Other names: EBV VIRAL CAPSID AG (VCA) AB (IGM), Epstein-Barr Virus, Antibody To Viral Capsid Antigen, IgM
EBV VCA IgM detects IgM antibodies your immune system makes against the viral capsid antigen (VCA) of Epstein–Barr virus (EBV).
VCA IgM appears early in a new (primary) EBV infection, then typically becomes undetectable within 4–8 weeks (sometimes a bit longer).
It is used alongside other EBV markers—VCA IgG, EBNA-1 IgG, and sometimes Early Antigen (EA) IgG—to determine whether infection is current/recent, past, or if results are non-diagnostic and need follow-up.
You may also see this test named EBV Ab VCA, IgM.
EBV is very common and spreads via saliva (kissing, sharing cups/utensils).
Many infections in childhood cause few or no symptoms. In teens/young adults, initial infection can cause infectious mononucleosis (“mono”): fatigue, fever, sore throat, swollen lymph nodes, sometimes enlarged spleen/liver.
After recovery, EBV becomes latent in the body. VCA IgM is not expected to persist in latency; long-term positivity is unusual and often reflects cross-reactivity, assay noise, or another cause—hence the need to interpret results in context.
Note: Exact units/cutoffs vary by lab. Always interpret using the reference range printed on your report and together with other EBV markers and symptoms.
Suggests no evidence of a current/recent EBV infection at the time of testing.
If you have strong mono-like symptoms, a negative VCA IgM can occur very early (before antibodies form) or if illness is due to another cause.
What to consider next
Order/confirm VCA IgG and EBNA-1 IgG:
VCA IgG (+) + EBNA-1 IgG (+) + VCA IgM (−) → past infection, not current.
All negative early on → retest in 1–2 weeks or consider EBV DNA (PCR) if diagnosis is urgent.
Evaluate other mono-like illnesses: CMV, acute HIV, hepatitis A/B/C, rubella, toxoplasmosis, and group A strep (strep throat needs antibiotics).
May reflect early seroconversion, minor assay variability, or non-specific binding.
What to do
Repeat testing in 1–2 weeks and add a full EBV panel (VCA IgG, EBNA-1 IgG, ± EA IgG) for stage clarification.
Consider PCR if the clinical picture is urgent or atypical.
Supports recent/acute EBV infection, especially if symptoms fit mono and VCA IgG is positive while EBNA-1 IgG is still negative (EBNA-1 IgG usually appears months after infection).
Persistently positive or isolated VCA IgM without supportive findings may be false-positive; confirm with repeat serology and/or PCR.
Context helps
VCA IgM (+) + VCA IgG (+) + EBNA-1 IgG (−) → often acute/recent EBV.
VCA IgM (−) + VCA IgG (+) + EBNA-1 IgG (+) → past infection, not active.
VCA IgM (+) alone → verify with repeat testing, add EBNA-1 IgG, EA IgG, and consider PCR.
| Pattern | VCA IgM | VCA IgG | EBNA-1 IgG | Usual interpretation* |
|---|---|---|---|---|
| Early/acute primary infection | + | + | − | Recent/acute EBV |
| Past infection (remote) | − | + | + | Previous exposure, not active |
| Very early window | − | − | − | Pre-seroconversion — retest |
| Atypical/reactivation† | ± | + | + | Correlate with symptoms; consider EA IgG/PCR |
* Clinical context is essential.
† “Reactivation” is typically considered with compatible symptoms/immunosuppression and supportive labs (e.g., EA IgG ↑ and/or EBV DNA).
Mono-like symptoms with negative/indeterminate heterophile (“mono”) test—common in children, who may not make heterophile antibodies.
To help time infection (recent vs. past) alongside VCA IgG and EBNA-1 IgG.
In immunocompromised patients, where serology may be blunted, clinicians may rely more on PCR.
Symptomatic + VCA IgM positive → supports recent EBV; add EBNA-1 IgG (often negative early), consider CBC, liver enzymes, and clinical follow-up.
Symptomatic + VCA IgM negative → add VCA IgG/EBNA-1 IgG, retest in 1–2 weeks, and assess for other causes.
Equivocal → repeat soon; consider full panel or PCR if needed.
Isolated VCA IgM positive → confirm with repeat/alternate assay and context labs to rule out false positivity.
EBV = Epstein–Barr virus.
VCA = Viral Capsid Antigen.
IgM = Early antibody in new infections; short-lived.
IgG = Appears in acute phase, persists for life (evidence of past infection).
EBNA-1 IgG = Typically turns positive months after infection; indicates past infection.
Disclaimer: Educational information only. Always review your results with your healthcare provider, who can interpret them in the context of your symptoms, timing, and medical history.
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A positive EBV VCA IgM result usually points to a recent or acute Epstein-Barr virus (EBV) infection. These IgM antibodies show up early—often around the time symptoms begin—and usually fade within 4–8 weeks (sometimes a bit longer).
Because IgM alone doesn’t give the full picture, your provider will interpret it together with other EBV antibodies: VCA IgG, EBNA-1 IgG, and sometimes Early Antigen (EA) IgG or EBV PCR testing. The exact meaning depends on when the blood test was done compared to when your symptoms started.
Fatigue
Fever
Sore throat
Swollen lymph nodes
Sometimes: an enlarged spleen or mild liver test changes
Sometimes IgM results can last longer than expected, or appear positive when they’re not truly specific for EBV. This is why repeat testing or a full EBV antibody panel is often needed to confirm.
If you have symptoms: add VCA IgG and EBNA-1 IgG (and sometimes EA IgG or EBV PCR) to confirm whether the infection is recent or if there may be another explanation.
If IgM is positive by itself: repeat the test in 1–2 weeks and confirm with a full EBV panel or PCR.
Supportive care: rest, stay hydrated, and avoid contact sports if your spleen is enlarged. Always follow your clinician’s guidance on activity and follow-up.
| EBV VCA IgG | EBV VCA IgM | EBNA-1 IgG | Usual interpretation* |
|---|---|---|---|
| Negative | Negative | Negative | No prior exposure or very early infection → retest if symptomatic |
| Positive | Positive | Negative | Recent/acute infection (typical early primary infection pattern) |
| Positive | Negative | Positive | Past infection (not active now) |
| Positive | Negative | Negative | Indeterminate: very early infection before EBNA develops, or ~5–10% who never develop EBNA; retest or add EA IgG/PCR |
| Positive | Positive | Positive | Late primary infection or reactivation; correlate with symptoms; may need EA IgG or PCR |
| Negative | Positive | Negative/Positive | Possible false-positive IgM; repeat and confirm with full EBV panel or PCR |
* Always interpret results with the lab’s reference ranges, your symptoms, and your clinician’s judgment.
Anthony
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Please refer to this interpretation chart:
| EBV CAPSID IgG | EBV CAPSID IgM | EBNA IgG | Interpretation |
| Negative | Negative | Negative | No previous exposure |
| Positive | Positive | Negative | Recent infection |
| Positive | Negative | Positive | Past infection |
| Positive | Negative | Negative | See note* |
| Positive | Positive | Positive | Past infection |
Note:
*Results indicate infection with EBV at some time (VCA IgG positive). However, the time of the infection cannot be predicted (ie, recent or past) since antibodies to EBNA usually develop after primary infection (recent) or, alternatively, approximately 5% to 10% of patients with EBV never develop antibodies to EBNA (past).
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Unlimited Plan Member since 2021
I have been using Healthmatters.io since 2021. I travel all over the world and use different doctors and health facilities. This site has allowed me to consolidate all my various test results over 14 years in one place. And every doctor that I show this to has been impressed. Because with any health professional I talk to, I can pull up historical results in seconds. It is invaluable. Even going back to the same doctor, they usually do not have the historical results from their facility in a graph format. That has been very helpful.
Karin
Advanced Plan Member since 2020
What fantastic service and great, easy-to-follow layouts! I love your website; it makes it so helpful to see patterns in my health data. It's truly a pleasure to use. I only wish the NHS was as organized and quick as Healthmatters.io. You've set a new standard for health tracking!
Paul
Healthmatters Pro Member since 2024
As a PRO member and medical practitioner, Healthmatters.io has been an invaluable tool for tracking my clients' data. The layout is intuitive, making it easy to monitor trends and spot patterns over time. The ability to customize reports and charts helps me present information clearly to my clients, improving communication and outcomes. It's streamlined my workflow, saving me time and providing insights at a glance. Highly recommended for any practitioner looking for a comprehensive and user-friendly solution to track patient labs!
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