Test ID: SEBV
Epstein-Barr Virus (EBV) Antibody Profile, Serum
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Diagnosing infectious mononucleosis when a mononucleosis screening procedure is negative and infectious mononucleosis or a complication of Epstein-Barr virus infection is suspected
Profile Information A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| EBVM | EBV VCA IgM Ab, S | No | Yes |
| EBVG | EBV VCA IgG Ab, S | No | Yes |
| EBVNA | EBNA Ab, S | No | Yes |
Method Name A short description of the method used to perform the test
Multiplex Flow Immunoassay
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
E. B. (Epstein-Barr) Virus
EBNA (Epstein-Barr Nuclear Antigen)
EBV (Epstein-Barr Virus) Battery
EBV (Epstein-Barr Virus) Panel
EBV (Epstein-Barr Virus)
EBV Ab, S
EBV Panel, Serum
Epstein Barr Virus
Epstein-Barr Virus AB
Epstein-Barr Virus Battery
Epstein-Barr Virus Panel
VCA (Viral Capsid Antigen) IgG and IgM
Viral Capsid Antigen (VCA) Titer
Infectious Mononucleosis
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Container/Tube:
Preferred: Red top
Acceptable: Serum gel
Specimen Volume: 1 mL
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | Mild OK; Gross reject |
| Lipemia | Mild OK; Gross reject |
| Icterus | NA |
| Other | Heat-inactivated specimen |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | Refrigerated (preferred) | 14 days |
| Frozen | 14 days |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Epstein-Barr virus (EBV), a member of the herpesvirus group, is the etiologic agent of infectious mononucleosis. EBV infections are difficult to diagnose in the laboratory since the virus does not grow in standard cell cultures. The majority of infections can be recognized, however, by testing the patient's serum for heterophile antibodies (rapid latex slide agglutination test; eg, MONOS/9081 Infectious Mononucleosis, Rapid Test, Serum), which usually appear within the first 3 weeks of illness, but then decline rapidly within a few weeks. The heterophile antibody, however, fails to develop in about 10% of adults, more frequently in children, and almost uniformly in infants with primary EBV infections. Most of these heterophile antibody-negative cases of infectious mononucleosis-like infections are due to cytomegalovirus, but in a series of 43 cases, EBV was the cause in 7. In cases where EBV is suspected but the heterophile antibody is not detected, an evaluation of the EBV-specific antibody profile (eg, EBV viral capsid antigen [VCA] IgM, EBV VCA IgG, and EBV nuclear antigen [EBNA]) may be useful.
Infection with 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 infection, infectious mononucleosis is the most common. Other disorders due to EBV infection have been recognized for several years, including African-type Burkitt lymphoma and nasopharyngeal carcinoma. EBV infection may also cause lymphoproliferative syndromes, especially in patients who have undergone renal or bone marrow transplantation and in those who have AIDS.
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.
Epstein-Barr Virus (EBV) VIRAL CAPSID ANTIGEN (VCA) IgM ANTIBODY
Negative
Epstein-Barr Virus (EBV) VIRAL CAPSID ANTIGEN (VCA) IgG ANTIBODY
Negative
EPSTEIN-BARR NUCLEAR ANTIGEN (EBNA) ANTIBODIES
Negative
Interpretation Provides information to assist in interpretation of the test results
The test has 3 components: viral capsid antigen (VCA) IgG, VCA IgM, and Epstein-Barr nuclear antigen (EBNA). Presence of VCA IgM antibodies indicates recent primary infection with Epstein-Barr virus (EBV). The presence of VCA IgG antibodies indicates infection sometime in the past. Antibodies to EBNA develop 6 to 8 weeks after primary infection and are detectable for life. Over 90% of the normal adult population has IgG class antibodies to VCA and EBNA. Few patients who have been infected with EBV will fail to develop antibodies to the EBNA (approximately 5%-10%).
| Possible Results | |||
| VCA IgG | VCA IgM | EBNA IgG | Interpretation |
| - | - | - | No previous exposure |
| + | + | - | Recent infection |
| + | - | + | Past infection |
| + | - | - | See note* |
| + | + | + | Past infection |
*Results indicate infection with EBV at some time (VCA IgG positive). However, the time of the infection cannot be predicted, (ie, recent or past) since antibodies to EBNA usually develop after primary infection (recent) or, alternatively, approximately 5% to 10% of patients with EBV never develop antibodies to EBNA (past).
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Specimens drawn too early during the course of the disease may not contain detectable antibody to Epstein-Barr virus (EBV). Another specimen drawn 1 to 2 weeks later may be required.
Test results should be evaluated in relation to patient symptoms, clinical history, and other laboratory findings.
The timing of the appearance of IgG antibodies to viral capsid antigen (VCA) or Epstein-Barr nuclear antigen (EBNA) or IgM antibodies to VCA is subject to variations among individuals and serological assays.
This assay's performance characteristics with immunosuppressed individuals, newborns, cord blood, or matrices other than human serum have not been established.
Assay performance characteristics have not been established for the diagnosis of nasopharyngeal carcinoma, Burkitt lymphoma, and other EBV-associated lymphomas.
This assay is not intended for viral isolation or identification.
Anti-VCA-specific IgG may compete with IgM for binding sites, leading to false-negative results. Rheumatoid factor (RF), in the presence of specific IgG, may contribute to false-positive results. The absorbent in the VCA IgM diluent is intended to neutralize the effects of RF and specific IgG. Studies have shown that the absorbent was able to neutralize up to 98% of the activity in a specimen known to contain 3,328 IU/mL of RF activity.
Testing for VCA IgM should not be performed as a screening procedure on the general population. The predictive value of positive or negative results depends on the pretest likelihood of Epstein-Barr-associated disease being present. Testing should only be performed when clinical evidence suggests the diagnosis of this syndrome.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Fields' Virology. 5th edition. Edited by DM Knipe, PM Howley, DE Griffin, et al. Philadelphia, Lippincott Williams & Wilkins, 2007
2. Linde A, Falk KI: Epstein-Barr virus. In Manual of Clinical Microbiology. 9th edition. Edited by EJ Barron, JH Jorgensen, ML Landry, et al. ASM Press, 2007, pp 1564-1573
Method Description Describes how the test is performed and provides a method-specific reference
Testing is performed on the BioPlex 2200 System. For the detection of viral capsid antigen (VCA)-IgG antibody, EA-D antibody, and Epstein-Barr nuclear antigen (EBNA) antibody, an aliquot of the patient serum, sample diluent, and bead reagent are combined in a reaction vessel. After washing, antihuman-IgG antibody conjugated to phycoerythrin (PE) is added to the beads and incubated. Another wash step removes excess conjugate, and beads are subsequently resuspended in wash buffer. The bead mixture passes through a detector where the identity of each bead is determined by the bead's dye fluorescence. In addition, the amount of antibody captured by the antigen is measured by the fluorescence of the bound PE.
For the detection of VCA-IgM antibody, the patient sample is combined with diluent containing antihuman IgG and bead reagent. The antihuman IgG is incorporated in the mix because any anti-VCA-specific IgG present may compete with the IgM for binding sites, leading to false-negative VCA-IgM results. After a wash cycle, antihuman-IgM antibody conjugated to PE is added. Detection of anti-VCA-specific IgM is performed as described above for the VCA IgG assay.(Package inserts: BioPlex 2200 System EBV IgG and EBV IgM, Bio-Rad Laboratories Clinical Diagnostics Group, Hercules CA, 2012)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Friday; Continuous 9 a.m.-6 p.m., Sunday; 6 a.m.
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
86664-EBNA
86665 x 2-VCA, IgG and IgM
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| EBVG | EBV VCA IgG Ab, S | 30339-6 |
| EBVM | EBV VCA IgM Ab, S | 30340-4 |
| EBNA | EBNA Ab, S | 22296-8 |
| INT73 | Interpretation | N/A |
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