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Test ID: EBVB    
Epstein-Barr Virus (EBV), Molecular Detection, PCR, Blood

Useful For Suggests clinical disorders or settings where the test may be helpful

Rapid qualitative detection of Epstein-Barr virus DNA in specimens for laboratory diagnosis of disease due to this virus

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Epstein-Barr virus (EBV) is the causative agent of infectious mononucleosis, Burkitt's lymphoma, and in Southern China, nasopharyngeal carcinoma. EBV-associated central nervous system (CNS) disease is most commonly associated with primary CNS lymphoma in patients with AIDS. In addition, CNS infection associated with the detection of EBV DNA can be detected in immunocompetent patients.

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Negative

Interpretation Provides information to assist in interpretation of the test results

Detection of Epstein-Barr virus supports the clinical diagnosis of disease due to the virus.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

A negative result does not eliminate the possibility of Epstein-Barr virus (EBV)

 

Although the reference is range is typically "negative" for this assay, this assay may detect viremia or viral shedding in asymptomatic individuals. However, this assay is only to be used for patients with a clinical history and symptoms consistent with EBV infection, and must be interpreted in the context of the clinical picture. This test should not be used to screen asymptomatic patients.

Supportive Data

The following validation data supports the use of this assay for clinical testing.

 

Accuracy/Diagnostic Sensitivity and Specificity:

Of 45 cerebrospinal fluid (CSF) specimens tested by both conventional PCR and LightCycler PCR, Epstein-Barr virus (EBV) DNA was detected in 34 specimens by both amplification methods. Eight specimens were exclusively positive by conventional PCR; 3 specimens were detected by only LightCycler PCR (p=NS).

 

Supplemental Data (Spiking Studies):

To supplement the above data, 30 negative specimens each of different types (CSF, blood, body fluid, ocular fluid, bone marrow and respiratory specimens) were spiked with Epstein-Barr positive control plasmid at the limit of detection (10-20 targets/mcL). The 30 spiked specimens of each type were run in a blinded manner along with 30 negative (non-spiked) specimens. 93% to 100% of the spiked specimens were positive and 100% of the non-spiked specimens were negative.

 

Analytical Sensitivity/Limit of Detection (LoD):

The lower LoD for this assay is 10 to 20 targets/mcL. The LoD was validated in each specimen type that is accepted for this assay.

 

Analytical Specificity:

No PCR signal was obtained from extracts of 40 bacterial and viral isolates that could cause similar symptoms including herpes simplex virus 1 and 2; cytomegalovirus; varicella zoster virus; and human herpesvirus (HHV) 6, HHV 7 and HHV 8.

 

Precision:

Interassay precision was 100% and intra-assay precision was 100%.

 

Reportable Range:

This is a qualitative assay and results are reported as either negative or positive for targeted EBV DNA.

Clinical Reference Provides recommendations for further in-depth reading of a clinical nature

1. Tachikawa N, Goto M, Hoshino Y, et al: Detection of Toxoplasma gondii, Epstein-Barr virus, and JC virus DNAs in the cerebrospinal fluid in acquired immunodeficiency syndrome patients with focal central nervous system complications. Intern Med 1999;38(7):556-562

2. Antinori A, Cingolani A, De Luca A, et al: Epstein-Barr virus in monitoring the response to therapy of acquired immunodeficiency syndrome-related primary central nervous system lymphoma. Ann Neurol 1999;45(2):259-261 

3. NIller HH, Wolf H, Minarovits J. Regulation and dysregulation of Epstein-Barr virus latency: implications for the development of autoimmune disease. Autoimmunity. May 2008:41(4):298-328.

4. Studahl M, Hagberg L, Rekvdar E, Bergstrom T: Herpesvirus DNA detection in cerebrospinal fluid: difference in clinical presentation between alph-, beta-, and gamma-herpes viruses. Scand J Infect Dis 2000;32(3):237-248

5. Lau AH, Soltys K, Sindhi RK, et al: Chronic high Epstein-Barr viral load carriage in pediatric small bowel transplant recipients. Pediatr Transplant 2010 Jun;14(4):549-553