Lupus and Epstein-Barr Virus
Last updated: April 2023
Research continues to shed light on the link between Epstein-Barr virus (EBV) and autoimmune diseases including lupus. The new insight can help people who are prone to such conditions in which the body’s defense system attacks itself. Knowing how EBV relates to and raises risks of these diseases may aid in treatment and prevention.
Lupus and Epstein-Barr virus infections
Few people in the world escape contact with EBV. However, not all people instantly become sick when infected with this common virus. Many never have symptoms. Only about 25 percent of kids and young adults exposed to EBV come down with infectious mononucleosis (mono). In some people, EBV causes symptoms and other illnesses long after their first exposure.1,2
A 2018 study found that EBV may lead to autoimmune diseases by affecting people’s genes. The researchers found the EBNA2 protein from the virus in nearly half of the genetic locations involved in lupus. The EBNA2 protein also showed up in genetic risk sites for celiac disease, multiple sclerosis, rheumatoid arthritis, and other autoimmune diseases.3
In 2021, another group of doctors confirmed that EBV can trigger autoimmune reactions like those found in lupus. EBV impairs immunity in different ways. This allows the virus to increase within the body even after being dormant (not active). Research shows that EBV becomes active again more often in people with lupus.4
Lupus risk from Epstein-Barr virus infection
Studies show that EBV raises some people’s chance of developing autoimmune diseases. An increased risk of autoimmunity after EBV infection has been linked to both genetic factors and the reactivation of EBV. More research is needed to determine exactly how the virus affects genes, reactivates, and sets off an autoimmune response that can lead to conditions like lupus.4
Lupus, mono, and reactivated Epstein-Barr virus symptoms
Lupus, mono, and reactivated EBV share common symptoms. These include fatigue, fever, and pain. Often, mono also comes with a rash, a sore throat, and swelling of the liver, lymph nodes, and spleen.1,2,5
While many people with lupus develop a rash as well, the rash appears on the face in a distinct shape. Fatigue and body pain are the main symptoms that occur when EBV becomes active after a time of dormancy.1,2,5
Not everyone with lupus, mono, and reactivated EBV develops all the symptoms at once. Some people may only feel fatigued. Some develop certain symptoms upfront and other symptoms later.1,2,5
The duration of symptoms also differs from person to person. While lupus is a chronic illness, the symptoms may come and go. In most people with mono, symptoms last a few weeks. Certain symptoms of mono and reactivated EBV such as fatigue can persist for 6 months or more in some people.1,2,5
Your doctor can help you find out the source of your symptoms. They can assess the existing signs and order bloodwork. Blood tests can find out what antibodies are present and measure the level of EBV in the body. The results can point to past EBV infections and whether EBV and lupus are now active.1,5
Lupus, mono, and reactivated Epstein-Barr virus treatments
Discovering more about the link between lupus and EBV may lead to new treatment options. For now, doctors prescribe existing drugs to treat lupus. Since EBV and mono are viral, treatment usually centers on easing symptoms.
Considering that EBV can cause autoimmune responses, some of the steps used to manage lupus symptoms can also be used to manage the symptoms of EBV infections. Reducing stress and resting are key. Drinking plenty of water and eating a healthy diet is also essential. Adding nutrients to support the immune system can help people overcome or prevent flare-ups of EBV and lupus.1
Thanks to doctors who pursue research, the mystery of autoimmune diseases like lupus unravels more each year. The new knowledge brings help and hope to those who suffer from these chronic illnesses. Discovering what causes certain diseases and how they progress informs treatments and lifestyle choices that may improve people’s health.
If you have concerns about developing lupus from a previous mono infection or a current EBV infection, talk to your doctor. They can discuss the risks. Your doctor can also suggest things you can do to lessen your chance of EBV reactivation and autoimmune responses.
Have there been things you have learned along your lupus journey that you wish had been explained to you by a healthcare provider earlier?