The system says that you have asked for a response from a new expert, and while there was no statement of any specific remaining question, I notice that your last post included a question about chronic EBV that was not addressed.
While EBV infection is very common, and there is evidence of a life-long infection in most people, a chronic active EBV infection is very rare. The diagnosis of chronic EBV infection can be very difficult. Certainly, high antibody levels are part of the work-up, but there is other evidence that is needed. A chronic active EBV infection may be suspected in someone with chronic fatigue that also has certain symptoms, such as fever, swollen lymph nodes, enlarged spleen, or liver dysfunction.
Diagnostic criteria for a chronic active EBV infection usually involves the antibody titers plus evidence of active disease, either by biopsy of affected tissue (such as of affected lymph nodes) showing typical inflammation or the ability to find evidence of active EBV growth in the affected tissue. If the only positive finding is a high antibody titer, then that is considered to be evidence of a previous infection.
The evaluation for chronic active EBV infection would usually require consultation with an Infectious Disease specialist (as you have apparently done), and even may require consultation with an Infectious Disease specialist at a teaching hospital.
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