Serum epstein–barr virus DNA load in primary epstein–barr virus infection

Abstract

Specific viral laboratory diagnosis of primary Epstein-Barr Virus (EBV) infection is usually based on antibody-detection assays. During acute, lytic phase of infection, viral DNA can also be detected in serum. In the present study, the diagnostic utility of EBV DNA detection and quantitation in serum in primary EBV infection was investigated. The level of EBV DNA in the serum of 98 immunocompetent patients aged 1-47 years with symptomatic, antibody-confirmed EBV primary infection was assessed using a quantitative real-time PCR assay. The association between viral load and time after onset of disease, age and clinical and laboratory data was investigated. Quantitative PCR detected EBV DNA in 93 of 98 samples (94.9%), and the measured viral loads ranged from 3.8 x 10(1) to 6.6 x 10(4) copies/ml. EBV DNA detection exhibited a sensitivity of 94.9% and a specificity of 97.4% for primary EBV infection. EBV DNA was always detectable until day 12 after onset of symptoms, whereas no further positive PCR results were found after a period of 22 days after onset of disease. Detection of EBV DNA also showed a clearer association with the clinical manifestation of disease than the presence of EBV specific VCA IgG antibodies of low avidity. EBV DNA load was found to correlate inversely with the time after onset of disease (P < 0.001), and higher viral load levels were detected in younger (P = 0.009) and in hospitalized patients (P = 0.038). The results indicate that real-time PCR is a reliable tool for diagnosis of primary EBV infection early in the course of disease. In addition, EBV DNA detection may serve as a useful diagnostic supplement in serologically indeterminate EBV infections.

Transcriptional profiling of Epstein–Barr virus (EBV) genes and host cellular genes in nasal NK/T-cell lymphoma and chronic active EBV infection

“…The EBV gene expression pattern of cells from a patient in the acute phase of IM exhibited a distinct feature, which did not mimic any other samples used in the current study. As peripheral blood cells in IM patients may be composed of EBV lytically infected cells as well as latently infected cells (Bauer et al, 2005), we found that a subset of EBV lytic genes including BZLF1 in Group 5 were expressed in IM-a cells. In Akata cells, a limited number of latency-associated genes, such as BKRF1, which encodes EBNR1 (Group 1) was detected.…”

Serological diagnosis of Epstein-Barr virus infection: Problems and solutions

“…EBV DNA can therefore be determined in serum or plasma as well as in PBMCs [84] . In patients with primary infection, it is frequently detected in whole blood (PBMCs and plasma/serum) within 14 d of symptom onset [85][86][87][88][89] . After the initiation of an immune response, viral load decreases slowly in PBMCs, but rapidly in plasma/serum, and it becomes undetectable after 3-4 wk [90][91][92] , whereas memory cells with EBV may remain latent for a long time in blood.…”

“…The presence of plasma/serum EBV-DNA is therefore considered a sign of primary infection [13] or reactivation, and the viral load correlates with disease severity [85,88,92] . A search for EBV DNA may be more sensitive than serology in the early stages of the disease [89] , and some studies have found that it correlates better with clinical acute infection than the avidity of VCA IgG [86] . However, in immunocompetent patients with acute infection, it is not usually necessary to look for EBV DNA as serology is sufficient except in cases with negative or doubtful serological findings in which there is a strong clinical suspicion of infection [89,97,98] .…”

“…Using this method to examine cases of isolated VCA IgG, about 20% was identified as acute infections and 80% as past infections [107] . A VCA IgG avidity test can also be used to distinguish acute and past infection [64,67] , which are respectively characterized by low and high levels of avidity; studies of patients with isolated VCA IgG have found low levels in about half of the cases, and high levels in the remaining half [75,86] . When using avidity test, it is important to have all the patients' temporal clinical data in order to interpret the results more appropriately.…”

New cellular tools reveal complex epithelial–mesenchymal interactions in hepatocarcinogenesis

“…PCR products were separated in 1.2% agarose gels, stained with ethidium bromide, and visualised by UV-light. Viral DNA of Epstein-Barr-virus (EBV) was detected as given elsewhere (Bauer et al, 2005;Drucker et al, 2006).…”