Can You Have Chronic Mono? - Verywell Health

Infectious mononucleosis, often known simply as mono, is a viral infection caused by the Epstein-Barr virus (EBV). While most cases of mono resolve after a few weeks, in very rare cases, the virus can remain active within the body indefinitely. When this happens, it is referred to as chronic active Epstein-Barr virus (CAEBV) infection, or chronic mono.

Complications of CAEBV infection may include anemia, neuropathy, liver failure, or interstitial pneumonia. In some cases, CAEBV can be fatal.

This article will explain the symptoms and risk factors of CAEBV, and how it is diagnosed. It will also address other illnesses that mimic mono and potential treatment options.

PixelsEffect / Getty Images

Chronic Epstein-Barr

CAEBV infection is a rare disorder that occurs when the body cannot control EBV. As the disease progresses, higher levels of EBV are found within DNA in the blood and organs.

Some symptoms of CAEBV infection, such as fever and an enlarged spleen and lymph nodes, are similar to those of the common type of mono. However, the chronic version can present with other symptoms as well, including:

• Anemia
• Nerve damage
• Pneumonia
• Enlargement of the airways of the lungs
• Decreased immune function
• Viral hepatitis

Causes

Certain things can make a person more likely to develop a case of CAEBV infection. Ethnicity may play a role. There is an increased risk among people who are Asian, South American, Central American, and Mexican.

Genetics can also play a role in the development of a CAEBV infection, and research has shown that an inherited immunodeficiency in certain immune cells can be a risk factor. The prevalence of the chronic condition in those of specific ethnic backgrounds also suggests that a genetic component may be at play.

According to research, no one genetic defect has been linked to an increased risk of developing the disease, but some believe that specific antigens known as A26 and B52 could play a role in its development.

Diagnosis

Because CAEBV is so rare and the symptoms mimic many other illnesses, diagnosing the disease can be challenging. According to one study, the mean length of time from onset to diagnosis in CAEBV patients was 20 months.

A healthcare provider will start by getting the patient's medical history, report of symptoms, and perform a physical examination. Other tests used to diagnose CAEBV include:

• Blood tests. These are used to identify specific antibodies, including viral capsid antigen (VCA) IgM, and IgG. High levels of these may suggest chronic or active infection.
• Immunophenotyping: This evaluates the distribution and function of different immune cell types, such as natural killer (NK) cells, T cells, and B cells, that are associated with CAEBV.
• Polymerase chain reaction (PCR) tests. These may be performed to detect the Epstein-Barr virus DNA in the blood or affected tissues.

In addition, other diseases with similar symptoms may need to be ruled out in order to come up with a CAEBV diagnosis. These include autoimmune disorders, lymphomas, and other viral infections.

When to See Your Healthcare Provider

Anytime you have symptoms that are consistent with mono for longer than a few days, you should check in with your healthcare provider. Since mono can mimic other conditions, getting a proper diagnosis is vital to your recovery.

Recurrent Mono

Many people with mono only experience symptoms of the infection once, but others may come down with the illness again months, or even years, after the initial transmission. This is different from chronic mono.

Often if the virus does reactivate for a second time, the symptoms will be either milder or nonexistent. Those who have a weakened immune system are most likely to experience symptoms from a reactivation of the virus.

Although it is not entirely clear what causes the virus to be active after being dormant, the recurrence of symptoms can likely be attributed to the function of the immune system.

For those with adequate immune function, natural killer (NK) cells and T-cells will fight off further infection by killing cells that are infected with EBV.

However, if the immune system isn't working as it should or there are defects in those cells, the virus can reactivate and cause symptoms. The virus can also reactivate while the body is fighting off another infection.

Risk Factors

A few risk factors can cause a mono infection to recur. Often referred to as mono relapse, those with weakened immune systems, autoimmune deficiencies, or other diseases that affect immune function are at a higher risk.

How Is Chronic Fatigue Syndrome Related to Mono?

Having mono may increase a person's risk of developing chronic fatigue syndrome, which is a long-term illness that hinders a person's ability to perform daily activities because of overwhelming fatigue.

Mono-Like Illnesses

It's important to get a proper diagnosis from a healthcare professional when you suspect mono or a CAEBV infection because there are some other health conditions that can mimic these conditions.

Strep Throat

Strep throat is caused by the bacteria Streptococcus. The overlapping symptoms of strep throat and mono include fever, sore throat, headache, rash, and swollen lymph nodes. However, strep throat also presents with pain when swallowing, red and swollen tonsils, red spots on the roof of the mouth, nausea, vomiting, and stomach pain.

The Flu and Other Viruses

A few different viral infections can mimic the symptoms of mono. The flu, for example, is incredibly common and presents with symptoms similar to mono such as fever, sore throat, muscle or body aches, headaches, and fatigue. Adenovirus infections can also cause symptoms similar to those of the flu and mono, such as fever and a sore throat.

Human herpesvirus 6 (HHV-6) and herpes simplex virus type 1 are from the same family of viruses that EBV belongs to. Because of this, some of the symptoms can overlap.

The symptoms of a human herpesvirus 6 infection include fever and enlarged lymph nodes. A herpes simplex virus type 1 infection can also present with fever and swollen lymph nodes, which are typical in a case of mono.

Cytomegalovirus (CMV)

A cytomegalovirus infection presents similarly to mono in many ways. Its prevalence is quite high, as is the case with mono, and it is thought that over half of all adults have been infected with CMV at some point in their life.

It also remains inactive in the body forever, but it can reactivate in the future in some cases. Most people who contract CMV don't have any symptoms, which is similar to mono, but when they do appear, they consist of fever, sore throat, fatigue, and swollen glands.

Hepatitis A

Hepatitis A is another viral infection that can present in the same way as mono. Since hepatitis A does affect the liver, there are typically other symptoms not related to mono that are present, such as:

• Dark-colored urine
• Jaundice
• Loss of appetite
• Diarrhea
• Nausea
• Abdominal discomfort

The symptoms of hepatitis A that overlap with those of mono include fever and fatigue. Research has found that a mono infection can also lead to a form of hepatitis known as acute hepatitis.

Toxoplasmosis

Toxoplasmosis is a parasitic infection caused by the Toxoplasma gondii parasite. The parasite can be found across the globe, but the prevalence of this infection is high in the United States, and more than 40 million Americans may have the infection.

The parasite can live within a human body for their entire lives without ever causing symptoms. When rare symptoms do occur, they tend to appear in those with a weak immune system and can include flu-like symptoms, such as swollen lymph glands and muscle aches and pains.

Acute Retroviral Syndrome

Acute retroviral syndrome is the first stage of infection with the human immunodeficiency virus (HIV) and can be found in the majority of those who have the infection. The symptoms present in the syndrome are so similar to those of mono that it can often be hard to tell the difference. These symptoms include headache, fever, enlarged lymph nodes, sore throat, and headache.

Treatment

There is no cure or medication that can treat mono. The treatment used to help speed up recovery often centers around relieving symptoms for those who have the infection so that they can rest comfortably while they get better.

Some management techniques for mono include:

• Rest: Fatigue is a dominating symptom of mono, and the best way to fight fatigue is to get plenty of rest.
• Hydration: Dehydration can make an infection worse, so making sure you are hydrated will help speed up your recovery.
• Pain-relieving medications: Mono can cause all types of pain, including headaches and muscle aches. It can also cause fever and inflammation. Taking over-the-counter medications such as ibuprofen (Advil), naproxen (Aleve), and acetaminophen (Tylenol), can help address the discomfort caused by these symptoms.
• Other medications to soothe a sore throat: Using throat lozenges or gargling with salt water can help soothe the pain of a sore throat.
• The avoidance of tiring activities: Sports and other physical activity can increase the risk of a spleen rupture in those with mono because of the pressure that it can cause on the already enlarged organ. All strenuous physical activity should be avoided while you are sick with mono and then up to four weeks after you recover. 

Because CAEBV in particular is so potentially dangerous, antiviral drugs such as ganciclovir or valganciclovir may be used to help suppress the replication of the Epstein-Barr virus, as well as high-dose corticosteroids and other immunosuppressive drugs, such as cyclosporine or methotrexate.

Coping

Coping with mono can be difficult because of the severity of symptoms and the length of time that they can last. The best way to deal with being sick is to let yourself rest, relax, and take the medications you need to alleviate your symptoms.

You could also focus on boosting your immune system with healthy whole foods that are designed to give the immune system everything it needs to fight off an infection. Foods such as green leafy vegetables, bell peppers, apples, and green tea are great choices to start an immune-aiding diet while coping with mono.

Summary

Mononucleosis, or "mono," is a common viral infection caused by the Epstein-Barr virus. Most cases of mono typically resolve within a few weeks with no complications, However, very rarely the virus can remain active within the body indefinitely. When this happens, it is referred to as chronic active Epstein-Barr virus (CAEBV) infection, or chronic mono.

It can be difficult to diagnose CAEBV because it is so rare and also shares several symptoms with other infections and diseases. If you've had mono and have symptoms that last for more than a month, see your healthcare provider for a proper diagnosis.

Frequently Asked Questions

• It can help. Studies show that people with high levels of vitamin C have some protection against mononucleosis. Increasing your intake of vitamin C as well as vitamin D can help you fight the infection.
  

• Mono can leave you feeling ill and tired for several months, but the effects can last even longer. The Epstein-Barr virus (EBV), which causes mono, remains in your body and can become active again down the road. Even when the virus is inactive, it can cause changes to your body's cells. EBV is linked to lymphoma and autoimmune diseases.

• The virus can be passed on to others as long as you're in an active state. This is typically about six months while symptoms are present. However, you may have no symptoms and mono could still be active in your body. It's very hard to tell when you're "all clear." If the virus becomes active again, you could again pass it on
  

Adblock test (Why?)