Serological diagnosis of Epstein-Barr virus infection: Problems and solutions

Abstract

Serological tests for antibodies specific for Epstein-Barr virus (EBV) antigens are frequently used to define infection status and for the differential diagnosis of other pathogens responsible for mononucleosis syndrome. Using only three parameters [viral capsid antigen (VCA) IgG, VCA IgM and EBV nuclear antigen (EBNA)-1 IgG],it is normally possible to distinguish acute from past infection: the presence of VCA IgM and VCA IgG without EBNA-1 IgG indicates acute infection, whereas the presence of VCA IgG and EBNA-1 IgG without VCA IgM is typical of past infection. However, serological findings may sometimes be difficult to interpret as VCA IgG can be present without VCA IgM or EBNA-1 IgG in cases of acute or past infection, or all the three parameters may be detected simultaneously in the case of recent infection or during the course of reactivation. A profile of isolated EBNA-1 IgG may also create some doubts. In order to interpret these patterns correctly, it is necessary to determine IgG avidity, identify anti-EBV IgG and IgM antibodies by immunoblotting, and look for heterophile antibodies, anti-EA (D) antibodies or viral genome using molecular biology methods. These tests make it possible to define the status of the infection and solve any problems that may arise in routine laboratory practice.

Heterogeneity in association of remote herpesvirus infections and pediatric MS

“…As mentioned previously, we did not analyze EBNA‐1 seropositivity because the manufacturing source of the antigen changed during the study and the results were not consistent. While antibody responses against VCA are universally present in EBV exposed persons, EBNA‐1 IgG is not produced in about 5% of patients after EBV infection and in some individuals, it may disappear over time 28. Hence, the anti‐VCA IgG is a more reliable indicator of previous EBV exposure.…”

Seroprevalence of Anti-EBV IgG among Various Age Groups from Khon Kaen Province, Thailand

“…The presence of anti-EBV IgM signifies an acute infection or a reactivation of the virus (De Paschale and Clerici, 2012;Nystad and Myrmel, 2007). Since we tested for IgM in young infants, it was very likely that a positive IgM was the result of an acute infection.…”

“…Epstein-Barr virus (EBV), a member of the Herpesviridae family, is a major cause of infectious mononucleosis in young children and adolescents (De Paschale and Clerici, 2012). More than 90% of the adult population worldwide has antibodies against EBV (Hsu and Glaser, 2000).…”

Solving Summer Fever in Early Pregnancy

“…Because the sensitivity of heterophile antibody test is 96-100 %, the patient's negative heterophile test makes the diagnosis of EBV unlikely, but does not exclude it. 6 Specific EBV serologies are indicated when there is a clinical suspicion for EBV infection but heterophile antibody testing is negative, as in this case. 6 Current EBV serologic testing is based on assaying for three different parameters to distinguish acute from prior infection.…”

“…6 Specific EBV serologies are indicated when there is a clinical suspicion for EBV infection but heterophile antibody testing is negative, as in this case. 6 Current EBV serologic testing is based on assaying for three different parameters to distinguish acute from prior infection. These include viral capsid IgM (VCAM), viral capsid IgG (VCAG) and nuclear antibody (VNAB).…”