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Test Code EBV ANTIBODY PANEL EBV ANTIBODY PANEL

Department

Immunology

Group Components

Antibodies to EBV Nuclear Antigen-1, Viral Capsid Antigen, and Early Antigen Diffuse and Heterophile Antibody IgM.

Specimen Type

Serum

Container

No additive with gel (gold hemogard) or No additive (red top)

Standard Volume

10ml

Minimum Volume

1ml

Pediatric Volume

N/A

Method

Multiplex Flow Immunoassay

Ship Temperature

Refrigerated

Stability Room Temp

8 hours

Stability Refrigerated

7 days

Stability Frozen

N/A

CPT Code

86663 × 2 , 86665 × 2, 86664 × 1

Days Test Set Up

Tuesday, Thursday

Clinical Information

Epstein-Barr virus(EBV) is a member of the herpesvirus family that infects human lymphocytes. It is known to cause Infectious Mononucleosis (IM) and is transmitted primarily by saliva. EBV causes a persistent latent infection with intermittent reactivations. EBV infection is usually asymptomatic in infants and young children. In adolescents and young adults usually results in IM. Diagnosis is generally based on the characteristic symptoms of sore throat, lymphadenopathy, fever, splenomegaly and possibly the presence of heterophile antibodies.

Test Use

Diagnosis of EBV infection.

Cautions

*The test should be performed on serum. The use of whole blood or plasma has not been validated.

*There is a possibility of cross-reactivity with specimens containing anti-E. coli antibodies.

*The performance characteristics have not been established for patients with nasopharyngeal carcinoma, Burkitt’s lymphoma, other EBV associated lymphadenopathies, and other EBV associated disease other than EBV-related mononucleosis.

*A single result cannot be used for diagnosis. Accurate interpretation of EBV infection is based on the results from VCA IgG, VCA IgM, EBNA-IgG, EBNA-IgM, EA-D IgG, EA-D IgM, EA-D IgG, EA-D IgM and the heterophile antibody testing.

*Results from immunosuppressed patients should be interpreted with caution.

*Since rheumatoid factor(RF) binds to IgG in immunocomplexes, a false positive may arise in sera with RF and specific IgG. False negatives may arise due to specific IgG complexing with the specific IgM. The goat anti-human IgG in the sample diluent diminishes RF interference and minimizes competing specific IgG in the samples. The sample diluent removes > 95% of the IgG at levels of 1400 mg/dl. Samples with IgG levles > 1400 mg/dl should be interpreted with caution.

Interpretation

Humoral response to primary EBV infections appears to be quite rapid. Antibodies to EBV are made to various viral proteins, with specific antibodies correlating to disease state. In acute infection, IgM and then IgG antibodies are sequentially made to early antigen –diffuse(EA), viral capsid antigen(VCA) and nuclear antigen(EBNA). Current or recent infection is marked by the presence of IgM antibodies to VCA, EA-D and EBNA. IgG antibodies to VCA and EA-D are normally present in current infection, while IgG antibodies to EBNA are absent. Post EBV infection is indicated by sustaining IgG antibody to VCA and EBNA and the absence of IgM antibodies.

Serological Diagnosis of EBV Infection

Disease State EA-D IgM EA-D IgG VCA IgM VCA IgG EBNA-1 IgM EBNA-1 IgG
Susceptible/
Seronegative Negative Negative Negative Negative Negative Negative
Acute Primary/
Current Positive Positive Positive Positive Positive Negative
Convalescent/
Transitional Negative Positive Pos/Neg Positive Pos/Neg Pos/Neg
Past Infection Negative Negative Negative Positive Negative Positive
Reactivation Negative Positive Negative Positive Negative Positive
EA-D Early Antigen-diffuse VCA Viral Capsid Antigen EBNA Nuclear Antigen