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Question for Dr. P
foreversore posted:
I recently tested positive for the Epstein-Barr virus. I did some reading and found that a large number of the population WILL test positive for the virus even if they never showed symptoms and that it is something you carry with you for life.

I also read that it has been weakly linked to CFS, FM, nasopharyngeal cancers, certain lymphomas and the list goes on. What is your take on the Epstein-Barr virus? Is it something that just lies dormant after initial infection/illness or could it cause life long problems?
Mark Pellegrino, MD responded:
Hi foreversore,

Once one tests positive for Epstein-Barr virus (EBV), he/she will always test positive which means the immune system has reacted to the virus and formed antibodies which are measured during EBV testing. The immune system always remembers the virus via these specifc antibodies circulating in the bloodstream.

Some people will have a chronic active form of EBV and get recurrent infections, but most people will have a dormant form. They may have initially had acute mono symptoms, but often there were no obvious symptoms. In most, the virus is vigorously defended against by our healthy immune responses and rendered harmless and dormant, even if we still test positive for EBV.

But in some, the EBV can trigger FM to develop, presumably in one who is genetically susceptible. The EBV infection goes away, but the fibro cascade gets triggered, and once fibro develops, it is a lifelong problem indeed. Fibro patients often report their symptoms began after a mono infection that was like "hitting a brick wall." Fatigue often dominates first, then the pain evolves over time, usually within a few months.

If a person with fibro tests positive for EBV but did not have any history of acute mono, I am less likely to attribute the fibro "cause" to the EBV. As you've indicated, a large number test positive for the virus so just testing positive does not seem to trigger the fibro; I think acute mono can trigger it, though.

Hope this helps.

Dr. P
foreversore replied to Mark Pellegrino, MD's response:
Thank you Dr. P. My Dr. does believe that I had mono as a child that piggy backed in on a case of scarlet fever. Ever since then I have had chronic sinusitis and chronic strep throat until my tonsils were removed.

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