Lab Test

Epstein Barr Virus Antibody to Nuclear Antigens, IgG

EBNA, EBV-NA

Test Codes

EPIC: LAB5833, SOFT: EBVNA

Specimen Collection Criteria

Collect: One Gold-top SST tube. (Minimum Whole Blood: 4.0 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: 0.2 mL)

Preparation for Courier Transport

Transport: Centrifuged collection tube, refrigerated (2-8°C or 36-46°F). (Minimum: 0.2 mL)

Rejection Criteria

  • Plasma specimens.
  • Heat inactivated serum.
  • Hemolyzed specimens.
  • Severely lipemic specimens.
  • Specimens with gross bacterial contamination.  

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: 0.2 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

Negative results are usually seen in patients without previous exposure to EBV and in acutely infected patients (within the first month after infection). EBNA antibodies are usually not detectable for 3-4 weeks after primary infection. False-negative EBNA titers may be seen in immunosuppressed patients.

Clinical Utility

The EBNA assay detects and human IgG antibodies to the nuclear antigen 1 of Epstein-Barr Virus. EBNA IgG antibodies are first detectable 3-4 weeks after the onset of symptoms and are rarely present in acute-phase sera. Antibodies persist throughout the patient's lifetime. (1)

EBNA testing may be used to determine past exposure to EBV. In conjunction with the VCA and EA test results, this test may aid in the serological diagnosis of past EBV associated 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 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

86664
LOINC: 20432-1

Contacts

Last Updated

5/5/2021

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