How can the Epstein-Barr virus be detected in the body. Epstein-Barr virus (EBV): symptoms, treatment, what diseases it causes

Epstein-Barr virus (EBV) is one of the pathogens of the herpesvirus family. It is transmitted in several ways:

airborne;
contact-household, through kisses and common dishes;
blood transfusion or organ transplant;
during pregnancy and childbirth from a sick mother to a child.

After entering the body, the virus primarily affects the mucous membranes of the mouth and nose. It then enters the bloodstream and spreads throughout the body. Its main difference from other types of herpes is the preservation of the cell and the stimulation of the growth of similar cells.

In response, the immune system destroys infected cells with the help of T-lymphocytes. Due to this process, the lymph nodes increase in size.

If a person's immunity is weak, then EBV becomes chronic or latent, affecting the salivary glands, liver and spleen. If a person has previously had chickenpox, then in his body there are antibodies that react to the presence of the virus and partially suppress it. But such cases rarely occur. Therefore, infection leads to infectious mononucleosis, which is successfully treated.

Developed antigens to EBV keep it inside the infected B-lymphocytes. And for most of its stay in the body, it is in a latent state. Weakened immunity leads to a relapse of the disease and turns a person from a passive carrier of the virus into an active source of infection.

Diseases and their symptoms

The main cause of EBV is infectious mononucleosis. In terms of symptoms, it is very similar to a cold or sore throat. It is characterized by a gradual increase in temperature, muscle pain, sore throat, general malaise, lack of appetite.

Serious illnesses result from the activation of the virus nervous system: meningitis, encephalitis, meningoencephalitis. They may be accompanied by a rash in the form of papules, redness, small subcutaneous hemorrhages. If the therapy is chosen correctly and at the right time, then these complications disappear without a trace.

EBV infects lymphatic tissue. This process is called polyadenopathy. The main symptom of this disease is a significant increase in the lymph nodes located on the neck, in the collarbone, in the groin. The inflammation is accompanied by pain.

The virus can also infect the tonsils and cause tonsillitis, which manifests itself with characteristic symptoms:

heat;
pus on the tonsils;
general intoxication of the body;

Hodgkin's disease may also appear, as a result of which malignant formations (tumors) occur in the lymph nodes, accompanied by severe poisoning by the decay products of inflamed body tissues, severe headaches, weakness and fatigue. Close nodes can unite with each other into larger neoplasms.

Hairy leukoplakia can also be a confirmation of the lack of immunity. It is accompanied by the formation of white growths in the oral cavity, which eventually transform into plaques.

In addition to these diseases, EBV causes many others:

generalized infection on the background of HIV/AIDS;
systemic hepatitis;
blood infection or cancer;
chronic fatigue syndrome;
cancerous tumors of the digestive organs of the upper circle and the oral cavity;
arthritis;
diabetes;
multiple sclerosis;
allergy.

Diagnostic methods and interpretation of results

Several types of blood tests are used to determine EBV in the body:

general;
biochemical;
enzyme immunoassay (ELISA);
polymerase chain reaction(PCR).

The first method is considered the basic analysis in the diagnosis of any disease. If the results confirm an increase in the number of platelets and lymphocytes and a simultaneous decrease in the number of red blood cells and hemoglobin levels, then they are an indirect symptom of the activity of the virus in the body.

The second method allows you to monitor the current state of internal organs. Since EBV affects the liver, special attention is paid to changing the amount of enzymes and proteins secreted by it. These include transaminases, bilirubin, alkaline phosphatase. Their control helps prevent the development of jaundice as a consequence of toxic hepatitis.

The third method examines the presence in the blood of antibodies to virus molecules, called antigens. There are 3 types in total:

EA, early antigen;
VCA, capsid antigen;
EBVA is a nuclear antigen.

For each antigen in the body, immunoglobulins of 2 classes are formed - IgG and IgM.

Detection of IgG to EA indicates primary infection and acute course of the disease. It is present in the blood until the symptoms disappear completely. Its reappearance indicates a relapse or chronic form of the disease.

IgM antibodies to EA appear in the first week and disappear at 8-12 weeks after the onset of the first symptoms. If the period of their presence in the blood exceeds this value, then this indicates the transition of the disease to a chronic form. Re-detection signals a secondary development of infection.

The presence of IgM antibodies to VCA (capsid protein antigen) signals the onset of the acute phase of the disease. They also appear in case of relapse. Their prolonged presence in the blood is a symptom of a chronic form of the disease.

The detection of antibodies of the IgG class to the capsid protein indicates that EBV is active for 8 weeks after the initial infection. Also, this indicates that a person has immunity to this strain.

Antibodies of the IgG type to the nuclear or nuclear antigen (EBNA) appear closer to the stage of the patient's recovery. They remain in the blood for a long time.

If there are no antibodies to the nuclear antigen of the IgG class in the blood, but there is IgM against the capsin protein, then this indicates an acute development of the infection.

In addition to IgG and IgM, the designation IgA is sometimes present in the form with the results. It indicates a latent or chronic form of the disease in the absence of IgM class antibodies.

Depending on the method used by the laboratory, a quantitative value called the antigen avidity index may be present in the table with the results of the study. It is measured as a percentage and allows you to determine the time elapsed since the onset of infection.

The use of enzyme immunoassay for diagnosis in children is ineffective. This is due to the fact that their immune system reacts to the pathogen very slowly.

Polymerase chain reaction is a procedure during which virus DNA is isolated from any biological fluid of a patient and compared with an extensive virus base. This method is accurate, but ineffective at the initial stage of the disease. If you take the material for analysis during this period of time, the result will be false negative.

A positive result of such an examination is a strong argument for making a final diagnosis. Also, this method allows you to detect EBV in the body of a child.

Preparation for the procedure

To improve the accuracy of blood tests, you need to fulfill a few simple requirements:

hand over the sampling of materials on an empty stomach;
fatty foods, alcohol and smoking should be avoided 12 hours before the procedure;
stop taking antiviral drugs and antibiotics;
children under 5 years of age drink warm boiled water 30 minutes before donating blood.

False results

All research methods are not 100% accurate. Therefore, when detecting EBV, errors can occur. The main reason may be an early examination, when the infection is in a state of development. In this case, a second examination after 14 days is usually prescribed.

Another obstacle to an accurate result is the presence of a related strain - cytomegalovirus or herpesvirus type 6.

The impact of the disease on the body of a pregnant woman and fetus

Before a planned pregnancy, a woman should undergo an examination that finds out the current state of immunity. If antibodies of the IgG class were detected, this means that EBV reactivation is unlikely during pregnancy. And it is advisable not to ignore tests confirming the presence of IgM class antibodies, and it is better to wait for a complete recovery before conception.

The presence of an active form of EBV in the body of a future mother can cause the following fetal pathologies:

stillbirth;
miscarriage or premature birth;
pathology of the development of the nervous system;
uterine bleeding, sepsis.

The Epstein-Barr virus is the cause of many diseases affecting the work of all systems and organs. For its detection, enzyme immunoassay and polymerase chain reaction are used. If antibodies to the Epstein-Barr IgG class are found in the blood during the first, then this positive result means that the person has an acute disease, but he has immunity to this strain. The interpretation depends on which antigen antibodies have arisen against.

Epstein-Barr virus (EBV infection) is one of the newest terms in medicine. And although 90% of the population or more are infected with EBV infection, there is still no complete information about the effect of the virus on the body.

You can live your whole life without even knowing about its presence, or you can learn about infection when a serious illness is detected.

So, the Epstein-Barr virus: a fashionable diagnosis that pulls money for expensive drugs, or a really serious problem that requires increased attention?

Epstein-Barr virus - what is it?

Epstein-Barr virus is a microorganism from the herpes virus family called herpes type 4. The virus invades B-lymphocytes, but does not destroy them, but transforms them.

Herpesvirus type 4 is spread exclusively among people (including patients with asymptomatic forms of infection) in the following ways:

Airborne - when saliva or mucus enters from the patient's nasopharynx;
Sexual and blood transfusion - through sexual contact or blood transfusion / bone marrow transplantation from an infected person;
Intrauterine - EBV disease in a woman during pregnancy leads to the formation of malformations in the fetus (earlier contact with the infection does not pose such a serious threat to the fetus).

Features of EBV infection:

Infection usually occurs during infancy (when kissing the mother).
Although EBV is contagious, infection occurs only through close contact between an infected person and a healthy person. That is why the disease is called the kissing disease.
Typical symptoms of the Epstein-Barr virus in children are frequent colds and inflammation of the upper respiratory tract (sinusitis, tonsillitis, rhinitis), which are difficult to treat traditionally.
In adults, the presence of EBV infection can be suspected with constant fatigue, weakness in the morning. It is herpetic infection that most often provokes chronic fatigue syndrome.

Recent medical studies have shown that the Epstein-Barr virus can trigger processes in the body that lead to severe and sometimes incurable diseases:,.

The virus, initially affecting the lymphoid tissue (B-lymphocytes) and epithelial cells of the salivary glands and nasopharyngeal region, can multiply to a minimum and not show external symptoms for a long time (latent course).

The impetus for active reproduction is any condition that causes immune weakness and an inadequate immune response (autoimmune reaction). An imbalance in the immune system - a decrease in the level of T-lymphocytes and an increase in B-lymphocytes - further provokes serious disturbances in the division and maturation of cells of various organs and often leads to cancer.

EBV infection can occur:

Acute and chronic;
With typical and latent (asymptomatic form) manifestations, lesions of various internal organs;
According to the mixed type - most often in combination with cytomegalovirus.

Diseases caused by the Epstein-Barr virus

EBV infection manifests itself in three scenarios: primary infection against the background of immunodeficiency, sluggish current infection, or activation of latent EBV infection with a sharp decrease in immune defense (surgery, colds, stress, etc.). As a result, the virus can provoke:

Hodgkin's lymphoma () and its non-Hodgkin's forms;
nasopharyngeal carcinoma;
herpes of the skin and mucous membranes - herpetic eruptions on the lips, herpes zoster,;
chronic fatigue syndrome;
Burkitt's lymphoma - a cancerous tumor that affects the jaw, kidneys, retroperitoneal lymph nodes and ovaries;
oncology of the digestive tract;
leukoplakia - the appearance of white spots on the skin and mucous membranes, while their high bleeding is noted;
severe damage to the liver, heart and spleen;
autoimmune diseases - lupus erythematosus, rheumatoid arthritis,;
blood diseases - pernicious anemia, leukemia,.

Varieties of EBV infection

The Epstein-Barr virus produces several specific proteins (antigens):

Capsid (VCA) - antigen to the internal protein content of the herpes virus;
Membrane (MA) - protein agents aimed at the shell of the viral substance;
Nuclear (EBNA) - an antigen that controls the reproduction of the virus and prevents its death.

In response to antigenic synthesis, the immune system produces antibodies to the Epstein-Barr virus, which serve as an indicator of the stage of the disease. Their presence in the blood and the amount varies depending on the stage of the disease:

In the absence of infection- antibodies to herpes type 4 IgM - less than 20 U / ml, IgG - less than 20 U / ml.

At an early stage of the disease- only antibodies to the capsid antigen of the Epstein-Barr virus (anti-VCA IgM more than 40 U / ml) are detected. The maximum indicators are reached for 1-6 weeks. from the onset of the disease, and their normalization takes 1-6 months. The presence of IgM in the blood indicates an active infection.

In case of acute- antiproteins to VCA IgM and VCA IgG appear. Caspid antibodies of the IgG class in Epstein-Barr virus in the acute phase are positive and show more than 20 U / ml and reach a maximum value by 2 months from the onset of the disease, decrease during the recovery process (several more years may be detected).

The more acute the infection during the primary infection, the higher the titer of anti-VCA IgG.

In the persistent stage- all types of antibodies are synthesized (VCA IgM, VCA IgG and EBNA IgG). The appearance of IgG-class antibodies to the EBNA nuclear protein antigen indicate the onset of regression of the disease and a speedy recovery. Their titer increases by 3-12 months. diseases and continues to be maintained at high numbers for several years.

In the absence of painful symptoms of anti-EBNA IgG in the blood, the fact of a previously transferred disease is ascertained, possibly in an asymptomatic form.

Epstein-Barr virus symptoms

Symptoms of infection with the Epstein-Barr virus, the duration of the course of the disease - depends on the form of the disease and the direction of the viral "strike".

Primary infection can go asymptomatically into the carrier phase, signs of viral presence are detected only with a serological blood test.

With an erased course, the traditional treatment of ARVI in children with the Epstein-Barr virus does not bring a quick recovery.

In other cases, an acute disease occurs with severe symptoms or a sluggish infection with a chronic pathological abnormality. Sometimes a generalized form develops with severe damage to organs and systems.

Infectious mononucleosis

From infection to the appearance of the first signs of the disease, 5-45 days pass. The main symptoms of mononucleosis:

Catarrhal phenomena - looseness of the tonsils and hyperemia of the palatine arches (symptoms of tonsillitis), clear or purulent discharge from the nose, ulcerative stomatitis.
Intoxication - from the first days of the disease, significant hyperthermia (above 38C), chills, joint pain, weakness. A similar picture persists for 1-4 weeks.
Enlarged lymph nodes - are found after 7 days from the onset of the disease, painless and dense. Palpated in the neck: occipital, submandibular, axillary, sub- and supraclavicular.
An increase in the liver - by 2 fingers (detected by tapping) a week later from the appearance of the first signs of the disease. Accompanied by abdominal pain, lack of appetite, nausea, jaundice (yellowish skin and sclera, discolored stools, dark urine).
Enlargement of the spleen - significant splenomegaly is accompanied by pain in the left side.

Recovery occurs not earlier than 2-3 weeks. With a gradual improvement in well-being, periods of exacerbation of the disease can be observed. Periodic return of symptoms indicates a weak immune system. Recovery can take up to 1.5 years.

chronic fatigue syndrome

A striking example of the symptoms of a sluggish current EBV infection. Patients constantly complain of weakness, even after a full sleep. Temperature up to 37.5ºС without apparent reason, headache, muscle and joint pain are often perceived as a cold.

At the same time, this state continues for a long time, and against the background bad sleep and mood swings, the exhausted body reacts with depression or psychosis.

The performance of adults also suffers markedly. In children, there is a pronounced decrease in memory, absent-mindedness and an inability to concentrate.

Generalized EBV infection

A generalized lesion by the virus occurs against the background of a significant failure of the immune system. After an acute course of infectious mononucleosis, the following may develop:

severe pneumonia accompanied by respiratory failure;
inflammation of the membranes of the heart (fraught with cardiac arrest);
, encephalitis (threat of cerebral edema);
toxic hepatitis and liver failure;
rupture of the spleen;
DIC (intravascular blood coagulation);
lymph nodes throughout the body.

Often, the generalization of EBV infection is accompanied by a bacterial attack, which leads to and is fraught with death.

For the complete elimination of EBV, no specific drugs have been created. Treatment for Epstein-Barr virus comes down to weakening the infection, balancing the immune system, and preventing complications. Drug therapy depends on the type of immune response to a viral attack and includes:

Antiviral drugs - Granciclovir, Valaciclovir, Famciclovir, Aciclovir (the least effective), the course is at least 2 weeks;
Interferons and immunoglobulins - Reaferon is the most effective;
Thymus hormones (Timalin, Timogen) and immunomodulators (Dekaris, Likopid) - an increase in the level of T-lymphocytes and a decrease in B-cells);
Corticosteroids (Prednisolone, Dexamethasone) and cytostatics - with an autoimmune reaction.

At the same time, symptomatic treatment and antibiotic therapy or Cefazolin (according to indications) are carried out. Be sure to observe a healthy sleep schedule, good nutrition, avoid alcohol and avoid stressful situations.

The effectiveness of treatment is confirmed by the normalization of blood serology.

Forecast

For most patients who have Epstein-Barr virus, the prognosis is favorable. You should only be attentive to your health and not delay consulting a doctor if signs of malaise appear.

The main criterion for success and prevention of severe consequences is the maintenance of immunity at a sufficient level.

By herpes, we are accustomed to understand unaesthetic painful blisters on the face in the area of the lips, which subsequently form brown crusts. Alas, this is only one of the faces of the herpes virus, which in humans can occur in 8 guises. What we commonly refer to as herpes is the type 1 virus, or herpes simplex virus. The 2nd type of virus causes genital herpes, the 3rd - "chickenpox" and shingles, the 4th - infectious mononucleosis and several other rather dangerous pathologies, etc. This list can go on and on, but we will focus on herpesvirus type 4, which is otherwise called the Epstein-Barr virus. Let's try to figure out what the type 4 herpes virus is, why it is dangerous, when and why they are tested for the Epstein-Barr virus, and what the results of laboratory tests say.

What is herpes virus type 4?

Herpesvirus type 4, as one of the varieties of herpes infection, was described 53 years ago by the English virologist Michael Epstein. His graduate student Yvonne Barr helped the professor work on the project. It is to these people that the virus owes its name. However, already 15 years after the discovery of the virus, its scientific name was changed to human herpesvirus 4, and a year ago the virus was called human type 4 gamma virus.

But what is the Epstein-Barr virus? Like any other virus, the virion (viral particle) of type 4 herpesvirus consists of genetic material (in this case, double-stranded DNA) and the surrounding protein coat (capsid). Additionally, the virus is surrounded by a membrane that helps it to easily enter the host cells.

Any virus is a non-cellular form, which is an infectious factor and cannot develop and multiply outside the cells of a living organism. The epithelial cells of the nasopharynx are considered a favorite habitat for type 4 herpesvirus. They do not disdain leukocytes either, preferring one of their varieties, called B-lymphocytes. It is B cells that are actively involved in providing the immune defense of the body. Upon contact with an antigen, which in our case is the herpes virus type 4 (more precisely, its antigens), B-lymphocytes produce antibodies (immunoglobulin proteins). It is they that can be detected in the patient's blood by analyzing the Epstein-Barr virus (EBV).

In the herpes virus of the fourth type, 4 antigens are isolated, which appear strictly in a certain sequence:

EA is an early antigen that appears at the initial stage of the disease, when viral particles are in the synthesis stage (primary acute infection or reactivation of a latent virus with a decrease in immunity),
VCA is a capsid antigen that is contained in a protein shell and also belongs to the early ones, because clinically the disease in this period may not even manifest itself,
MA - membrane antigen, appears when the virion is already formed,
EBNA - nuclear (polypeptide or nuclear) antigen is one of the late antigens, antibodies to which can be detected even several months after the illness and remain in the blood throughout life.

Herpesvirus type 4 is very insidious. Since the virus is inactive outside a living organism, it can only become infected from a person who is the source of infection. And it is not at all necessary that he has all the symptoms of the disease, the infection can have an erased form, masquerading as ordinary fatigue. For example, chronic fatigue syndrome in most cases is associated with the Epstein-Barr virus.

Individual virions can be found in blood, saliva, semen, vaginal secretions, and tissues of various organs. Virus particles, along with saliva and blood, can get into objects that do not surround us, where they will remain in an inactive state until they somehow enter the human body. In the vast majority of cases, infection occurs by airborne droplets or contact (through kissing) by. But intrauterine transmission of the virus from mother to fetus is also possible, infection during a blood transfusion procedure (if the donor blood contained virus virions), and through sexual contact.

After entering the body and introducing into cell structures, it can take from 5 to 50 days before the disease reminds of itself. But it may not remind, flowing in a latent form, as it happens in most cases.

Yes, according to studies, about 90% of the adult population has had a herpes infection associated with EBV at least once in their life. Most people did not even know about it, because their body was able to cope with a viral attack. But this is not always the case.

How does the Epstein-Barr virus manifest itself?

Most often, doctors have to deal with the following types of the course of type 4 herpesvirus infection in their practice:

Chronic form (occurs after the acute phase of the disease, has some general symptoms ill health),
Latent or latent form (no symptoms, but the virus remains active and is shed in environment),
Slow form (less common, symptoms occur one at a time over a long period, ending in the death of the patient).

For the first time, a person becomes infected with the Epstein-Barr virus, mainly in childhood and adolescence. The peak incidence occurs between the ages of 14 and 18.

Primary viral infection has 3 different forms:

asymptomatic (no clinical manifestations),
respiratory (symptoms of a respiratory infection: fever, nasal discharge, general weakness, etc.),
infectious mononucleosis with a triad of main symptoms: high fever, signs of sore throat with yellowish crusts on the tonsils, enlargement of organs such as the liver and spleen; while there is an increase in the level of leukocytes and an increase in lymph nodes.

There are several options for exiting the acute phase of the disease:

complete recovery,
the symptoms of the disease disappear, but the virus remains in the body and develops, although it no longer leads to noticeable changes in the cells (virus carrier),
there are no symptoms of the disease, the virus does not leave the body, but also shows special activity (latent form),
reactivation (reactivation) of the virus from a latent form,
chronic course of infection (with relapses of the disease, chronic active form, generalized with lesions of organs and body systems).

The result of a long stay of the virus in the body can be:

Chronic form of infectious mononucleosis.
Hematophagocytic syndrome: stable fever, decrease in blood components (increased clotting), enlargement of the liver and spleen, bleeding of mucous membranes, jaundice (due to impaired liver function), swollen lymph nodes, neurological symptoms.
Erased form with the development of secondary immunodeficiency: hyperthermia for a long time, general weakness, enlargement and soreness of the lymph nodes, muscle and joint pain, frequent infectious diseases.
The development of autoimmune pathologies in the form of lupus erythematosus, rheumatoid arthritis, etc.
Manifestations of chronic fatigue syndrome with deterioration in general well-being and performance.
Generalized form of chronic infection with damage to the central nervous system, myocardium of the heart, kidneys, liver, lungs.
The development of oncological diseases (lymphatic leukemia and lymphoma), in which there is a pathological increase in the number of cells of the lymphatic system. The herpes virus type 4 does not destroy carrier cells, but forces them to actively multiply, resulting in neoplasms from the lymphoid tissue.

As you can see, the Epstein-Barr virus is not at all as harmless as it seems at first glance, which means that you should not treat it carelessly. Moreover, type 4 herpesvirus is characterized by frequent episodes of virus carriage and a latent form, not to mention various forms chronic infection, when a person remains a source of infection without knowing it.

In this case, it is possible to determine the presence of an infectious agent in the body only with the help of a special analysis for the Epstein-Barr virus, the biomaterial for which is usually blood.

A blood test for the Epstein-Barr virus (EBV) allows you to confirm or deny the presence of this human herpesvirus (herpesvirus type 4) in the patient's body. Although the viral infection caused by EBV in preschool age carry at least half of all children (and after 35 years, antibodies to EBV are found in 95% of men and women), herpesvirus type 4, being in the body in a latent state, can be activated when immunity is reduced and cause the development of a number of diseases:

hepatitis;
sore throat caused by the herpes virus;
Infectious mononucleosis,
chronic fatigue syndrome;
multiple sclerosis.

A blood test for EBV is complex, as it involves the detection of various antibodies specific to this virus.

This test is called an enzyme-linked immunosorbent assay for the Epstein-Barr virus with the determination of antibodies IgG, IgM to the capsid antigen (VCA), IgG to the early antigen (EA) and IgG to the core antigen (EBNA).

An important addition to such serological analyzes is the molecular diagnosis of EBV infection using polymerase chain reaction (PCR) to detect Epstein-Barr virus DNA. The PCR method allows you to detect the virus not only in the blood, but also in other biological materials (smear from the oral cavity or genital organs, saliva, urine, etc.).

Interpretation of tests for EBV should be carried out only by the attending physician, who has at his disposal the results of other studies.

It is worth mentioning that in recent decades an important fact has been established: EBV, previously considered relatively “harmless”, can also provoke a number of oncological diseases. This discovery significantly changed the attitude towards the virus on the part of doctors. The role of the Epstein-Barr virus in the development of the following cancers has been proven:

Hodgkin's disease (lymphogranulomatosis);
non-Hodgkin's lymphomas;
Burkitt's lymphoma;
nasopharyngeal cancer (nasopharyngeal carcinoma).

For this reason, the detection of Epstein-Barr virus in the patient's body using analysis can greatly facilitate the diagnosis in complex or unclear cases.

Women who plan to conceive a child, pregnant women and children are especially in need of a blood test for EBV.

If infectious mononucleosis affects a pregnant woman, EBV can cause miscarriage, premature birth, or some intrauterine birth defects. The presence of infectious mononucleosis within the previous 6 months in the anamnesis of a woman planning to become a mother is a serious reason to postpone pregnancy for at least another six months.

And in children, herpesvirus type 4 often causes a sore throat, which is of a viral nature. Prescribing antibiotics to such a baby, at least, will be completely useless - and a blood test for EBV will indicate that it was herpesvirus type 4 that caused the disease, and not a bacterial infection.

Ask your question

Questions and answers for: Epstein Barr virus blood test

2015-12-07 11:10:55

Anna asks:

Hello. I have such a problem. My son is 5 years old, he was sick a lot and often, coughing, severe colds and his face began to swell, sometimes a low temperature rose. The pediatrician sent me for a blood test for the Epstein-Barr virus. it turned out to be positive and Atypical mononucleides were found in the clinical blood test (I apologize if I didn’t name it exactly). We were diagnosed with infectious mononucleosis. Treated with Isoprinosine for 14 days. passed all sorts of blood tests, ultrasound of the abdominal cavity, everything was normal. Now the child began to get sick again, without fever, snot and cough ... feeling like an allergic one. We went to the pediatrician and again passed the test for this virus.
Epstein-Barr Virus capsid protein (VCA), IgM
Method and equipment: Immunochemiluminescent assay (Immulite 2000 XPi, Siemens Healthcare Diagnostics)
S/CO ratio (signal/cutoff) 2.39
The result is positive

The doctor again prescribed Isoprinosine for us.
I feel like we're doing it wrong...
What does this re-analysis mean, what threatens my son ... how dangerous is it for him and for those around him? Can he infect someone? We recently visited relatives with a child of 2 years.
Thank you in advance!

Responsible Medical consultant of the portal "site":

Hello Irina! An elevated level of IgM to VCA in the blood can persist up to six months after the initial infection with the Epstein-Barr virus. Therefore, if the first episode of the disease was less than six months ago, it may be residual antibodies, in which case your child's illness is not associated with EBV infection. However, a repeated increase in the level of IgM antibodies to VCA is also possible - in this case, we are talking about reactivation of chronic EBV infection. To understand and determine which of the options you are dealing with, you need to donate the child’s blood for analysis for the entire spectrum of antibodies to EBV infection and discuss the results with a pediatric infectious disease specialist. Until an accurate diagnosis is made, treatment should not be carried out. A child with active EBV infection is a source of infection for others. Take care of your health!

2011-02-08 12:49:33

Natalia asks:

I am 28 years old! For more than half a year the temperature has been 36.9-37.3.
Passed the analysis (blood) for the Epstein-Barr virus by PCR:
- EB virus DNA - positive
-EBV-EA IgG - negative (critical=0.229, analysis=0.024)
-EBV-VCA IgM - negative (critical=0.221, analysis=0.024)
-EBV-NA IgG - positive (critical=0.126, analysis=2.834)
I also passed on herpes viruses by the method of immunofluorescence research:
Only Epstein-Barr virus detected = +10%
I drank groprinosin and cycloferon.
Re-examined by immunofluorescent study. Result = EB virus not detected.
Tell me, can my husband and I plan a child if the temperature continues to stay at 36.9-37.3. At the same time, clinical blood and urine tests are good. Ultrasound also revealed nothing. Feeling great. Nothing worries.

Responsible Markov Igor Semenovich:

Hello, Natalia! I assume that the result of the PCR blood test for EBV is erroneous. To do this, you need to retake blood and saliva for EBV DNA by PCR in another laboratory. The question of pregnancy planning can be decided after examination for all TORCH infections (there are 12 of them). You can read more about this on my website.

2016-08-23 09:30:53

Marina asks:

Good afternoon I am 23 years old, I have a lymph node enlarged on the side of my neck, I noticed it unexpectedly. And on the back of the head in the hair a purulent sore pimple popped up, I think that this is probably interconnected. I began to take lymphomyosot at 10k x 3p. per day, went to the doctor, who gave a referral for blood collection for the Epstein-Barr virus. But I began to take amoxiclav 1000 2 times a day to stop the inflammation. I received the results of the tests, all indicators are normal, but IgG-NA antibodies are late to VEB KP-17.2 (the norm is up to 1.0). Please write what it means and how dangerous it is. THANK YOU!

Responsible Vasquez Estuardo Eduardovich:

Hello Marina! It is likely that the lymph node has increased due to the abscess. Lab tests may need to be repeated after some time (your doctor will tell you when and if you need to), but for now they only talk about past exposure to the virus.

2015-09-11 15:04:49

Christina asks:

Good afternoon please explain the blood test for epstein-barr virus
1) Ig EBV EBNA antibodies
Norm: Negative: less than 0.9
Doubtful: 0.9-1.1
Positive: more than 1.1
my result: 7.8
2) Ig G CMV antibodies
>1-positive 0.8-1.--doubtful my result 0.57
The urologist diagnosed with Epstein-Barr virus and prescribed treatment with injections - Immunoglobulin and Allokin-alpha. Correct diagnosis? Is it possible to cure the virus with these drugs?

2015-02-10 07:58:39

Natalia asks:

Hello! My daughter is now 7 years old, she was diagnosed with the Epstein-Barr virus. Handed over a saliva by a pcr-positive method. And blood by ifa method:
lgG-EA (early white) lgG-EBNA (toxic white) 141.0
lgM-VCA (caps.white) 10.8
lgG-VCA (caps. white) 53.4
An ENT doctor sent me for testing because of monthly sore throats. Previously, we donated blood for the Epstein-Barr virus using the PCR method, they did not find anything, but there were tonsillitis. Please tell me if our frequent (long-term) sore throats are connected with this virus. And if they are, is there a guarantee that if we remove the tonsils, the virus will not affect other organs? So far, we have not had our tonsils removed, because they are in good condition, there is no chronic tonsillitis. How can these sore throats be stopped? Thank you in advance for your response.

Responsible Markov Artyom Igorevich:

Hello, Natalia! Your child has chronic EBV infection in the stage of minimal replication activity (healthy viral shedding with saliva) and does not need treatment. Epstein-Barr virus is not related to recurrent tonsillitis. The reason is a chronic focus of Staphylococcus aureus in the nasopharynx. Antibiotic treatment is not effective. Removing the tonsils will not solve the problem, but on the contrary, will lead to the spread of infection. Proper Treatment- Vaccination against Staphylococcus aureus. You can read more about the treatment on the website of our clinic. Dr. Artem Markov

2014-01-21 17:53:51

Masha asks:

Good afternoon. I really hope that you can help clarify my situation)
In May 2013, antibodies were found in the blood for the Epstein-Barr virus and DNA in the saliva (clean in the blood) I sent an ENT for examination, as there were changes in the tonsils (plug), as well as swelling of the nasopharynx and difficulty breathing, mucus draining from the nasopharynx There was no angina, a rheumatic test was normal, culture from the pharynx did not reveal the growth of pathogenic microflora. An infection was suspected and it was confirmed.
On this moment PCR virus dna was not found in blood and saliva (after 8 months of active treatment).
All my symptoms have not disappeared ((and in addition, now I feel an ache in the joints and unpleasant pain from the side of the lower back, lower right.
There are a number of issues that are bothering me:
1) Is it necessary to take control and generally pay attention to antibodies now? How to recognize that the virus has become active again, is it only by DNA PCR?
2) I admit that swelling in the nasopharynx, plugs in the tonsils (which disappeared for a while, but then returned again), endless mucus in the throat - due to violations of local immunity. But why did the bones, joints and lower back break? I also sometimes feel burning lips without the formation of bubbles as such. Just a place on the lip swells and burns for 1-2 days. These symptoms were also observed as soon as she got sick and throughout the treatment.
3) What analysis can I take to determine if the virus has struck my kidneys, liver, or in general how to find out the cause of pain in the lower back and muscles?
I will be glad to comment. Thank you!

Responsible Sukhov Yuri Alexandrovich:

Dear Masha, the questions you asked will be enough for a full-fledged, 4-hour lecture on this issue for infectious disease doctors (!). I think that a conversation and discussion with you would take 2-3 hours. So, excuse me, I can only recommend you contact your doctor, who, judging by your letter, treats you successfully + undergo a comprehensive examination + (possibly) consultations with an ENT and other doctors.
But I will answer your specific question: serological diagnostics (antibodies) is important in the diagnosis and monitoring of the treatment of pathology caused by the Epstein-Barr virus infection, and especially in dynamics.
Sincerely, Yu. Sukhov.

Answers:

Hello! First of all, without accurate results the tests performed (types and levels of antibodies to the Epstein-Barr virus, rheumatological markers (indicator, detected level, laboratory norm), complete blood count, results of bacterial culture discharge from the pharynx and throat, and all the steel tests that you passed) it is impossible not only to determine the adequacy of 8 -monthly (!) treatment, but even the correctness of the diagnosis.
The presence of Epstein-Barr virus in saliva does not in itself have diagnostic value, since healthy viral shedding is possible. Enhanced Level antibodies to the nuclear antigen in many cases is a sign of a previous EBV infection and does not indicate the need for therapy. Therefore, accurate indicators of the detected antibodies are needed.
Further.
It is not known what exactly you were treated for EBV - some drugs, especially when used for an excessively long time or in certain combinations, can cause the development side effects, including those associated with changes in the joints, muscles, liver and kidneys. Therefore, information is needed on the exact scheme (drugs, doses, duration and frequency of treatment courses) of the treatment. It is also very important to have information of anamnestic nature (your age, past illnesses, chronic diseases, nature of work, chronically taken medicines etc.), since in some cases it is in the anamnesis that the key to the cause of the patient's ailments lies.
And of course, neither diagnosis nor treatment is possible without a targeted examination of the patient - in your case, you should assess the condition of the nasopharynx, joints, muscles and, in general, conduct a full physical examination.
From the point of view of additional examinations, judging by the symptoms, you are shown a general urinalysis, a biochemical blood test, ultrasound of the abdominal organs and kidneys.
It does not hurt to consult a neurologist - since back pain is often associated with osteochondrosis and its complications. The doctor will decide if an X-ray of the spine and other examinations of the spinal column are needed.
It is recommended to re-consult an ENT doctor (you may have to change a specialist who has not been able to diagnose and cure you in 8 months) and repeat cultures from the pharynx and throat (perhaps the previous culture was made against the background of antibiotics, so the result was indicative , antibiotics should be discontinued at least 10-14 days before the examination).
The results of tests for EBV infection should be discussed with a competent infectious disease specialist, since not all doctors of related specialties can understand the results of an examination for an infection such as an infection caused by the Epstein-Barr virus.
And, in general, you should take care of finding a competent therapist who will closely deal with your clinical case - clinical search, diagnosis and treatment.
Take care of your health!

2013-11-12 21:35:34

Eugene asks:

Hello, help, please. 2.5 weeks ago, the temperature rose sharply in the evening to 39 and the sacrum fell ill. I drank paracetamol and went to bed, woke up at 39.2. The ultrasound of the heart is normal, the ECG is good. She gave blood for culture, it was negative. The temperature lasted 9 days. Tests for hepatitis, HIV, tuberculosis are negative. Biochemical analysis is normal. All the time I had a very headache, from 5-6 days the muscles on my legs and stomach ached. On the 7th day, my kidney began to pull. EBV igG-EA>150 (>40 positive); anti-EBV-igG-EBNA>600 (>20 positive); anti-EBV igM-VCA 78.8 (>40 positive); anti-EBV igG-VCA 581.0 (with >20 - positive); AT to phospholipids igM 58.8 at the norm And yet, is it possible to get sick with this disease twice? the shaft was analyzed for this virus, there were antibodies. Many thanks in advance.

Responsible Vasquez Estuardo Eduardovich:

Hello Evgenia All your questions should be directed to your doctor. The analyzes show the exacerbation of old viral processes, which the doctor probably emphasized when prescribing vitamin therapy. What's next? Each specialist acts in his own way, but if possible, I would prescribe an MRI of the pelvic organs, but again, your doctor may have an alternative opinion, depending on the possibility of your area.

2013-06-20 17:38:05

Julia asks:

Good money! My name is Julia, I am 35 years old. Help for God's sake. Doctors don’t explain anything, they say everyone has this virus, it’s nonsense. I read, I roar day and night, because I have two small children !!! Has handed over analyzes one of these days biochemistry, and a blood on Epstein-Barr's virus and Helikobakter. Blood, biochemistry everything is fine. Here are the infections!

1. anti-EBV IgG capsid IHLA- 43.4 (NORMAL 0-1.1)
2. anti-Helycobacter IHLA quant. - 5.43 (norm 0.4-1.1)
I went to the therapist, she prescribed treatment:
1. Amoxicillin 500mg*2t. 3r/day 10days
2. Metronidazole 500mg*2t. 2p/day 10 days
3. OMEZ 1t*2r/day 30 days

I made an appointment with a gastroenterologist for an examination of the internal organs. At me last time on US have revealed hr. cholecystitis and chronic pancreatitis.

I also tested for HPV at a gynecologist, the HPV virus was also found there (16,18,45,46 ...) DETECTED 6.43 units (normal 0-3), cured erosion, I go through colposcopy and cytology 2 times a year.

Which doctor should I contact to get myself in order? Get cured, do not infect children. And is pregnancy ever possible with such tests? Many thanks in advance. Really looking forward to the answer.

Responsible Medical laboratory consultant "Synevo Ukraine":

Good afternoon Julia.
These test results are not at all a hindrance to pregnancy.
Detection of class G antibodies to the EBV capsid antigen is only an indicator that you have previously been infected with EBV and they persist, as a rule, for life. Comprehensive testing of EBV infection also includes IgM VCA, IgG EA and PCR for the presence of virus DNA in the blood and, of course, an examination by an infectious disease specialist and the presence of a clinical picture are also taken into account.
The detection of antibodies to H.pylori and even H.pylori itself during a biopsy indicates that it is present, albeit in small quantities.
But since it can also be detected in absolutely healthy people, that is, only you and your doctor can know whether there is a reason for treatment. Because if there is no clinic, nothing bothers you, no inflammation was detected during the biopsy, personally, I don’t see a reason for treatment.
In order to talk about the activity of the process and the need for treatment, it is necessary to know whether there is a clinic, which one, whether there are antibodies of the IgA, Ig M class and the detection of inflammation during endoscopy and the pathogen itself in a histological examination and by PCR. So the decision to carry out the eradication of Helicobacter pylori and, in general, the choice of a course of treatment is made by your attending physician at an internal appointment.
HPV - in most cases, within 6-18 months, most people disappear on their own. Because If you already had clinical manifestations of HPV infection (erosion), then naturally, you were treated for it and now you need dynamic monitoring by a gynecologist, which is what you actually do.
So if you have no complaints, then visit a doctor and undergo any treatment until there is a reason.
Take care of your health!

The Epstein-Barr virus is very common in the human environment, more than half of the population is infected with it. The manifestations of infection are varied. It can be asymptomatic or cause serious pathologies that lead to death. Therefore, the Epstein Barr virus test has wide application in clinical practice and allows you to determine the stage of the course of the disease and its activity.

Indications for diagnosis

To prescribe a blood test, you need to decide on the indications for analysis and choose the most appropriate type of diagnosis. A blood test is prescribed in such cases:

confirmation of infectious mononucleosis;
enlargement of the occipital, cervical, submandibular lymph nodes;
symptoms resembling mononucleosis in immunosuppressed individuals, after chemotherapy, organ transplants;
frequent recurrences of inflammatory diseases of the oropharynx;
preventive research;
hepatitis of unknown etiology, as well as an increase in the liver and spleen;
diseases of the gastrointestinal tract, poorly amenable to standard treatment;
transferred mononucleosis in women planning a pregnancy;
burdened obstetric history, children with congenital malformations, stillbirths or spontaneous miscarriages;
children with signs of intrauterine infection or born to women with high risk disease transmission;
newborns with sepsis, hepatitis, meningoencephalitis, pneumonia.

For adults, serological tests are used to identify different classes of antibodies. The polymerase chain reaction is also indicative. For newborns, PCR should be used to determine the presence of viral DNA. In serological tests, it is impossible to detect IgM, sometimes IgA to some early types of antibodies appear.

Preparation for analysis

Proper preparation for analysis avoids blood clotting and incorrect interpretation of the results. The main test material is blood, but for PCR, cerebrospinal fluid, mucus from the nasopharynx, scraping of cells of the nasopharynx, and genital organs can be used.

The day before the analysis exclude alcohol, fatty foods. The last meal should be no later than 20:00. Blood is taken on an empty stomach, while before taking it, you can not smoke and you should rest for about 15 minutes. If the patient is taking any medication, it is necessary to stop doing this for the duration of the analysis, in other cases it is enough to warn the laboratory assistant.

A child under 5 years old needs to drink boiled water within 30 minutes before donating blood. The volume drunk can reach 200 ml.

Serological diagnosis

For research it is necessary to donate venous blood. Using enzyme immunoassay, various classes of immunoglobulins are determined. These are specific proteins that are produced by blood cells to neutralize and remember the pathogen. They are derived separately for various peptide structures of the virus: capsid, nucleus.

You can decipher the results of the analysis in the order of appearance of antibodies. IgM are the first to be detected in the blood, they are synthesized to the capsid antigen (VCA) and appear during an acute illness. Immunoglobulins disappear after 4-6 weeks from the onset of the disease. When a latent infection is reactivated, these antibodies will also appear.

IgG is also secreted against the capsid antigen. These antibodies persist for life, but with an exacerbation of the disease, their number increases.

IgG to the early EA antigen appear with the onset of the acute phase of the disease during primary infection, as well as during reactivation. They can be detected 1-2 weeks after infection, they persist up to 4 months after recovery.

The identification of the nuclear antigen IgG EBNA indicates a previous infection. They appear in the blood only 4-6 months after the onset of the disease. Even with a latent course of the disease, this class of immunoglobulins is excreted in the blood. They do not disappear throughout life.

Deciphering the serological analysis for the Epstein-Barr virus includes the quantitative determination of antibodies. Each laboratory uses its own test systems, which use different standards of indicators. Therefore, only the attending physician can decipher a specific analysis.. Diagnosis is carried out in dynamics, tests are prescribed after 2 weeks, then after another 4 and 6 weeks, 3 and 6 months. By increasing and decreasing types and titers of antibodies, you can determine the course of the disease.

PCR

The laboratory search method is aimed at identifying the DNA of the pathogen. The subject of the study are any biological fluids, including urine, prostate secretion, saliva.

Both in patients and in carriers of the virus, the study will reveal its nucleic acid. Therefore, for the accuracy of diagnosis, an analysis with a given sensitivity is used. For carriers, this is up to 10 copies per sample; patients should have 100 copies.

A child under 3 years of age has unformed immunity, so the PCR method is the main one in the diagnosis of a viral infection.

Deciphering the conclusion of the laboratory is not difficult: a positive result indicates the presence of a virus in the body, a negative one indicates no pathogen.

Other laboratory studies

It is possible to detect altered cells that are affected by EBV using a complete blood count. In the smear, atypical mononuclear cells are determined, as well as an increase in the total level of leukocytes and ESR, at a rate of 3.9-10.0 * 109 units / l and 2-16 mm / h, respectively. In some cases, doctors confine themselves to a blood test to make a diagnosis of infectious mononucleosis.

The virus infects the liver and spleen, so liver tests are performed. Deviations relate to an increase in the level of transaminases, thymol test, total bilirubin and alkaline phosphatase. A significant increase in indicators indicates the development of a complication of mononucleosis - toxic hepatitis.

In some cases, according to indications, an immunogram is prescribed. This analysis determines the immune status of the patient, which may be elevated or reduced. The results of the diagnosis help to choose the appropriate treatment.