Other names: EBV NUCLEAR AG (EBNA) AB (IGG)
EBNA-1 IgG is a blood test that measures IgG antibodies your immune system makes against the Epstein–Barr virus (EBV) nuclear antigen. These antibodies don’t show up right away. They usually appear weeks to a few months after a first (primary) EBV infection and then stay in your body for life. Because of this, EBNA-1 IgG is a marker of past EBV infection, not of current illness.
Modern labs usually measure EBNA-1 IgG specifically. Some older or specialty tests may report other EBNA targets, but interpretation is similar. Always review your own lab’s report.
To help tell the difference between recent/acute EBV infection and a past infection (when combined with VCA IgM and VCA IgG, and sometimes EA-D IgG or EBV DNA PCR).
To check prior EBV exposure, for example before an organ transplant.
To clarify mixed or confusing results, such as positive VCA IgG with ongoing symptoms.
Always compare your results to the reference range on your report, and remember this test works best when viewed together with VCA IgM, VCA IgG, symptoms, and timing.
Negative (Non-reactive) EBNA-1 IgG
In someone with recent mono-like symptoms: a negative EBNA-1 IgG test supports a recent primary infection, if VCA IgM and VCA IgG are positive. The body hasn’t made EBNA antibodies yet.
Negative results can also mean you’ve never been exposed to EBV.
About 5–10% of people who had EBV in the past will never develop measurable EBNA-1 IgG. This means a negative result doesn’t always rule out prior infection.
Positive (Reactive) EBNA-1 IgG
Shows you’ve had EBV in the past.
Stays positive for life in most people, even when you feel well.
By itself, a positive EBNA-1 IgG does not mean you currently have an active infection.
Here’s how doctors usually interpret EBV antibodies:
| Pattern | VCA IgM | VCA IgG | EBNA-1 IgG | What it usually means |
|---|---|---|---|---|
| Early/acute infection | + | + | − | Recent/acute EBV infection |
| Past infection | − | + | + | Previous exposure, not active |
| Very early window | − | − | − | Before antibodies develop – retest if symptoms continue |
| Possible reactivation* | ± | + | + | May suggest EBV reactivation if symptoms or PCR confirm |
* Reactivation requires supportive symptoms or additional labs. EBNA-1 IgG alone does not prove reactivation.
Sample: Blood (serum).
Fasting: Not needed.
Timing matters: Testing too early may show EBNA-1 IgG negative, even if infection is present. Retesting after 1–2 weeks often gives a clearer result.
Testing very early (before antibodies develop).
Weak antibody responses in people who are immunosuppressed.
Lab-to-lab differences in assay type and cut-offs.
Small group of EBNA-1 “non-responders” who never develop this antibody despite past exposure.
You feel well and EBNA-1 IgG is positive: This usually means past infection; no treatment is needed.
You have mono-like symptoms and EBNA-1 IgG is negative: Ask your doctor about VCA IgM/VCA IgG, and possibly EA-D IgG or EBV DNA PCR. Repeat testing may be needed.
Mixed or unclear results: Retest in 1–2 weeks, or ask about EBV PCR, especially if you’re immunocompromised.
EBNA-1 IgG appears later after EBV infection and usually lasts for life.
A positive result = past EBV infection.
A negative result = no prior infection, or possibly very recent infection before EBNA antibodies appear.
For accurate interpretation, EBNA-1 IgG should always be read together with VCA IgM, VCA IgG, symptoms, and timing.
Disclaimer: This information is for educational purposes only. Always discuss your lab 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 EBNA-1 IgG usually means you’ve had Epstein–Barr virus (EBV) in the past. EBNA-1 IgG appears weeks to a few months after the first infection and then persists for life, so a “positive” EBNA-1 IgG by itself does not indicate an active infection or reactivation. Antibody tests like this are generally interpreted as positive/negative, not “elevated/low,” and numbers above the cutoff don’t correlate with how sick you are.
How clinicians interpret a positive EBNA-1 IgG (context matters)
Past infection (most common): VCA IgM (−) + VCA IgG (+) + EBNA-1 IgG (+) → prior exposure; not acute.
Recent/acute infection less likely: If you currently have mono-like symptoms, a pattern of VCA IgM (+) + VCA IgG (+) with EBNA-1 IgG (−) fits better with a recent infection (EBNA hasn’t developed yet).
Possible reactivation: Consider only when symptoms or immune status suggest it, and when other tests (e.g., EA-D IgG, EBV DNA PCR) support ongoing activity. EBNA-1 IgG alone cannot prove reactivation.
What to do next
If you feel well: a positive EBNA-1 IgG simply documents past EBV—no treatment is needed.
If you have current symptoms (fatigue, fever, sore throat, swollen nodes): ask for the full EBV panel (VCA IgM, VCA IgG, ± EA-D IgG) and consider EBV DNA PCR if the diagnosis is uncertain.
If results seem inconsistent with your symptoms or timing: repeat testing in 1–2 weeks can clarify the pattern.
Remember: cutoffs vary by lab—always interpret your result using the reference range on your report and with your clinician’s guidance.
Key point: A positive EBNA-1 IgG nearly always reflects past infection, not something that needs treatment now. It’s the pattern with VCA IgM/VCA IgG (and sometimes EA-D IgG or PCR) that tells whether infection is recent, reactivated, or simply remote.
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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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