Immunoassays for the qualitative detection of specific antibodies to Epstein-Barr virus (EBV)
The Elecsys® EBV panel consists of three immunoassays to detect antibodies specific to the Epstein-Barr virus (EBV). The three assays, Elecsys® EBV IgM, Elecsys® EBV VCA IgG, and Elecsys® EBV EBNA IgG should be used in combination to accurately determine the patient’s EBV infection stage.
Epstein-Barr virus (EBV) is the most ubiquitous virus in humans, infecting more than 90 % of the global population by adulthood.1,2 It is mainly transmitted by saliva, but also sexually, and via transplantation of solid organs and hematopoietic stem cells.2 After primary infection, EBV persists for life in a latent state in B-cells.1 Clinical symptoms vary according to the immune status of the patients. Primary infection is often asymptomatic during childhood, but often results in infectious mononucleosis (IM) in adolescents and adults. IM is characterized by the triad of fever, pharyngitis and lymphadenopathy, but is self limiting and rarely results in severe complications.3 In immunocompromised individuals, EBV infection has been associated with a variety of autoimmune and neoplastic disorders including lymphomas and carcinomas.3
EBV serology tests are routinely performed to determine the EBV infection stage, to confirm the clinical diagnosis of infectious mononucleosis, and to determine the immune status of transplant donors and recipients before transplantation.2,4,5 In immunocompetent individuals, the presence of VCA (viral capsid antigens) IgG and IgM EBV specific antibodies in the absence of EBNA-1 (Epstein-Barr nuclear antigens) IgG antibodies indicates acute infection. In contrast, the presence of VCA IgG and EBNA-1 IgG antibodies in the absence of IgM antibodies indicates past infection.4,6
* 95 % confidence interval (2-sided)
* 95 % confidence interval (2-sided)
* 95 % confidence interval (2-sided)
Assay result | Corresponds to EBV infection stage | ||
---|---|---|---|
Elecsys® EBVIgM | Elecsys® EBV VCA IgG | Elecsys® EBV EBNA IgG | |
non-reactive | non-reactive or borderline | non-reactive | Seronegative |
reactive or borderline | non-reactive | non-reactive | Presumed early phase of EBV infection* |
reactive or borderline | reactive or borderline | non-reactive | Acute phase of EBV infection |
reactive | reactive or boderline | reactive | Presumed transient phase of EBV infection* |
non-reactive or borderline | reactive or borderline | reactive | Past EBV infection |
non-reactive | reactive | non-reactive | Isolated VCA IgG* |
non-reactive | non-reactive | reactive | Isolated EBNA IgG* |
Abbreviations
EBNA: Epstein-Barr virus nuclear antigen.
VCA: Viral capsid antigen.
References