The presence of class G antibodies to Epstein-Barr virus or cytomegalovirus does not justify treating herpes. This portal shares insights from Ekaterina Stepanova, an infectious diseases specialist and head of the H-Clinic vaccination center, who emphasizes practical guidance for patients and clinicians alike.
In clinical practice, therapists and pediatricians often order antibody tests for Epstein-Barr virus and cytomegalovirus when patients report fatigue or weakness. Yet a positive IgG result against these herpesviruses is common. Most people encounter herpesviruses early in life, around ages two or three, and subsequently retain IgG antibodies for years. In many cases, there are no noticeable symptoms, and the infections resolve without medical intervention. A clinician might observe lymph node enlargement or, occasionally, liver involvement during the initial infection, but these manifestations are not universal and often subside without treatment.
It is not unusual for patients to arrive with a diagnosis such as “Combined cytomegalovirus infection” accompanied by broad, sometimes unnecessary, drug prescriptions. In these situations the clinician highlights a key point: Immunoglobulin M antibodies, which would indicate a recent or worsening infection, are not present in these tests. If IgM is absent, there is no active infection to treat. The presence of IgG alone signals past exposure rather than a current disease requiring antiviral therapy.
The discussion also notes that fatigue is more frequently linked to factors like iron or vitamin D deficiency, dehydration, or a sedentary lifestyle rather than to active viral infections. Recognizing these connections helps prevent unnecessary worry and directs attention to evidence-based approaches for managing persistent tiredness.
In summary, positive IgG antibodies to Epstein-Barr virus or cytomegalovirus reflect prior exposure, not an ongoing infection needing treatment. For patients with chronic fatigue, a comprehensive assessment is essential to identify nutritional deficiencies, hydration status, sleep quality, and activity patterns, rather than focusing solely on herpesvirus antibodies. Clinicians advise a balanced approach, reserving antiviral therapies for clearly identified acute infections with appropriate markers.
[Citation: Ekaterina Stepanova, infectious diseases specialist, head of H-Clinic vaccination center, provider of clinical guidance on herpesvirus antibody interpretation.]