Epstein-Barr virus (EBV) | Antibodies VCA-IgG (serum)

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

The main way of transmission of the virus is contact with infected oropharyngeal secretions. EBV replicates in the oropharyngeal epithelium, resulting in the release of virions from infected lymphocytes and their secretion into 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.

Latently infected B lymphocytes are under the control of T lymphocytes, so most reactivated infections remain subclinical. And in AIDS patients, a clone of infected, preserved B-cells can develop into lymphoma.

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 is serologically defined VCA-IgM antibodies With early onset, possibly even before clinical symptoms.

Epstein-Barr virus Against nuclear antigen IgG  Antibodies (VCA-IgG) Rarely manifested in the acute phase of the disease. It occurs during the recovery period (3-12 months after the onset of the disease) and can persist for many years after the onset of the disease.

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 in differentiating the early stage of infectious mononucleosis recovery from the acute phase of infection.

When should we test for Epstein-Barr IgG?

• Past EBV infection;
• Comprehensive assessment of the stage of the infectious process (by determination of VCA, EBNA-IgM and IgG antibodies);
• Diagnosis of lymphoproliferative and oncological diseases 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:

• Acute, ongoing EBV infection;
• Past infection;
• Chronic EBV infection

Negative result:

• Early stage of EBV acute infection;
• Absence of past infection.

If there is a clinical suspicion of EBV infection, re-testing is recommended after 10-14 days.

Resources

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