Lab Test

Epstein Barr Virus Antibody to Early Antigens (EBV-EA), IgG

EBV EA IgG

Test Codes

EPIC: LAB5832, SOFT: EBVEA

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

Last Updated

5/5/2021

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