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A 23-year-old female asked:

I need help understanding my epstein-barr virus test result. i have been very sick for over a month and doctors are sure its mono, but 2 mono tests were negative. on ebv test i see that only ebv vca igm is elevated. is this a positive result?

2 doctor answers3 doctors weighed in
Dr. Hunter Handsfield
Infectious Disease 53 years experience
Probably not EBV: IgM antibody tests are very unreliable; your positive result likely is false -- if you really had EBV, your mono tests would be positive. You may have "heterophile negative" mononucleosis, i.e. mono not caused by EBV. Probably not serious -- mono (whether due to EBV or otherwise) almost always clears up over a few weeks with no long term health consequences. Discuss with your doctors.
Dr. Jay Park
Dr. Jay Parkanswered
Pediatrics 50 years experience
Probably yes: Monospot test when tests positive allows prompt diagnosis of infectious mononucleosis, however, is not specific for EB virus infection. Moreover, the sensitivity runs at 85% when tested during the 2nd week of illness. In your case, EBV specific tests are very helpful. Elevated EBV VCA IgM plus VCA IgG or Antibodies against EA (early antigen) confirms EBV infection.

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Last updated Nov 15, 2020

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