What to know about Epstein-Barr virus testing
The Epstein-Barr virus is very common and most people are affected by it at some point in their lives.
The Epstein-Barr virus is highly contagious, and people contract it through contact with saliva or other bodily fluids. When a person has contracted the virus once, it remains dormant in the body and can reactivate at any time.
In children, the virus often does not cause any symptoms. However, in teens and adults, it may cause mono, or mononucleosis, and can be associated with other illnesses, including some types of cancer.
The symptoms of Epstein-Barr virus infection are similar to symptoms of several other illnesses. Because of this similarity, doctors may recommend an Epstein-Barr virus test, or EBV test, to see if a person has a current or past Epstein-Barr virus infection.
The symptoms of Epstein-Barr virus infection include:
In some cases, a person's liver or spleen may also swell and become enlarged.
What is the Epstein-Barr virus test?
The Epstein-Barr virus test is used to identify the presence of certain antibodies.
When a person has Epstein-Barr virus, their body's immune system releases proteins, known as antibodies, to fight off the virus. The Epstein-Barr virus test checks their blood for these Epstein-Barr virus antibodies through a simple blood draw.
The presence of these antibodies would confirm that someone has had Epstein-Barr virus in the past or currently has an active infection.
How is the test performed?
A medical technician performs an Epstein-Barr virus antibody test the same way they would do any other simple blood test. No preparation is required.
A technician will use the following steps:
- check the arm for a suitable vein from which to draw the blood
- clean the area with antiseptic
- wrap an elastic band around the upper arm, causing the vein to swell with blood
- use a small needle to collect a sample of blood
- remove the needle and apply gauze over the injection site to prevent bleeding
The blood will be sent to a laboratory to check for the presence of the Epstein-Barr virus antibodies.
When should a person be tested?
A sore throat or stiff neck can be symptoms of mononucleosis.
A doctor may recommend a person be tested for the Epstein-Barr virus if they exhibit symptoms of the infection or mononucleosis, particularly if they have already tested negative for mononucleosis.
The symptoms may include:
- swollen glands
- stiff neck
- sore throat
- enlarged spleen
A doctor is more likely to order this test if a person is in their teens or early 20s.
Understanding the results
The results of the Epstein-Barr virus test can come back as either 'normal' or 'non-normal.'
If the results come back as 'normal,' this means that the lab did not detect any Epstein-Barr virus antibodies in the blood. In this case, it is unlikely that the person has Epstein-Barr virus or mononucleosis.
When the test is done too soon after infection, there may not be enough antibodies in the blood to trigger a positive result. So if a person's symptoms continue and a doctor cannot find another cause, the test may need to be redone after 2 weeks.
If the test results are normal, a person may still contract the Epstein-Barr virus at some point in the future.
If the results of the Epstein-Barr virus are 'non-normal,' it means the lab has detected any one of three or a combination of Epstein-Barr antibodies. These antibodies give doctors information about when the virus occurred:
- If the antibody called VCA IgG is present, the Epstein-Barr virus has occurred at some time recently or in the past.
- If the VCA IgM antibody is present without the Epstein-Barr nuclear antigen (EBNA), the virus is likely to be currently active or occurred very recently.
- If the antibody to EBNA is present, this means the virus was contracted at least 6 to 8 weeks previously, but possibly longer, as this antibody takes some time to develop after infection and remains in the body for life.
It is important to stay hydrated when treating symptoms of the Epstein-Barr virus.
There are no medical treatments for Epstein-Barr virus or mononucleosis. However, a doctor may recommend the following to ease a person's symptoms:
- Get plenty of rest.
- Avoid strenuous activity until the symptoms resolve.
- Drink lots of fluids to stay hydrated.
- Ease sore throats with acetaminophen or ibuprofen.
- Gargle with salt water several times per day.
People with an active case of mononucleosis may feel better more quickly if they reduce their activities until the illness resolves. Doing too much too soon can lead to a relapse or longer recovery time.
Heavy lifting or strenuous activities can increase the risk of rupturing the spleen, a rare but life-threatening complication of mononucleosis.
The Epstein-Barr virus affects people differently. Some people, especially children, may not be aware that they have the virus, while others may have symptoms for weeks or months.
Usually, symptoms resolve from an active Epstein-Barr infection or mononucleosis after 1 to 2 months. After a person recovers, the virus remains dormant in the body, and an Epstein-Barr virus antibody test will still work. The virus can reactivate at any time but usually will not cause symptoms if it does.
While most people with Epstein-Barr virus recover, there may be a link between Epstein-Barr virus and chronic illnesses and cancers, including Burkitt's lymphoma and Hodgkin's lymphoma.
In rare cases, the Epstein-Barr virus may remain active and lead to long-lasting symptoms.