Serological Markers and EBV DNA of Epstein–Barr Virus Infection in a Health Examination Cohort from Chongqing, China

This study aimed to characterize Epstein-Barr virus (EBV) serological markers and EBV DNA profiles in a healthy examination cohort from Chongqing, China, and to examine their associations with routine hematological and biochemical parameters. This retrospective cross-sectional study included adults undergoing routine health examinations in Chongqing between 2019 and 2024. EBV serology (EA-IgA and VCA-IgA) was assessed in 4,535 individuals using ELISA, and EBV DNA was measured in 6,508 individuals by quantitative PCR. Hematological indices and liver and renal function markers were compared across EBV antibody subgroups and EBV DNA status. Multivariable linear regression analyses were performed with adjustment for age and sex. VCA-IgA seroprevalence was significantly higher than EA-IgA (13.38% vs. 6.09%, <i>p</i> < 0.001), with both peaking in the 41-50-year age group. EBV DNA was detected in 7.24% of individuals, with positivity increasing with age (≥61 years: 12.09%) and being higher in males than females (7.81% vs. 6.06%, <i>p</i> = 0.010). Among EBV DNA-positive individuals, 86.17% had low viral loads (<10⁴ copies/mL). After adjustment, EBV seropositivity and EBV DNA positivity were independently associated with statistically significant differences in leukocyte subsets and hepatic and renal markers; however, all median values remained within established clinical reference ranges. EBV infection markers in this inland Chinese health examination population exhibited distinct age- and sex-related distributions and showed independent associations with subtle physiological variations rather than overt pathology. Importantly, EBV serological markers and EBV DNA demonstrated differential association patterns, indicating that they convey complementary and nonredundant biological information in assessing EBV infection status.