EPSTEIN-BARR VIRUS (EBV) SEROLOGY

EPSTEIN-BARR VIRUS (EBV) SEROLOGY

 

A. Description.EBVis the causative agent of Burkitt’s lymphoma, nasopharyngeal carcinoma,

and most commonly, infectious mononucleosis (IM). The virus is ubiquitous; 80% to 90%

of healthy adults have EBV antibodies. EBV infects B lymphocytes.

B. Infectious mononucleosis (IM) is an acute, self-limiting disease typically seen in young

adults. The disease is characterized by fever, sore throat, cervical lymphadenopathy,

splenomegaly, and mild hepatitis. TheWBCcount is elevated, and reactive lymphocytes are

seen in the peripheral blood. There is a relative and absolute lymphocytosis. The average

incubation period is approximately 2 to 8 weeks (see Web Case Study 5–2).

C. Antigens and antibodies

1. Viral capsid antigen (VCA) is found in the cytoplasm of EBV-infected lymphocytes.

IgM antibodies against VCA are detectable early in the infections, but disappear within

2 to 4 months. IgG antibodies against VCA develop within 1 week after infection and

can persist for life.

2. Early antigen-diffuse (EA-D) and early antigen-restricted (EA-R) antigens are found

in the cytoplasm of infected B lymphocytes. EA-D is also found in the nucleus. IgG

antibodies to EA-D can be indicators of active disease. IgG antibodies to EA-R are

sometimes seen in young children who have active IM infection, but not in infected

young adults.

3. Epstein-Barr nuclear antigen (EBNA) is found in the nuclei of all infected cells. IgG

antibodies to EBNA develop slowly but can remain detectable throughout life.

4. Heterophile antibodies are stimulated by one antigen and will react with unrelated

antigens from different mammalian species. The heterophile antibodies of IM are IgM

antibodies and are seen in 50% to 70% of patients with IM. They persist for 4 to

8 weeks after infection