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HelpTest Code LAB4236 EPSTEIN-BARR VIRUS (MONO) ANTIBODY PROFILE
Specimen Volume
1 mL
Minimum: 0.5 mL
Turnaround Time
Monday-Friday, Days
Sample Stability
Room Temp: 8 hours
Refrigerated: 2 days
Frozen: 1 year
Specimen Type and Processing
Serum (SST, Gold, Corvac, Tiger, Red Top Tube)
Allow specimen to fully clot. Centrifuge specimen within 2 hours of collection. Pour off serum and freeze if testing is not performed within 48 hours.
Specimen Rejection
Do not use lipemic, hemolyzed, or turbid specimens.
Reference Ranges
Negative
Test Components
EBNA (Anti-Epstein-Barr Virus Nuclear Antigen, IgG)
EBVG (Epstein-Barr Virus Viral Capsid Antigen IgG)
EBVM (Epstein-Barr Virus Viral Capsid Antigen IgM)
Result Interpretation
Anti-Epstein-Barr Virus Nuclear Antigen (EBNA), IgG:
| Index Value | Interpretation |
|
< 0.9 |
Negative for anti-EBNA IgG antibody |
|
> 0.9 and 1.1 |
Equivocal |
|
> 1.1 |
Positive for anti-EBNA IgG antibody |
Index values which fall between 0.9 and 1.1 indicate an equivocal result. Subsequent samples should be drawn at least fourteen days later and tested simultaneously with the initial sample. If the subsequent sample is positive, seroconversion has occurred, which may be indicative of recent infection. If the subsequent sample remains equivocal, antibody status is undetermined and the sample is deemed equivocal. Other clinical and serological evidence should be sought in these cases.
Epstein-Barr Virus Viral Capsid Antigen IgG:
|
Index Value |
Interpretation |
|
< 0.9 |
Negative for anti-EB VCA IgG antibody |
|
> 0.9 and < 1.1 |
Equivocal |
|
> 1.1 |
Positive for anti-EB VCA IgG antibody |
Index values which fall between 0.9 and 1.1 indicate an equivocal result. Subsequent samples should be drawn at least fourteen days later. If the subsequent sample is positive, seroconversion has occurred, which may be indicative of recent infection. If the subsequent sample remains equivocal, antibody status is undetermined and the sample is deemed equivocal. Other clinical and serological evidence should be sought in these cases.
Epstein-Barr Virus Viral Capsid Antigen IgM:
|
Index Value |
Interpretation |
|
< 0.9 |
Negative for anti-EB VCA IgM antibody |
|
>0.9 and < 1.1 |
Equivocal |
|
>1.1 |
Positive for anti-EB VCA IgM antibody |
Index values which fall between 0.9 and 1.1 indicate an equivocal result. Subsequent samples should be drawn at least fourteen days later and tested simultaneously with the initial sample. If the subsequent sample is positive, seroconversion has occurred, which may be indicative of recent infection. If the subsequent sample remains equivocal, antibody status is undetermined and the sample is deemed equivocal. Other clinical and serological evidence should be sought in these cases.
Negative results do not rule out the diagnosis of disease associated with Epstein-Barr virus. The specimen may be drawn before appearance of detectable antibodies. Negative results in suspected early disease should be repeated in 3-4 weeks. This information should accompany the reporting of results to the clinician.
Clinical Information
Epstein-Barr virus (EBV) is the etiological agent of infectious mononucleosis (IM). The designation of infectious mononucleosis classically refers to an Epstein-Barr virus-induced illness in young adults characterized by reactive blood smears, exudative pharyngitis, prominent cervical lymphadenopathy, and serologically detectable heterophile antibodies. These clinical manifestations can also be caused by a number of other pathogenic agents including cytomegalovirus, Toxoplasma gondii, rubella virus, hepatitis virus, human immunodeficiency virus (HIV), and uncommonly by drugs such as Halothane, Hydantoin, Dapasone, and Azulfidine.
Diagnosis of acute EBV IM is generally confirmed by a positive heterophile antibody test. The severity of the disease, however, is not indicated by the relative titer of heterophile antibodies. In addition, difficulties in diagnosis arise when the heterophile antibody test is negative, or when the clinical manifestations are atypical or unusually severe.
Heterophile-negative IM occurs in 10 to 20 percent of adults, and in an even greater percentage of children. IM diagnosis in these individuals may be confirmed by the detection and identification of antibodies to specific EB antigens which include viral capsid antigen (VCA), early antigens, diffuse and restricted (EA-D and EA-R), and Epstein-Barr nuclear antigen (EBNA).
IgG antibodies to VCA may be present early during EBV infection, but they persist indefinitely after the occurrence of clinical disease and may merely indicate EBV infection at some time in the past. IgM antibodies to VCA, on the other hand, are present in the circulation 1 to 6 weeks after the onset of EBV illness and usually disappear in 3 to 6 months. Thus, the presence of VCA IgM usually suffices for the diagnosis of acute IM. Further verification may be obtained by testing for the presence of antibodies directed against the other EBV-specific antigens, early antigen, and EBNA. Heterophile antibody negative sera demonstrating VCA IgM and transient levels of antibody to early antigen are considered diagnostic for acute IM. In contrast, antibodies to EBNA appear late during IM infections, and IgG antibodies to EBNA may persist for years, even for life, and are indicative of the convalescent phase of IM infection.
Method
Qualitative Enzyme Immunoassay (EIA)
Synonyms
Epstein-Barr Virus, EBV
Mononucleosis, Heterophile Ab, Blood
CPT Codes
86665,86664