Determination of serological profiles and avidity of specific antibodies in the sera of patients with potential Epstein-Barr virus (EBV) infection

Abstract

Abstract:Background: Epstein-Barr Virus, frequently referred to as EBV, is a member of the herpesvirus family and one of the most common human viruses. The virus occurs worldwide, and most people become infected with EBV sometime during their lives. Objectives: The purpose of this study was to investigate the serological profi les of specifi c antibodies among the sera of suspected EBV infection patients along with VCA-IgG avidity. Methods: A total of 522 patient's sera were sent to The Clinical Microbiology Laboratory for EBV specifi c antibody detection and were studied by IFA method during a two year period. The serum samples were tested for EBV specifi c VCA IgG, VCA IgM, EA, EBNA antibodies and VCA IgG aviditity. Results: Among 33 patients those who had low avidity for VCA IgG, 27 (81.8 %) of them had a serologic profi le as follows; positive VCA IgG, negative VCA IgM, negative EA and negative EBNA. Conclusion: While this profi le is considered as a primary infection, the frequency of the coexistence of VCA IgG low avidity with this profi le is interepreted that avidity may lead to detect primary infection (Tab. 2, Ref. 25 Abbreviations: IFA -indirect fl uorescent antibody, EBV -Epstein-Barr virus, EA -early antigen,VCA -viral capsid antigen, EBNA -epstein-barr nuclear antigen.Epstein-Barr virus, commonly referred to as EBV, is a human specifi c member of the herpesvirus family and is a B-cell lymphotropic virus. An EBV infection occurs by close contact with EBV presented in oral secretions. The virus initially wells in the oropharyngeal epithelial cells and causes persistent infections. Seroepidemiologic studies indicate that EBV infections are common in all communities and occur worldwide, and most people become infected with EBV sometime during their lives. In Europe including Turkey, as many as 70-80 % of adolescents and 80-90 % of adults are reported to be seropositive for EBV (1).The course of EBV infection can vary with regard to the age and health status of the person. In young children host-virus infection can take place with no apparent symptoms. By contrast, in 30-50 % of the adult patients EBV infection can cause diffuse lymphadenopathy, hepatomegaly, splenomegaly, and tonsillitis. In some cases exanthematous reactions triggered by EBV can be mistaken with an eruption of rubella (2). Moreover, EBV infection is shown to be associated with lymphoproliferative disorders in patients who are suffering from immunodefi ciency, Burkitt lymphoma, and nasopharyngeal carcinoma (3,4). Infectious mononucleosis is also caused by infection of B cells by EBV and is generally diagnosed by serological methods. EBV serology is utilized to help distinguish EBV reactivation infections from primary EBV infections and to demonstrate acute EBV infections. During this process, it is critically important to perform the tests at the same time for the presence of EBV-VCA IgM, EBV-VCAIgG, anti-EBV-EA, anti EBV-EBNA and VCA IgG avidity (2).The spectrum of antibody assays comprises unspecifi c tests, such as the long-known te...

Analysis of two laboratory tests for determination of EBV‐IM in children

“…17 This study showed that, although the specificity of lowaffinity EBV-CA IgG alone was good for the diagnosis of EBV-IM, its sensitivity was only 59.6%, and the ROC curve showed that its AUC was the highest among the individual indices, which could reach 0.798, indicating a high diagnostic predictive value, which is consistent with that reported in the literature. 17 Antibody affinity testing is also the recommended diagnostic method according to current guidelines. This finding may be attributed to the fact that the body first produces low-affinity antibodies when invaded by pathogens and the antibody affinity gradually increases as the infection process progresses.…”

“…In recent years, antibody affinity testing has gradually been adopted to determine whether a patient is in the acute phase of infection 17 . This study showed that, although the specificity of low‐affinity EBV‐CA IgG alone was good for the diagnosis of EBV‐IM, its sensitivity was only 59.6%, and the ROC curve showed that its AUC was the highest among the individual indices, which could reach 0.798, indicating a high diagnostic predictive value, which is consistent with that reported in the literature 17 . Antibody affinity testing is also the recommended diagnostic method according to current guidelines.…”