My EBV test results interpretation

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I received results of EBV test. My question: Could be normal for healthy individual that EBV-VCA-IgG-ab is increased 10 times or could be that a strong indication that this is the cause of my fatigue? I know that more than half people have been infected with EBV in life and most of them don't have any problems. I am wondering if this group of people that don't have any problems could also have such big increased in IgG.

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I received results of EBV test. My question: Could be normal for healthy individual that EBV-VCA-IgG-ab is increased 10 times or could be that a strong indication that this is the cause of my fatigue? I know that more than half people have been infected with EBV in life and most of them don't have any problems. I am wondering if this group of people that don't have any problems could also have such big increased in IgG.

View attachment 43724
IgG titers increase after an infection. Then decrease slowly and stabilize (life-long).
Some ME experts think that high IgG (I think it was Learner who said 8x the reference) indicate an active infection and treats it with antivirals. Afaik, there is no evidence for it. I had my titers interpreted by an infectious disease specialist years ago and he said if they (IgG) would rise again, that would be an indicator for reactivation.
But to know this, you have to monitor your IgG.

You could also call the lab and/or do a Western Blot to be sure!
 
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From what my immunologist explained to me, Early Antigen IgG is really the one to look at in most cases, unless it's a new infection in which case IgM will be elevated. Supposedly EA IgG elevates only in response to EBV actively replicating. In your case, EA IgG is equivocal, which is kind of unhelpful, though since your other IgG are unequivocally positive (and rather high), and presumably you have symptoms which match EBV reactivation, I'd lean towards saying it's at least a factor. Taking something like famciclovir for EBV is pretty low risk, so you might as well give it a shot even if the test results are only suggestive and not 'proof', per se.
 

ljimbo423

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Could be normal for healthy individual that EBV-VCA-IgG-ab is increased 10 times or could be that a strong indication that this is the cause of my fatigue?
It's common for healthy people to have high EBV antibodies and no symptoms. Ron Davis found healthy controls to be positive for EBV through PCR testing and yet they had no symptoms.

I don't think anyone can give you any definite answer to weather your high antibody levels are causing your symptoms, even specialists disagree on what an EBV reactivation is (ie. what level of antibodies are considered a reactivation).

I wish I could give you a better answer but I don't think there is one. Look at the number of healthy controls here that have high EBV antibodies and yet no symptoms-

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https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC5778394/
 

Hip

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Dr Martin Lerner says ME/CFS patients have an active EBV infection if there are high antibody levels in the VCA IgM and/or EA IgG diffuse tests. Refs: 1 2

In your case, neither of these are high.


But ME/CFS is linked to several viruses, so you might find you have chronically high antibody levels to another one of these ME/CFS viruses.
 

5vforest

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Personally I have not just antibodies but also a positive PCR, and even then, my doctor (an ME/CFS specialist) won't really commit one way or the other about its significance.
 

Hip

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Personally I have not just antibodies but also a positive PCR, and even then, my doctor (an ME/CFS specialist) won't really commit one way or the other about its significance.
Have you seen the PR threads talking about a study which found spironolactone is effective for EBV ME/CFS?
 

5vforest

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Have you seen the PR threads talking about a study which found spironolactone is effective for EBV ME/CFS?
I have briefly read. Thanks for reminder, I will go look again. I was considering asking my doctor to try it.
 
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Learner1

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I received results of EBV test. My question: Could be normal for healthy individual that EBV-VCA-IgG-ab is increased 10 times or could be that a strong indication that this is the cause of my fatigue? I know that more than half people have been infected with EBV in life and most of them don't have any problems. I am wondering if this group of people that don't have any problems could also have such big increased in IgG.

View attachment 43724
It might be prudent to request a EBV PCR test and then you would know for sure. The chart that @godlovesatrier posted is for immunocompetent people, and has led more than one patient to be dismissed when they actually have an active EBV infection.

If you have the positive antibodies and a positive PCR it's hard to argue that you shouldn't be treated. I never had a positive EA or EBNA, only high VCA IGG and positive EBV PCR. My doctor who is a top ME/CFS specialist and who was an AIDS doctor for many years Said he'd never seen my exact combination of results, but I definitely had it and he treated me, and my brain fog cleared in fatigue improved.
Personally I have not just antibodies but also a positive PCR, and even then, my doctor (an ME/CFS specialist) won't really commit one way or the other about its significance.
In this case, a positive PCR test is a sign that you have an active infection. Valacyclovir, valgoncyclovir, or famvir are the typical drugs used, and taking lysine, zinc, and vitamin C may also be good ideas.
Dr Martin Lerner says ME/CFS patients have an active EBV infection if there are high antibody levels in the VCA IgM and/or EA IgG diffuse tests. Refs: 1 2

In your case, neither of these are high.
Current practice is different, and running a PCR and looking at the combination of all of the antibodies are used.

I agree with @DrUniverse and @katabasis that you should probably get treatment.
 
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