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1 year+ of CMV/EBV-related liver discomfort?

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Posted 7/10/2014 10:56 AM (GMT 0)
Hi all. In May 2013 I fell ill... flu symptoms, and enlarged spleen and liver. A doctor tested my blood and told me I had tested positive for CMV and EBV, but that all my liver tests were normal and he wasn't even sure if my current issues were related to the CMV and EBV. All he could tell me definitively was that "it's nothing serious, because if it was, the tests wouldn't be normal." I had no fatigue or any of the other classic EBV/CMV symptoms. He told me I could continue drinking so I did. I'm not an alcoholic but I don't hold back either. I know it wasn't smart of me. No matter what a test says, if your liver feels weird you should listen to your body.

That's what I'm finally doing now. After over a year of just living my life and banking that this thing would disappear, it has not. At all times my liver is a little bit larger than it should be and occasionally it'll tingle. I have absolutely no symptoms of any other kind, I'm otherwise very healthy and energetic. My liver has been a little bit more active than usual since I got back on the road a couple of months ago. I'm a constant traveler (writing now from Moscow en route to Bangkok) and things have been pretty challenging this go-round. I heard stress can affect this kind of thing.

So, no more caffeine or alcohol until I get this figured out. But it really is a bummer. It sounds stupid, but when you're traveling alone, the people at a bar are often the only friends you can find. I'm going to visit a hospital in Malaysia and get some more blood tests. But I have a feeling they're just gonna tell me what the last doc told me.

Is it heard of for EBV/CMV liver problems to persist over a year? Could this be more serious? What should I be doing about this?
Posted 7/10/2014 12:51 PM (GMT 0)
Mr. Malcovich,

Welcome to the HW Hepatis forum. WE provide support to patients and family of those with liver disease. We are not doctors or nurses and our comments and suggestions are the sum of our personal experience, not our professional expertise.

That said...if you think something is going on with the liver...no booze is the right first step...

AND, here is a case history. My partner was diagnosed with EBS long ago. His EBS viral load is sometimes very high. They give him an antiviral drug to bring it back down, but it doesnt' go away.

AND, until there was a clear lab for Hepatitis C, the docs just said he had EBS and that was that.

This is for many many years. In the mid 90s they began to test for Hep C and it is determined that he has had Hep C (had?) since the late 1960s. He did not quit drinking "socially" (he was a very social guy...lol) until 2010...so he helped the Hep C cause a lot of trouble. He has been sober since, has had and survived a liver transplant (with liver cancer also), and just recently cleared his body of the Hep C virus.

Your intro does not include whether they have done the viral tests for Hep A, B, C, etc...there are more.

It does not say if you have been tested for several autoimmune disorders that can cause problems with the liver, pancreas, and biliary system.

Yes, you need tests. A full work up with a certified HEPATOLOGIEST, not a general doc, not a GI doc, someone who does livers preferably at a liver transplant center....they have the leading edge docs there.

They are all over the world. I'll take a peek and see what is available.



Best to you,

Mama Lama
Posted 7/10/2014 1:33 PM (GMT 0)
Mr. M.

Welcome! I'd eliminate alcohol. I wouldn't eliminate the caffeine though. So instead of meeting people abroad in bars, meet them in coffeehouses :)

Since you have a confirmation on EBV & CMV, you should see an infectious disease doc. CMV can cause a lot of different issues. Because you feel pressure around your liver, seeing a hepatologist as ML suggested, is a good idea too. I'd speak to the hepatologist about your gallbladder too since your LFTs are normal.

As ML also mentioned, there are many non alcohol, non viral liver diseases. It's better safe than sorry to ask a specialist to rule them out.
Posted 7/11/2014 9:02 AM (GMT 0)
Thanks for your replies, guys. I'll type in verbatim what my results sheet says. Note that these results were from May 2013, right after the initial flu-like symptoms hit.

I was tested for FBR & ESR, LFT, CYTOMEGALOVIRUS A/B, EBV, G, M, EA, NA

S-TOTAL PROTEIN: 75
S-ALBUMIN: 44
S-GLOBULIN: 31
S-ALB./GLOB. RATIO: 1.4
S-TOTAL BILIRUBIN: 18
S-CONJ. BILIRUBIN: 3
S-UNCONJ -S BILIRUBIN: 15

S-ALK. PHOSPHATASE: 76
S-GAMMA GT: 28
S-ALT: 31
S-AST: 31
S-LD: 156

ICTERIC: ABSENT
HAEMOLYSIS: CLEAR

red cells
RED CELL COUNT: 5.77
HAEMOGLOBIN: 17.3
HAEMATOCRIT: 0.53
MCV: 92
MCH: 30
MCHC: 32
RDW: 14.8

white cells
WHITE CELL COUNT: 6.3
NEUTROPHILS 30.6% 1.92
LYMPHOCYTES 56.3% 3.53
MONOCYTES 9.4% 0.59
EOSINOPHILS 2.4% 0.15
BASOPHILS 1.3% 0.08


The doc examined me, said he couldn't find a single thing wrong with me. No symptoms, no liver tenderness, nothing. But I could and still can feel an enlargement and sporadic tingles.

What are the chances that it's still the EBV/CMV? I'm reading online about people who deal with those illnesses for years.
Posted 7/11/2014 9:19 AM (GMT 0)
woops, didn't include maybe the most important part of the results.

CYTOMEGALOVIRUS IGM: NEGATIVE
CYTOMEGALOVIRUS IGG: 134.40 (POSITIVE)

EBV VCA IGM: NEGATIVE (the ebv results indicate a past infection. there is no evidence of reactivation.)

EBV VCA IGG: POSITIVE
EBV EARLY AG: NEGATIVE
EBV NUCLEAR ABS: POSITIVE
Posted 7/11/2014 2:06 PM (GMT 0)
Did your lab work include the normal range for each of these tests or was there a low or high written beside any of the values? Labs have different normal ranges depending on the equipment they use. I know if the lab I go to tells me my bilirubin is 18, I'm back at the hepatologists yesterday...that's why there would be an indication beside each test if it's out of range.

I would also ask to see a hepatologist as your unconjugated bilirubin is higher than your conjugated... which could indicate Gilbert's Syndrome. It says you weren't jaundiced but it would be good to double check on that too.

If I were you, I would set up an appointment for when you return home and have your labs run again including the CMV. I'd also request a referral to an infectious disease doc to discuss your CMV results. If all your labs come back normal again, also ask to have your gallbladder checked.

Sometimes pressures around where your liver is could be intestinal. The liver is a huge organ. Your intestines share a lot of the same space (they roll around under the liver).
Posted 7/11/2014 4:05 PM (GMT 0)
er yeah. there are more numbers on this paper probably corresponding to what you're asking for. didn't include those. i wish this forum would allow me to upload the pdf. in any event, the doc said there was nothing out of the ordinary. i won't be home for a year at least. ill be in Penang, Malaysia next week for a month, so I'll go to Island Hospital over there. It's a medical tourism hub, they know what they're doing, so I've heard. Again, what do you think are the chances that this could still be the EBV/CMV?

Thanks for all your input.
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