From the Guidelines
The EBV test results indicate a past EBV infection that is not currently active, with elevated EBV Viral Capsid IgG and EBV Nuclear Antigen IgG antibodies, and negative EBV Viral Capsid IgM, EBV Early Antigen IgG, and Heterophile IgM, suggesting a previous infection that has been cleared by the body. The elevated EBV Viral Capsid IgG (6.8) and EBV Nuclear Antigen IgG (2.9) antibodies are markers of previous infection, as these antibodies typically remain positive for life after exposure, as noted in the guidelines for diagnosing EBV infection 1. The negative EBV Viral Capsid IgM (0.2), negative EBV Early Antigen IgG (<0.2), and negative Heterophile IgM (0.8) all suggest this is not an acute or recent infection.
This pattern is consistent with someone who had mononucleosis or an EBV infection sometime in the past, likely months to years ago. The proposed guidelines for diagnosing chronic active EBV infection also support this interpretation, as they recommend the use of EBV antibody testing, including IgG and IgM to viral capsid antigen (VCA) and Epstein-Barr nuclear antigen (EBNA), to differentiate EBV infection from other mononucleosis-like illnesses 1. No specific treatment is needed for past EBV infections as the body has already cleared the active virus. These results simply confirm previous exposure to EBV, which is extremely common, with over 90% of adults worldwide having been infected at some point in their lives.
Some key points to consider in the interpretation of these results include:
- The presence of EBV antibodies, such as VCA-IgG and EBNA-IgG, which are typically positive for life after exposure 1
- The absence of EBV IgM antibodies, which suggests that the infection is not acute or recent 1
- The use of EBV antibody testing to differentiate EBV infection from other mononucleosis-like illnesses 1
- The fact that past EBV infections do not require specific treatment, as the body has already cleared the active virus.
From the Research
Interpretation of EBV Serological Results
The provided serological results show:
- EBV Viral Capsid IgG: 6.8 High
- EBV Viral Capsid IgM: 0.2
- EBV Nuclear Antigen IgG: 2.9 High
- EBV Early Ag IgG: <0.2
- EBV Heterophile IgM: 0.8
Serological Patterns and Infection Status
According to 2, the presence of VCA IgG and EBNA-1 IgG without VCA IgM is typical of past infection. In this case, the high levels of VCA IgG and EBNA-1 IgG, along with low levels of VCA IgM, suggest a past EBV infection.
Diagnostic Challenges and Solutions
As noted in 3, the interpretation of EBV serologies can be challenging due to the various possible serological patterns. However, the use of multiple markers, such as VCA IgG, VCA IgM, and EBNA-1 IgG, can help to define the infection status. In this case, the results are consistent with a past infection.
Assay Performance and Concordance
Studies have evaluated the performance of various EBV antibody assays, including the Architect EBV antibody panel 4, 5, 6. These studies have shown high concordance and good performance of the assays in detecting EBV antibodies and categorizing infection status.
Key Findings
- The presence of high VCA IgG and EBNA-1 IgG levels, along with low VCA IgM levels, is consistent with a past EBV infection 2.
- The use of multiple markers can help to define the infection status and solve diagnostic challenges 3.
- The Architect EBV antibody panel has been shown to have high performance and concordance with other assays 4, 5, 6.