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What is the Epstein-Barr virus test?

The Epstein-Barr virus (EBV) is a member of the herpes virus family. It’s one of the most common viruses to infect people around the world.

According to the Centers for Disease Control and Prevention, most people will contract EBV at some point in their lives.

The virus typically causes no symptoms in children. In adolescents and adults, it causes an illness called infectious mononucleosis, or mono, in about 35 to 50 percent of cases.

Also known as “the kissing disease,” EBV is usually spread through saliva. It’s very rare for the disease to be spread through blood or other bodily fluids.

The EBV test is also known as “EBV antibodies.” It’s a blood test used to identify an EBV infection. The test detects the presence of antibodies.

Antibodies are proteins that your body’s immune system releases in response to a harmful substance called an antigen. Specifically, the EBV test is used to detect antibodies to EBV antigens. The test can find both a current and past infection.

Your doctor may order this test if you show any of the signs and symptoms of mono. Symptoms typically last for one to four weeks, but they can last up to three to four months in some cases. They include:

Your doctor may also take into account your age and other factors when deciding whether or not to order the test. Mono is most common in teens and young adults between the ages of 15 and 24.

The EBV test is a blood test. During the test, blood is drawn at your doctor’s office or at an outpatient clinical laboratory (or hospital lab). Blood is drawn from a vein, usually on the inside of your elbow. The procedure involves the following steps:

  1. The puncture site is cleaned with an antiseptic.
  2. An elastic band is wrapped around your upper arm to make your vein swell with blood.
  3. A needle is gently inserted into your vein to collect blood in an attached vial or tube.
  4. The elastic band is removed from your arm.
  5. The blood sample is sent to a lab for analysis.

Very little (or even zero) antibodies may be found early in the illness. Therefore, the blood test may need to be repeated in 10 to 14 days.

As with any blood test, there’s a slight risk of bleeding, bruising, or infection at the puncture site. You may feel moderate pain or a sharp prick when the needle is inserted. Some people feel light-headed or faint after having their blood drawn.

A normal result means that no EBV antibodies were present in your blood sample. This indicates that you’ve never been infected with EBV and don’t have mono. However, you can still get it at any point in the future.

An abnormal result means that the test has detected EBV antibodies. This indicates that you’re currently infected with EBV or have been infected with the virus in the past. Your doctor can tell the difference between a past and a current infection based on the presence or absence of antibodies that fight three specific antigens.

The three antibodies the test looks for are antibodies to viral capsid antigen (VCA) IgG, VCA IgM, and Epstein-Barr nuclear antigen (EBNA). The level of antibody detected in the blood, called the titer, doesn’t have any impact on how long you’ve had the disease or how severe the disease is.

  • The presence of VCA IgG antibodies indicates that an EBV infection has occurred at some time recently or in the past.
  • The presence of VCA IgM antibodies and the absence of antibodies to EBNA mean that the infection has occurred recently.
  • The presence of antibodies to EBNA means that the infection occurred in the past. Antibodies to EBNA develop six to eight weeks after the time of infection and are present for life.

As with any test, false-positive and false-negative results do happen. A false-positive test result shows that you have a disease when you actually don’t. A false-negative test result indicates that you don’t have a disease when you really do. Ask your doctor about any follow-up procedures or steps that can help make sure your test results are accurate.

There are no known treatments, antiviral drugs, or vaccines available for mono. However, there are things you can do to ease your symptoms:

  • Stay hydrated and drink a lot of fluids.
  • Get plenty of rest and avoid intensive sports.
  • Take over-the-counter pain relievers, such as ibuprofen (Advil) or acetaminophen (Tylenol).

The virus can be hard to treat, but symptoms usually resolve on their own in one to two months.

After you recover, EBV will remain dormant in your blood cells for the rest of your life.

This means that your symptoms will go away, but the virus will stay in your body and can occasionally reactivate without causing symptoms. It’s possible to spread the virus to others through mouth-to-mouth contact during this time.