Test ID: SEBV Epstein-Barr Virus (EBV) Antibody Profile, Serum
Reporting Name
EBV Ab Profile, SUseful For
Diagnosing infectious mononucleosis when a mononucleosis screening procedure is negative and infectious mononucleosis or a complication of Epstein-Barr virus infection is suspected
This assay is not intended for viral isolation or identification.
Clinical Information
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 / 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.
Interpretation
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).
Profile Information
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 |
Analytic Time
Same day/1 dayDay(s) and Time(s) Performed
Monday through Friday; Continuous 9 a.m.-6 p.m.
Sunday; 6 a.m.
Clinical Reference
1. Knipe DM, Howley PM, Griffin DE, eds: Fields Virology. 5th ed. Lippincott Williams and Wilkins; 2007
2. Linde A, Falk KI: Epstein-Barr virus. In: Barron EJ, Jorgensen JH, Landry ML, et al, eds. Manual of Clinical Microbiology. 9th ed. ASM Press. 2007;1564-1573
3. Johannsen EC, Kaye KM: Epstein-Barr virus (infectious mononucleosis, Epstein-Barr virus-associated malignant diseases, and other diseases). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020:1872-1890
Method Name
Multiplex Flow Immunoassay
Specimen Type
SerumSpecimen Required
Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Specimen Volume: 1 mL
Specimen Minimum Volume
0.6 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 14 days | |
Frozen | 14 days |
Reference Values
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
Test Classification
This test has been cleared, approved or is exempt by the U.S. Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
86664-EBNA
86665 x 2-VCA, IgG and IgM
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
SEBV | EBV Ab Profile, S | 87554-2 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
EBVG | EBV VCA IgG Ab, S | 30339-6 |
EBVM | EBV VCA IgM Ab, S | 30340-4 |
EBNA | EBNA Ab, S | 22296-8 |
INT73 | Interpretation | 69048-7 |
Forms
If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:
-General Request (T239)
-Microbiology Test Request (T244)
mml-CNS-Infections, mml-Pediatric, mml-Spinal-Cord