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Q. I have chronic fatigue with positive EBV. What should I do further?

Answered by
Dr. Parth R Goswami
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Sep 29, 2020

Hello doctor,

I have had problems with chronic fatigue for the past 10 years. I was reading about EBV and the test came back positive. Can you review the attached report and give me analysis and next steps as far as testing and treatment?

Dr. Parth R Goswami

Hematology Pathology


Welcome to

I have seen the report (attachment removed to protect patient identity).

The positive IgG report can be due to past infection as well. To rule out recent infection, you need to investigate with IgM antibody estimation against EBV (Epstein-Barr virus).

Kindly mention if you have a sore throat, enlarged neck node, enlarged spleen like presentation,etc.? No specific treatment is needed for EBV induced mononucleosis infection.

For your weakness, investigate with ANA (antinuclear antibody) estimation, and neurological examination is also advisable.

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Thank you doctor,

My concern is that I am having a reactivation of the EBV. Can this be the case and is there another test to confirm or deny?

Dr. Parth R Goswami

Hematology Pathology


Welcome back to

As I have mentioned in my answer, IgG antibody positivity to VCA can be due to past infection of EBV. IgG antibody can be positive for many years after acute infection.

But to confirm reactivation or acute infection you can investigate with IgM antibody test. So you can investigate with IgM testing against EBV. IgM antibody if positive, it does not indicate an old infection. It can be due to recent infection only at least within the last few months. Clinical correlation also should be done.

I hope this helps.

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