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Epstein-Barr Virus (EBV) Antibody Profile

CPT: Call client services.

Synonyms

  • EBV
  • Mononucleosis

Expected Turnaround Time

1 - 2 days


Specimen Requirements


Specimen

Serum


Volume

2 mL


Minimum Volume

0.5 mL (Note: This volume does not allow for repeat testing.)


Container

Red-top tube or gel-barrier tube


Storage Instructions

Room temperature


Stability Requirements

Temperature

Period

Room temperature

14 days

Refrigerated

14 days

Frozen

14 days

Freeze/thaw cycles

Stable x4


Causes for Rejection

Hemolysis; lipemia; grossly icteric; visible particulate matter; gross bacterial contamination


Test Details


Use

Aid in determining past or present infection with EBV as well as susceptibility to future infection.


Limitations

The results from this panel are not by themselves diagnostic and should be considered in association with other clinical data and patient symptoms. This test is intended for qualitative determination only. The numeric value of the final result above the cutoff is not indicative of the amount of antibodies present.


Methodology

Chemiluminescent Immunoassay (CLIA)


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 heterophile antibody, as many as 20% may be heterophile-negative, at least at presentation (Heterophile 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

VCA-IgM

VCA-IgG

EBNA-IgG

Key — Antibody present: (+); Antibody absent: (−)

No previous infection/Susceptibility

Primary infection (new or recent)

+

+

Past infection

±

+

+

See comment below*

+

*Results indicate infection with EBV at some time however cannot predict the timing of the infection since antibodies to EBNA usually develop after primary infection or, alternatively, approximately 5-10% of patients with EBV never develop antibodies to EBNA.


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CPT Statement/Profile Statement

The LOINC® codes are copyright © 1994-2018, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. Permission is granted in perpetuity, without payment of license fees or royalties, to use, copy, or distribute the LOINC® codes for any commercial or non-commercial purpose, subject to the terms under the license agreement found at https://loinc.org/license/. Additional information regarding LOINC® codes can be found at LOINC.org, including the LOINC Manual, which can be downloaded at LOINC.org/downloads/files/LOINCManual.pdf