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Epstein Barr Virus Antibody Panel

Test Codes

EPIC: LAB1231655, SOFT: EBVP, Antrim #30931

Department

Immunology

Specimen Collection Criteria

Collect: One Gold-top SST tube. (Minimum Whole Blood: 2.0 mL)

Physician Office/Draw Specimen Preparation

Preparation for Courier Transport

Transport: Centrifuged collection tube, refrigerated (2-8°C or 36-46°F). (Minimum: 0.5 mL)

Rejection Criteria

• Plasma specimens. 
• Severely lipemic, icteric, or grossly hemolyzed specimens.

In-Lab Processing

Let specimen clot 30-60 minutes then immediately centrifuge to separate serum from cells. Room temperature is acceptable for a maximum of twelve hours. (Minimum: 0.5 mL)

Storage

Specimen Stability for Testing:

Centrifuged SST Tubes, Red-top Tubes, and Microtainers^®
Room Temperature (20-26°C or 68-78.8°F): 12 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): Unacceptable

Serum Specimens (Pour-Overs)
Room Temperature (20-26°C or 68-78.8°F): 12 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): 3 months

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 7 days

Laboratory

Royal Oak Special Testing Laboratory

Performed

Monday – Friday.
Results available within two business days.

Reference Range

EBV-VCA IgG: Negative
EBV-VCA IgM: Negative
EBNA IgG: Negative
EBV-EA IgG: Negative

Test Methodology

Indirect Chemiluminescent Immunoassay (CLIA).

Interpretation

EBV Panel Interpretation:

Condition	VCA IgG	VCA IgM	EBNA IgG
EBV seronegative	negative	negative	negative
Acute infection	positive	positive	negative
Past infection	positive	negative	positive
Indeterminate
VCA IgG only	positive	negative	negative
VCA IgM only	negative	positive	negative
EBNA IgG only	negative	negative	positive
Convalescent	positive	positive	positive

Interpretation	VCA IgG	VCA IgM	EBNA	EA IgG
Susceptible	negative	negative	negative	negative
Acute primary infection	negative	positive	negative	positive
Late primary infection	positive	positive	positive	positive
Past infection	positive	negative	positive	negative
EBV Reactivation	positive	negative	positive	positive

The above table contains the most frequently observed serological patterns. These patterns may be helpful when correlated with the clinical presentation.

Some children will appear to be seronegative except for EBNA IgG or EBV-EA IgG. This serological pattern is suggestive of an exposure to a cross-reacting antigen.

Clinical Utility

Epstein-Barr virus (EBV) is difficult to diagnose using one serological assay. Diagnosis of an acute or recurrent infection is best accomplished by using a panel of assays including: concurrent EBV VCA-IgG, EBV VCA-IgM, EBNA IgG, and Early Antigen tests.

Clinical Disease

Epstein-Barr virus (EBV) is the etiological agent of infectious mononucleosis and has been implicated in African Burkitt's lymphoma and nasopharyngeal carcinoma. 

Childhood infections may be asymptomatic or produce "flu-like" illness. Adolescents and adults who escape infection during childhood experience infectious mononucleosis (IM). IM is characterized by irregular fever, pharyngitis, and lymphadenopathy lasting 1 to 4 weeks. Hematological abnormalities include an absolute increase in lymphocytes and monocytes exceeding 50% and more than 15% atypical lymphocytes, lasting for at least 2 weeks. Liver function tests generally reveal a mild to moderate increase in SPGT, SGOT, bilirubin, and LDH levels. IM is usually a benign and self-limited disease. Complications including splenomegaly and splenic rupture, hepatitis, pericarditis, myocarditis, or central nervous system involvement (Guillain-Barre syndrome, Bell's palsy, transverse myelitis, and meningoencephalitis) may occur following IM infection. (1)

Epidemiology

EBV occurs throughout the world and more than 90% of adults have antibodies to the virus. Most individuals acquire EBV early in life. Seroepidemiologic studies have indicated that 50% of children have antibodies to the virus by the time they are 5 years of age. No seasonality has been demonstrated. (1)

Incubation Period

The incubation period is 4–7 weeks. (1)

Transmission

EBV is poorly contagious. Transmission is via salivary contact, either through kissing or by exposure to contaminated eating implements. (1)

Reference

1. Wiedbrauk D, Johnston SLG. Manual of Clinical Virology, Raven Press, New York, NY, 1993.

CPT Codes

86663, 86664, 86665.

Contacts

Last Updated

10/23/2024