EBNA-1 IgG
Positive is considered a normal result. All genders and ages >12 months
EB-VCA IgG
Not applicable
EB-VCA IgM
Negative is considered a normal result. All genders and ages.
Uncertainty of measurement:
EBNA-1 IgG, EB-VCA IgG and EB-VCA IgM are all reported qualitatively and as such, determination of UOM is not applicable
.
EBNA-1 IgG
is used as a screening assay for all patient EBV serology requests. If the EBNA-1 IgG assay is positive there will be no further testing. In settings where the EBNA-1 IgG assay result is negative, there will be automatic reflexing and reporting for EB-VCA IgG and EB-VCA IgM.
Testing is performed daily
with automatic release of all results except when the EB-VCA IgM assay is reactive.
EB-VCA IgM
reactive results require review which will occur within 48h.
EBNA-1 IgG
Effective from 30 September 2024
Assay:
Elecsys EBNA-1 IgG (qualitative)
Method Principle
: Sandwich assay principle using Electrochemiluminescence (ECLIA)
Platform
: COBAS e801 Immunoassay module
EB-VCA IgG
Effective from 30 September 2024
Assay:
Elecsys EB-VCA IgG (qualitative)
Method Principle
: Sandwich assay principle using Electrochemiluminescence (ECLIA)
Platform:
COBAS e801 Immunoassay module
EB-VCA IgM
Effective from 30 September 2024
Assay:
Elecsys EB-VCA IgM (qualitative)
Method Principle:
Mu (u) - capture assay principle using Electrochemiluminescence (ECLIA)
Platform:
COBAS e801 Immunoassay module
Clinical
Epstein Barr Virus (EBV), also known as human herpesvirus-4 [HHV 4], is one of the commonest human viruses with most people becoming infected at some point in their lives. EBV infection is often asymptomatic although in teenage and young adult Caucasians, primary infection may be symptomatic, presenting as infectious mononucleosis (IM), in 35-50% of cases.
Symptoms of IM include fever, sore throat and lymphadenopathy. Occasionally, hepatosplenomegaly may develop and rarely, heart problems or involvement of the central nervous system. Symptoms usually resolve within 8-12 weeks. As is typical for the Herpesviridae, latency is established (B lymphocytes) and under certain conditions which includes host immunosuppression, viral re-activation may occur.
EBV is associated with a variety of lymphoproliferative disorders, especially in immunocompromised hosts, and is also associated with nasopharyngeal carcinoma and Burkitt's lymphoma.
Viral replication occurs in nasopharyngeal epithelial cells and thus EBV is present in oropharyngeal secretions (saliva). Transmission is primarily through salivary secretions (hence 'kissing disease').
Infectious mononucleosis was traditionally diagnosed clinically, supported by presence of atypical lymphocytes in blood films. Testing for heterophile antibody is still used as a convenient although non-specific screen
Serology
Serology results in the immunosuppressed patient and those receiving blood products should be interpreted with caution and may require discussion with a Clinical Virologist.
As EBNA-1 IgG is produced 6-12 weeks after symptom onset in primary infection and persists life-long, patients with positive EBNA-1 IgG results need no other EBV serological marker testing.
Patients with negative EBNA -1 IgG results will be have reflexed testing for both EB-VCA IgG and EB-VCA IgM. Detection of EB-VCA IgM in such patients is presumptive serological evidence of primary EBV infection (refer graph below)
Other EBV tests:
|
| EBV Serology over the time |
Dr. Gary McAuliffe
GMcAuliffe@adhb.govt.nz
- Clinical Virologist
Dr. Erasmus Smit
ErasmusS@adhb.govt.nz
- Clinical Virologist
Centrifuge primary blood specimens and / or separated serum and transport with refrigerated chiller packs (4 0 C)