Epstein-Barr Virus (EBV) Acute Infection Antibodies Profile

CPT: 86663; 86664; 86665(x2)
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Test Details

Synonyms

  • EBV Acute Infection Antibodies

Test Includes

EBV-EA, IgG; EBV-VCA, IgG; EBV-VCA, IgM; Epstein-Barr nuclear antigen antibodies (EBNA); interpretation

Use

Differentiation of acute from chronic or reactivated infections with Epstein-Barr virus

Methodology

Chemiluminescent immunoassay (CLIA)

Reference Interval

See individual tests.

Additional Information

Epstein-Barr (EB) virus is a herpes group virus that is ubiquitous. It is the cause of classic infectious mononucleosis and is causally implicated in the pathogenesis of Burkitt lymphoma, some nasopharyngeal carcinomas, and rare hereditary lymphoproliferative disorders. The serologic response to EB virus includes antibody to early antigen, IgM and IgG antibodies to viral capsid antigen (VCA), and antibodies to Epstein-Barr nuclear antigen (EBNA).

Although most cases of infectious mononucleosis can be diagnosed on the basis of clinical findings, blood count and morphology, and a positive test for heterophil antibody, as many as 20% may be heterophil-negative, at least at presentation (Heterophil may become positive when repeated in a few days.). In some of these cases, a test for Epstein-Barr virus antibodies may be useful.

The most controversial use of EBV serology is in chronic fatigue syndrome, a complaint predominantly (but not exclusively) of young to middle-aged women, characterized by long persistent debilitating fatigue and a panoply of usually mild somatic complaints. The high levels of EBV antibodies in the general population, their long persistence, and the poor correlation of antibody titers with symptoms combine to make EBV serology useless in diagnosing, following, or ruling out chronic fatigue syndrome. See table.

EBV Interpretation Table

Interpretation

EBV-IgM

EA(D)-IgG

VCA-IgG

EBNA-IgG

Key — Antibody present: + Antibody absent: −

EBV seronegative

Early phase

+

Acute primary infection

+

±

+

Convalescence/past infection

±

+

+

Reactivated infection

±

+

+

+

Specimen Requirements

Specimen

Serum

Volume

2 mL

Minimum Volume

1 mL

Container

Red-top tube or gel-barrier tube

Storage Instructions

Room temperature. Specimen is stable for two days at room temperature or refrigerated. For storage longer than two days, freeze the specimen.

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
216655 EBV Acute Infection Antibodies 096739 EBV Ab VCA, IgM U/mL 5159-9
216655 EBV Acute Infection Antibodies 096252 EBV Early Antigen Ab, IgG U/mL 24007-7
216655 EBV Acute Infection Antibodies 096235 EBV Ab VCA, IgG U/mL 5157-3
216655 EBV Acute Infection Antibodies 010276 EBV Nuclear Antigen Ab, IgG U/mL 30083-0
216655 EBV Acute Infection Antibodies 169992 Interpretation: 8251-1

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