Epstein-Barr Virus (EBV) Antibody Profile

Epstein-Barr (EB) virus is a herpes group virus that is ubiquitous. It is the cause of classic infectious mononucleosis and is causally implicated in the pathogenesis of Burkitt lymphomasome nasopharyngeal carcinomasand rare hereditary lymphoproliferative disorders. The serologic response to EB virus includes antibody to early antigenIgM and IgG antibodies to viral capsid antigen (VCA)and antibodies to Epstein-Barr nuclear antigen (EBNA).

Although most cases of infectious mononucleosis can be diagnosed on the basis of clinical findingsblood count and morphologyand a positive test for heterophile antibodyas many as 20% may be heterophile-negativeat least at presentation (Heterophile may become positive when repeated in a few days). In some of these casesa test for Epstein-Barr virus antibodies may be useful.

The most controversial use of EBV serology is in chronic fatigue syndromea complaint predominantly (but not exclusively) of young to middle-aged womencharacterized by long persistent debilitating fatigue and a panoply of usually mild somatic complaints. The high levels of EBV antibodies in the general populationtheir long persistenceand the poor correlation of antibody titers with symptoms combine to make EBV serology useless in diagnosingfollowingor ruling out chronic fatigue syndrome. See table.

*Results indicate infection with EBV at some time however cannot predict the timing of the infection since antibodies to EBNA usually develop after primary infection oralternativelyapproximately 5-10% of patients with EBV never develop antibodies to EBNA.