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Abnormally High EBV levels
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Abnormally High EBV levels

Two weeks ago I was tested for several things due to the following symptoms: fatigue and generalized lymphadenopathy that is painful and lasting for 7 weeks (at this point). The only thing I tested positive for was EBV. However, my levels were extremely high.
EBV early antigen IGG: 124 (positive is greater than 10.9)
EBV AB VCA IGG: >600 (pos is greater than 21.9)
EBV Nuclear antigen AB IGG: >600 (pos is greater than 21.9)

Basically, I have had a reactivation of this virus.
I am extremely scared and concerned because I've read that a compromised immune system causes a reactivation of EBV. In late April, I had an oral sexual encounter with a male of unknown status and I have been very anxious about HIV due to these persistent symptoms. It has been 20.5 weeks since the exposure and I have tested up to 18 weeks with 3rd generation antibody test which was negative and an oral swab Oraquick test yesterday which was negative, too. My question is what else can cause such high levels of reactivation and have any of you had EBV and had lymph nodes swell all over and be tender for so long? Any help would be appreciated.
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Avatar_f_tn
Your results show that you have past infection not active. Just because your antibody level is high just means you have a good immunity to it. It doesn't mean you have reactivation. Did you have a IgM result too for the EA? or VCA? You have been negative with the HIV tests for over 4 months now. So really there is no reason to suspect you have HIV. You can take it at 6 months to finalize that. But if your immune system appears to be working quite well I wouldn't worry. When did you actually get mono for the first time? The lymph nodes take 4 months or so to go down if it was some what recent. But if not it could be due to a variety of things. Any time you have a infection of any kind such as a strep throat, ear infection or a number of other things your lymph nodes can swell. That is their purpose. Try not to worry.
mkh9
mkh9
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Avatar_m_tn
How do those results show past infection not active, I don't understand.
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Avatar_m_tn
This is what I was given as a rule of thumb
Test results most likely indicate the following:
VCA-IgM VCA-IgG EA-D, IgG EBNA, IgG Possible Interpretation
Negative Negative Negative Negative No infection, symptoms due to another cause, susceptible to EBV infection
Positive Positive Negative Negative Early, primary infection
Negative or positive Positive Positive Negative Active infection, though EA-D IgG may persist for life in about 20% of people
Negative Positive Negative Positive Past infection
Negative Positive Positive Positive May indicate reactivation of virus
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Avatar_m_tn
Let me know if you are familiar with this virus, I am trying to learn because I was told I have Chronic Active EBV which I now understand is very rare and I am not sure if the results are right. I am going to see a doctor next week and I would appreciate any information that would help me understand the lab results.
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Avatar_f_tn
Yes that is correct except the EA can be Positive in case #4 and doesn't have to be reactivation. What is EA-D? I haven't seen the D?  is D for Delayed or something? I understand serology and am familiar with the virus. I don't see how you know if you have chronic active EBV. Actually new data suggests that people with Chronic fatigue syndrome may actually have human herpes type 6. Human herpes virus type 6 causes a lot of things so don't worry about that.  EBV is actually in the Herpes family as is CMV and Herpes simplex. But people seem to be more comfortable calling their syndrome chronic EBV  or Chronic fatigue syndrome.  

So how do your results show past infection. IgM is the first antibody produced in infection then it goes down and IgG is produced and remains for life. You can be re-exposed to EBV and your antibody titer may rise (igG not igM) as it is protective. Your high values of IgG just mean you have been exposed to it in the past not an acute or current infection since IgM is not present. Also, with EBV testing it goes like this ; viral capsid antigen IgM appears early in infection and disappears after 4-6weeks.  Anti VCA IgG Appears  2-4 weeks after infection and remains for life. Early antigen IgG acute phase is gone in 3-6 months but like you said 20% remain for life Nuclear antigen is not seen in early acute phase at all. It appears at 2-4 months and remains for life. Does this help?
mkh9
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Avatar_f_tn
My other result was negative. I don't have my paperwork in front of me, but I know it was the IGM for either EA or VCA. The chart provided to me on my lab results stated that this indicated a reactivation. However, I never even knew I had mono in the past. I remember having "walking pneumonia" about two years ago that had me down for several weeks.
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Avatar_f_tn
A lot of kids get mono and don't know they have it. You can sometimes think you have a cold or some virus and not know you have mono.
mkh9
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Avatar_f_tn
Right. I'm not concerned about how I got originally. I'm just curious as to what could have reactivated it.
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Avatar_f_tn
If you have reactivation, stress, getting too tired, a lot of things like that can do it.
mkh9
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Avatar_f_tn
I have definitely been under EXTREME stress and anxiety. I guess the puzzling aspect is that the lymph nodes are small, painful and spread out all over my body in random places. However, different areas hurt more different days. It is almost as if it fluctuates.
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Avatar_f_tn
I'm not sure why your lymph nodes are sore. But if they are not big it doesn't generally mean anything is wrong with them. They have to be a certain site to be clinically significant. Maybe it is really a fibromyalgia kind of thing? Or do you really think it is lymph nodes? As in specific spots. I was just wonder if it is trigge points instead of lymph nodes.
mkh9
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Avatar_f_tn
I meant trigger points.
mkh9
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Avatar_f_tn
I can definitely feel small round "knots" at each place that is painful. They are different sizes depending on where they are. I have them at and around my elbows, one on my knock, on the underside of my bicep, sometimes under my arm, on my thighs, and behind my knees mostly. I also can feel some on my upper abdomen sometimes. None of them are extremely large. However, I am very confident that they are definitely lymph nodes. Also, the pain isn't a soreness, it's more of a burning/sharp pain in each area. It's very hard to describe because I have never experienced anything like it before. I'm going on my 9th week of having the symptoms now. I'm so frustrated and afraid.
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Avatar_f_tn
My GP has me coming in for my 6 month HIV test at the end of this month. She said that I basically have a 1% chance of my symptoms being HIV related, but that's what I am most afraid of having. However, if the 6 month HIV test is negative, she is referring me to an Infectious Disease specialist.
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Avatar_f_tn
I really think she is exaggerating the HIV thing. How is your CD4 count? I guess it can't hurt to see an infectious disease specialist. It would be interesting to see if they can think of anything. Let me know.
mkh9
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Avatar_f_tn
Is the CD4 something you would have to ask for separately? I've had a CBC with differential, test for rheumatoid markers, and urine analysis for different proteins and such. I don't think I have had a test to show my CD4 count. I guess maybe the ID specialist will test me for that? She didn't seem convinced that it is HIV, but she didn't completely rule it out, either.
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Avatar_f_tn
Yes if the Infectious Disease specialist wants to know if your immune system is low he/she can check your CD4 count. It would be very low if you had HIV and some other problems. It is a separate test they don't normally take unless they suspect HIV or something that affects your immune system. So the other doctor much not be worried about it.
mkh9
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Avatar_f_tn
Ok, that's good to know. Thanks for the information. I will let you know how it turns out.
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Avatar_f_tn
OK, take care.
mkh9
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Avatar_f_tn
So boss,how did it turn out? I mean did u test again?
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Avatar_f_tn
I think you may be referring to completellyanxieous. Haven't heard back from that person yet. I'm not getting tested.
mkh9
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Avatar_f_tn
Hey,  I went in yesterday for my 6 month HIV test and had a PCR RNA test. Waiting for the results now. I have an appointment with an ID specialist on the tenth of this month.
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Avatar_f_tn
6 month PCR RNA for HIV was negative. Now, on to other options.
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Avatar_f_tn
Great news. So you shouldn't have to worry about that.
mkh9
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Avatar_f_tn
Wow,wow and wow! Congrats boss. U have proved to us dat its not only HIV dat can cause such symptoms. Thanks so much for sharing with us.
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