Epstein Barr Virus Antibody to Early Antigens (EBV-EA), IgG
EBV EA IgG
Test Codes
EPIC: LAB5832, SOFT: EBVEA
Department
Special Chemistry
Specimen Collection Criteria
Collect: One Gold-top SST tube. (Minimum Whole Blood: 2.0 mL)
Physician Office/Draw Specimen Preparation
Let specimen clot 30-60 minutes then immediately centrifuge to separate serum from cells. Refrigerate (2-8°C or 36-46°F) the centrifuged collection tube within twelve hours of collection. (Minimum: 0.5 mL)
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 Serum: 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
Negative.
Test Methodology
Indirect Chemiluminescent Immunoassay (CLIA).
Interpretation
EBV- Early Antigen is a complex of at least two components, restricted and diffuse. This assay cannot distinguish restricted from diffuse antibodies. EBV-EA may be present in asymptomatic patients and in children under 2 years of age. Recurrence of EBV-EA antibody in EBV-VCA IgM-negative patients may indicate EBV reactivation. EBV-EA assay results should be evaluated in relation to the patient's clinical findings and the results of other diagnostic tests (i.e. IgG and IgM EBV VCA and EBNA). Of normal, healthy seropositive individuals, 22-32% will have EBV-EA antibody. Therefore, these titers may not indicate acute or recurrent EBV infection.
Absence of EBV-EA antibody has been observed in 10-20% of individuals in early acute IM (infectious mononucleosis).
Some children will have transient, low-level EBV-EA titers when all other EBV serological markers are absent. This seroligical pattern is thought to represent an antibody response to cross-reacting antigens.
Clinical Utility
EBV-EA assay detects IgG antibodies against EBV-early antigen (EA) of the restricted (R) and diffuse (D) classes, that can aid in the diagnosis of infectious mononucleosis.
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 IgG 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
LOINC: 16823-7
Contacts
Special Chemistry Laboratory – RO
248-551-8044
Name: Special Chemistry Laboratory – RO
Location:
Phone: 248-551-8044
Last Updated
1/11/2023
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