Epstein-Barr virus (EBV) is a ubiquitous herpesvirus that infects the majority of the world population (seroprevalence is greater than 95%). After a primary infection (transmission through contact with saliva), EBV remains latent in B cells.
Periodically, EBV can reactivate in immunocompetent individuals. This reactivation is characterized by the production of virions in the oropharynx but is asymptomatic.
EBV is the causative agent of infectious mononucleosis (Glandular fever). It is also involved in the pathogenesis of several cancers such as Burkitt’s lymphoma, Hodgkin’s lymphoma, and nasopharyngeal carcinoma. In immunosuppressed individuals, EBV can lead to B-cell lymphoproliferative disorders.
Post-transplant lymphoproliferative disorders (PTLD) are lymphoid and/or plasmacytic proliferations that occur as a result of immunosuppression in the setting of solid organ or allogeneic hematopoietic cell transplantation. PTLDs are among the most serious complications of transplantation.
Serological investigations are recommended prior to requesting DNA testing. Please refer to Infectious Mononucleosis screen or Epstein-Barr serology tests.
Diagnosis of EBV infection in immunocompromised patients can be problematic. Serological testing may be difficult to interpret due to most adults being seropositive due to prior EBV infections.
EBV is known to cause encephalitis and other neurological syndromes. EBV is associated with most cases of primary CNS lymphoma in patients with AIDS.
Viral load testing is a specialist test intended for monitoring in immunocompromised patients. Please make very clear on the request form that viral load/PCR is required, if EBV only is requested then serology is likely to be collected/registered.
Microbiology - Virology
Dedicated EDTA required
Testing is performed routinely on Thursday afternoons, with results available Friday morning.
Full clinical details are essential.
Viral Load / PCR must be clearly stated on the request form. Please do not request EBV titre, as this can be mis-interpreted as serology.
Tissue: consult lab
CSF: referred to LabPlus, Auckland for testing
Chilled (2 - 8 degrees Celsius)
Post-transplant Lymphoproliferative disorder (PTLD)
PCR assays performed on PBLs are positive in only 10-20% of normal EBV-seropositive patients and quantity of EBV DNA is low. Most patients with PTLD have high levels of EBV DNA that can be distinguished by quantitation. Some PTLD patients do not have elevated levels of EBV DNA and some transplant recipients with elevated levels in the same range as PTLD do not develop clinically evident PTLD.
It has not been clearly established whether EBV DNA may be detected in CSF during uncomplicated infectious mononucleosis, in other neurological illnesses, or even apart form any illness. The recommended approach is to use serological diagnosis to determine acute infection combined with CSF PCR to provide evidence of CNS involvement.
Dissociated CNS lymphoma: EBV PCR may be helpful in distinguishing lymphoma from other syndromes. A negative result does not rule out lymphoma.
EBV DNA detection using nucleic acid extraction and quantitative PCR.
$213.17 (Exclusive of GST)
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