgot to add my EA-D test:

 

[sometexan84]

Hm, well the EBV result tables I've seen seem to point to either just a past infection, or Burkitt's lymphoma?

Idk, might want to test the EA-R

 

[Pyrrhus]

Without a primary infection or reactivation, why would the capsid IgG have increased so much?

Good question. I don't have a good answer, but it's not unusual to see such fluctuations in test results. Could be due to general immune fluctuations or lab mistakes...

Do you know if a PCR for EBV would be helpful?

I'm not sure, but I kind of doubt it. Since your antibodies are more consistent with past infection, it may be a long shot to try PCR. This doesn't mean there can't be a reactivation somewhere in your body, it just means it will be hard to detect in the blood.

Hope this helps.

 

[Springbok1988]

Thank you everyone, I think my results are odd but I don’t think I have an active EBV infection. I don’t have the symptoms of Burkitt’s lymphoma and it sounds like that comes on rather quickly.
I really appreciate everyone’s input!!!