XXII. EPSTEIN-BARR VIRUS SEROLOGY

EBV

1. ____ virus

2. Member of the _____

3. Transmission is through ____

4. ____ lasts a lifetime; however, the virus causes _____, and persons infected remain ____ for life.

5. Serologic tests detect ____ and virus-specific antibodies.

1. DNA

2. herpes virus group

3. saliva

4. Immunity ; latent infections ; carriers

5. heterophile

• A disease of the reticuloendothelial system

• Incubation period is 4–7 weeks.

• Onset may be acute or insidious with sore throat, fever, and lymphadenopathy.

• Common findings are lymphocytosis, with many reactive (atypical) lymphocytes, and enlarged cervical lymph nodes.

Infectious mononucleosis (IM)

• EBV is able to transform B cells into long-lived cells.

• Burkitt lymphoma is a malignant neoplasm of B lymphocytes.

• Found in restricted areas of Africa and New Guinea

• Primarily seen in children

Burkitt lymphoma

____ is a nasopharyngeal squamous cell carcinoma found mainly in southern China.

Nasopharyngeal carcinoma

• Produced in IM are not EBV specific and react with sheep, beef, ox, and horse RBCs.

• Approximately 80–85% of adult patients with IM will develop heterophile antibodies, whereas only 50% of children less than 12 years of age will produce heterophile antibodies

Heterophile antibodies

Principle:

• Heterophile antibodies peak around 2–3 weeks after infection.

• Serial dilutions of serum are incubated with a 2% suspension of sheep RBCs.

• Agglutination is a positive reaction

Paul-Bunnell presumptive test

Paul-Bunnell presumptive test

Results

• The reference value is a titer of ____.

• Titer of ____ is suggestive of IM.

Interpretation

• The Paul-Bunnell test is a screening test to detect heterophile antibodies that is not specific to IM.

• The test is rarely used today.

• False-negative rate is ____.

• 28 or less.

• >56

• 10–15%

• Most frequently used methods are based on EIA and chemiluminescence.

• Immunofluorescence is the reference method but is labor intensive.

EBV-specific tests