The immune system is designed to protect you from illness and disease. When it works as it should, the body is kept healthy and relatively safe from various pathogens. However, some things can cause the immune system to malfunction. From not eating the right foods to leading a sedentary lifestyle and missing out on precious sleep, there is no shortage of lifestyle factors associated with weakened immunity. Environmental risks can also cause the immune system to run poorly, including viruses like Epstein-Barr. But does having Epstein-Barr make you immunocompromised?
Research has long examined what being immunocompromised means, how it affects health, and what causes it. To date, there are some answers to all these questions – but some things are still a mystery. Recent data surrounding the Epstein-Barr virus has painted a picture of its connection to autoimmune disease and immunocompromised individuals. But does it cause a person’s immune system to falter, or is there more to the story than that?
What are the causes of Epstein-Barr?
Technically, there is no “cause” of the Epstein-Barr virus. EBV is a virus that can lead to various illnesses, including mononucleosis (or “mono”). It’s thought that as many as 90% of the world’s population has the Epstein-Barr virus in their body. We often simply don’t realize it because not everyone experiences symptoms.
EBV is a highly contagious virus. Methods of transmission include:
- Sharing a toothbrush, drinking glass, straw, or other objects that cause saliva to spread from one person to another
- Kissing (which is why mono is often referred to as “the kissing disease”)
- Sexual transmission through semen
- Blood transfusions
- Organ transplants
Once a person has the Epstein-Barr virus in their body, they can spread it to others for weeks before experiencing any symptoms (if they experience them at all).
What are the symptoms of Epstein-Barr?
There are many symptoms of Epstein-Barr virus, but they don’t always develop in every person. This is especially true in children who contract the virus. Since transmission most commonly happens during childhood, it’s no surprise that most of the world’s population has the virus but does not know it.
Symptoms of Epstein-Barr virus include:
- Fatigue
- Fever
- Inflamed throat
- Swollen lymph nodes in the neck
- Enlarged spleen
- Swollen liver
- Rash
These symptoms are also present in other common infections, so even if a person experiences them, they are unlikely to assume they have Epstein-Barr right off the bat. Once the symptoms subside, the virus becomes inactive in the body but remains there for the rest of a person’s life.

What dos immunocompromised mean?
Immunocompromised is the term used to describe a weakened immune system. When the cells and processes of immunity are not firing as they should, they are less able to fight off infection. Some versions of weakened immunity are temporary, while others are permanent – it depends on the cause.
Is Epstein-Barr considered an autoimmune disease?
Epstein-Barr is a virus, so it is not considered an autoimmune disease. Autoimmune diseases occur when the body’s immune system attacks itself. This happens when healthy cells are mistaken for foreign pathogens, and immune cells start to engage in “friendly fire,” damaging the area of the body that’s affected.
What does EBV put you at risk for?
While Epstein-Barr isn’t an autoimmune disease in and of itself, it can put the body at risk for developing certain types of autoimmune diseases and various forms of cancer. Some of the conditions linked to Epstein-Barr include:
- Hodgkin’s lymphoma
- Non-Hodgkin’s lymphoma
- Burkitt’s lymphoma
- Post-transplant lymphoproliferative disease
- Nasopharyngeal carcinoma
- Systemic lupus erythematosus
- Rheumatoid arthritis
- Multiple sclerosis
- Inflammatory bowel disease
- Type 1 diabetes
- Juvenile idiopathic arthritis
- Celiac disease
Other issues that Epstein-Barr can cause include:
- Inflammation of the brain, spinal cord, and eye nerves
- Facial paralysis
- Ataxia
- Paralysis on one side of the body
- Sleep disorders
- Psychoses
Research is still ongoing to determine precisely how Epstein-Barr can cause these issues, but some suggest that genetics may be a factor.

Does having Epstein-Barr make you immunocompromised?
Because of the way Epstein-Barr affects the blood and bone marrow, it can lead to weakened immune systems in some people. Blood and bone marrow house and produce the cells that help the body fight off infection. Lymphocytes, which are white blood cells that fight pathogens, are produced by the bone marrow, and when a person has Epstein-Barr, production can kick into high gear. That means these cells will be made in excessive amounts, which can lead to a condition known as lymphocytosis.
This alone doesn’t cause a weakened immune system. It signals an infection or inflammation in the body that’s being fought off. That said, the Epstein-Barr virus can weaken the immune system in other ways by causing:
- Neutropenia
- Hemophagocytic syndrome
- Acquired hypogammaglobulinemia
- X-linked lymphoproliferative disease
These conditions are all known to hinder the immune system’s ability to fight against harmful substances.
How is EBV treated in immunocompromised patients?
Treating Epstein-Barr is difficult in healthy individuals because there are limited therapeutic options for viruses. In immunocompromised people, the choice of medication is even slimmer because many antivirals that can be used for Epstein-Barr shouldn’t be used in those with weakened immune systems. Treatments are still being explored for those with active Epstein-Barr infections and weakened immunity.
Featured image by Engin Akyurt on Unsplash