Mobile Site ›

Print Page Email Page
Print Friendly View

Test ID: EBEA
Epstein-Barr Virus (EBV) IgG Antibody to Early Antigen, Serum

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

Investigation of infectious mononucleosis

 

As an aid in the diagnosis of African-type Burkitt's lymphoma

 

As an aid in the evaluation of patients with malignant lesions of type 2 and 3 in whom is suspected; for example, patients with metastases to the cervical lymph nodes from an unknown primary source

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

Infection with Epstein-Barr virus (EBV) usually occurs early in life. For several weeks to months after acute onset of the infection, it is spread by upper respiratory secretions that contain the virus.

 

Among the clinical disorders due to EBV infections, infectious mononucleosis is most common. Other disorders due to EBV infection have been recognized for several years, including African-type Burkitt's lymphoma and nasopharyngeal carcinoma (NPC). The World Health Organization classifies NPC as type 1 (keratinizing squamous cell carcinoma), type 2 (nonkeratinizing squamous cell carcinoma), and type 3 (undifferentiated carcinoma).

 

EBV infection also may cause lymphoproliferative syndromes, especially in patients who have undergone renal or bone marrow transplantation and in those who have AIDS.

 

A chronic mononucleosis-like syndrome has been described in which individuals experience persistent or relapsing episodes of fatigue, depression, dyslogia, sometimes with low-grade fever, adenopathy and weight loss. Actively replicating EBV may be responsible for the persisting illness and fatigue associated with this viral infection.

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.

<1:10

Titers < or =1:20 are present in up to 15% of normal population.

Interpretation Provides information to assist in interpretation of the test results

Normal titers are <1:10. However, low levels are present in up to 15% of the normal population. Only 3% of 200 normal blood donors in Rochester, MN had antibody titers of >1:40 to this antigen.

 

The presence of antibody to the early antigen (EA) of EBV indicates that Epstein-Barr virus (EBV) is actively replicating.

 

Generally, this antibody can only be detected during active EBV infection, such as in patients with IM. Clinical studies have indicated that patients who have chronic active or reactivated EBV infection commonly have elevated levels (> or =1:40) of IgG class antibodies to the EA of EBV.

 

IgG antibody specific for the of EBV is often found in patients with nasopharyngeal carcinoma (NPC). Of patients with type 2 or 3 NPC, 94% and 83%, respectively, have positive antibody responses to EA Only 35% of patients with type 1 carcinomas have a positive response. The specificity of the test is such that 82% to 91% of healthy blood donor controls and patients who do not have NPC have negative responses. Although this level of specificity is useful for diagnositc purposes, a 9% to 18% frequency of false-positive results implies that this procedure is not useful for screening.

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

This test detects both restricted (R) and diffuse (D) components of early antigen (EA). It is not designed to differentiate between them. Usually, antibodies to the R component, together with antibodies to Epstein-Barr virus (EBV) nuclear antigen (EBNA) and IgG anti-viral capsid antigens (VCA), may be associated with reactivation of the latent viral carrier state. In contrast, patients with NPC may produce high titer antibodies to the D component.

 

High titers of antibody to EA may be detected in patients with chronic or recurrent illness suspected of being caused by EBV. However, a diagnosis of chronic EBV should not be based on this finding alone, since high titers also may be found in patients with other diseases as well as in healthy individuals with past EBV infections.

 

It should be noted that there are some patients with nasopharyngeal carcinoma whose serum will contain IgA antibodies to VCA (#8891 Epstein-Barr Virus, (EBV),IgA, Serum) but not antibodies to the early antigen of the virus and vice versa.

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

1. Jones JF, Ray CG, Minnich LL, et al: Evidence for active Epstein-Barr virus infection in patients with persistent unexplained illness: elevated anti-early antigen antibodies. Ann Intern Med 1985;102:1-7

2. Strauss SE, Tosato G, Armstrong G, et al: Persisting illness and fatigue in adults with evidence of Epstein-Barr virus infection. Ann Intern Med 1985;102:7-16