Epstien-Barr Viruse

Epstein-Barr virus (EBV) antibodies are a group of tests that are requested to help diagnose a current, recent, or past EBV infection.

EBV is a member of the herpes virus family. Passed through the saliva, the virus causes an infection that is very common. As many as 95% of people in the United Kingdom will have been infected by EBV by the time they are 40 years old. After exposure to the virus, there is an incubation period of several weeks. After recovery from this initial infection the virus remains dormant (‘sleeping’) in the body for the rest of a person’s life. EBV can reactivate from time-to-time during a person’s life, but causes few problems unless the person’s immune system is significantly weakened.

Most people catch EBV infection in childhood and experience few or no symptoms, even during the infection. However, when the initial infection happens during adolescence, EBV can cause a glandular fever illness. This happens in about 35 – 50% of those infected at this age. Glandular fever commonly causes: tiredness, fever, sore throat, swollen lymph nodes, an enlarged spleen. Less commonly it can also cause: an enlarged liver or hepatitis, rash. Those who have glandular fever usually have symptoms for a month or two before the infection gets better. A few people can have symptoms that last many months, but this is uncommon.

A doctor will suspect glandular fever based on a person’s symptoms. A full blood count (FBC) test will be done and usually shows clues that suggest EBV. For example the lymphocyte count is usually high and the lymphocytes may have an unusual appearance when the blood is looked at down a microscope. These findings on FBC are called ‘atypical lymphocytosis’. Although healthy people will recover from glandular fever due to EBV infection it is important to make the right diagnosis. For instance, the enlarged spleen of those with an EBV infection is vulnerable to rupture (bursting). Patients who have glandular fever should not be involved in contact sports for several weeks to months after infection, as a ruptured spleen can be a medical emergency.

It is also important to distinguish EBV from other illnesses that have similar symptoms. For example, cytomegalovirus (CMV), toxoplasmosis, and HIV can also cause a glandular fever-like illness. Because these infections can be very hard to tell apart, many laboratories will check for all these infections at the same time as testing for EBV. It is especially important to look for these other infections in pregnant women. This is because EBV infection has not been shown to affect the baby, but cytomegalovirus (CMV), or toxoplasmosis infection can cause complications during the pregnancy and may damage the growing baby.