Epstein-Barr virus (EBV) One hundred VCA-IgM (serum)

Epstein-Barr virus (EBV) Is a ubiquitous lymphotropic herpes virus that infects approximately 95% of the population into adulthood. It is the etiologic agent of infectious mononucleosis and is also involved in the development of Berkeley lymphoma, nasopharyngeal carcinoma, X-linked lymphoproliferative syndrome, and chronic fatigue syndrome.

The main route of transmission of the virus is through contact with infected oropharyngeal secretions. EBV replicates in the oropharyngeal epithelium, releasing virions from infected lymphocytes and excreting them in saliva.

Infection in children is often asymptomatic. Infectious mononucleosis is most common in young people who do not have a history of EBV viral infection. After the primary infection, EBV remains dormant throughout the body.

In immunocompetent patients, latently infected B lymphocytes are under the control of T lymphocytes, so most reactivated infections remain subclinical. In patients with AIDS, lymphoma may develop from an infected, conserved B-cell clone.

Other pathogens, such as cytomegalovirus (CMV), Toxoplasma gondii, hepatitis viruses, human immunodeficiency virus (HIV) - can cause clinical and hematologic manifestations similar to infectious mononucleosis (mononucleosis syndrome).

Diagnosis of infectious mononucleosis is based on clinical data (fever, pharyngitis, lymphadenopathy, hepatosplenomegaly), peripheral blood smear examination (atypical lymphomonocytes) and serological tests (heterophilic antibodies to specific antibodies and / or TB).

Confirmation of the diagnostics of acute EBV infection usually occurs in serum Heterophilic antibodies By demonstrating existence. However, diagnostic difficulties may arise in situations where heterophilic antibodies are not present on the face and the clinical manifestations are atypical.

Heterophilic antibodies are not observed in 10-20% of cases of infectious mononucleosis in adults, the percentage is higher in children with obvious infection. In these situations the diagnostics is confirmed Specific EBV proteins against antibodies Based on detection: Viral capsid antigen (VCA) და Early Diffuse Antigen [EA (D)] Anti-antibodies.

Primary EBV infection Serologically determined VCA-IgM antibodies With early onset, possibly even before clinical symptoms. High titers of antibodies are present in the face within 1-6 weeks after the onset of infection, followed by a progressive decrease in its level; The increase in VCA-IgG antibody levels occurs almost in parallel with this process. Most patients with infectious mononucleosis have elevated levels of VCA-IgG and IgM antibodies during the very first test. Although VCA-IgM disappears within 2-3 months of disease onset, VCA-IgG persists indefinitely in healthy people indefinitely.

VCA-IgM antibodies Can also be found During infection reactivation. The presence of VCA-IgM in the absence of anti-EBNA IgG confirms primary infection. Long-term maintenance of high titers of these antibodies is characteristic of chronic viral infection, tumors caused by chronic viral infection, and autoimmune diseases.

There is another category of EBV antibodies EBV Nuclear Antigen (EBNA) Against which appear in the circulation within a few weeks or months after the onset of the disease and persist for a long time or even a lifetime. In patients with asymptomatic infection, detection of EBNA-IgG in combination with VCA-IgG and IgM antibodies is useful for differentiating early-stage recovery from infectious mononucleosis.

When should we test for Epstein-Barr IgM?

• Comprehensive diagnostics of EBV acute infection and assessment of the stage of active infection;
• Confirmation of the etiological role of Epstein-Barr virus in immunodeficiency conditions associated with Epstein-Barr virus.

How to prepare for the test?

No special preparation is required for the test.

Research material

Venous blood

Possible interpretation of the results

Positive result:

• Primary acute or recent EBV infection;
• Reactivation of infection;
• Chronic viral infection in immunodeficient patients.

An increase in VCA-IgM antibody levels during a dynamic test indicates the progression of the infection from the early phase of infection to the acute stage. Decreased VCA-IgM levels indicate the progression of the infection from the acute phase to the recovery stage.

Negative result:

• Infection is not noted;
• Early period of current infection;
• Late period of current infection;
• Atypical primary infection.

If there is a clinical suspicion of EBV infection, re-testing is recommended after 1 week

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