Epstein-Barr virus: Difference between revisions
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+ | == Background == |
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+ | === Microbiology === |
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+ | * A DNA virus in the [[human herpesvirus]] family |
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+ | * Infection can remain quiescent in B cells for life |
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+ | |||
+ | === Epidemiology === |
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+ | * Seroprevalence about 95% in adults |
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+ | |||
+ | == Clinical Presentation == |
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+ | * In childhood, mostly asymptomatic or mild febrile illness |
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+ | |||
+ | === Infectious mononucleosis === |
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+ | * Causes about 80% of mononucleosis, with the rest being [[CMV]] |
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+ | |||
+ | === Complications === |
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+ | * Linked to a number of malignancies, including Burkitt lymphoma, nasopharyngeal carcinoma, and lymphoproliferative disorders |
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+ | |||
== Diagnosis == |
== Diagnosis == |
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=== Serology in immunocompetent hosts === |
=== Serology in immunocompetent hosts === |
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+ | {| class="wikitable" |
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− | ![Graph of serology](EBV serology.jpg) |
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− | {| |
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!align="center"| VCa-IgM |
!align="center"| VCa-IgM |
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!align="center"| VCA-IgG |
!align="center"| VCA-IgG |
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|align="center"| – |
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|align="center"| + |
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+ | | Uninterpretable |
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− | | ?? |
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=== Serology in EBV-associated diseases === |
=== Serology in EBV-associated diseases === |
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+ | {| class="wikitable" |
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! Disease |
! Disease |
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!align="center"| VCA-IgM |
!align="center"| VCA-IgM |
Revision as of 08:13, 24 October 2019
Background
Microbiology
- A DNA virus in the human herpesvirus family
- Infection can remain quiescent in B cells for life
Epidemiology
- Seroprevalence about 95% in adults
Clinical Presentation
- In childhood, mostly asymptomatic or mild febrile illness
Infectious mononucleosis
- Causes about 80% of mononucleosis, with the rest being CMV
Complications
- Linked to a number of malignancies, including Burkitt lymphoma, nasopharyngeal carcinoma, and lymphoproliferative disorders
Diagnosis
- Anti-VCA (viral capsid antigens): most useful
- Anti-VCA IgM: appears early and disappears within 4 to 6 weeks
- Anti-VCA IgG: appears in acute phase, peaks at 2 to 4 weeks, then declines but remains positive for life
- Anti-EA (early antigen) IgG: appears in acute phase and falls to undetectable within 3 to 6 months (but may persist for years)
- Least useful test
- Anti-EBNA (EBV nuclear antigen): negative during acute phase converts after 2 to 4 months and stays positive for life
- Monospot test: cross-reacts with many other conditions, and is often falsely negative in children
Serology in immunocompetent hosts
VCa-IgM | VCA-IgG | EBNA-IgG | Interpretation |
---|---|---|---|
– | – | – | Susceptible |
– | – | + | Past infection or non-specific |
– | + | – | Acute or past infection |
– | + | + | Past infection |
+ | – | – | Acute infection or non-specific |
+ | – | + | Uninterpretable |
+ | + | – | Acute infection |
+ | + | + | Late primary infection or reactivation |
Serology in EBV-associated diseases
Disease | VCA-IgM | VCA-IgG | VCA-IgA | EA(D)-IgG | EA(R)-IgG | EA-IgA | EBNA-IgG |
---|---|---|---|---|---|---|---|
Chronic active infection | ± | ++ | ± | + | ++ | – | ± |
Burkitt lymphoma | – | ++ | – | ± | ++ | – | + |
ENT carcinoma | – | ++ | + | ++ | ± | + | + |
Hodgkin lymphoma | – | ++ | – | + | – | – | + |
Reactivation | ± | ++ | ± | + | ± | ± | ± |
References
- ^ Massimo De Paschale. Serological diagnosis of Epstein-Barr virus infection: Problems and solutions. World Journal of Virology. 2012;1(1):31. doi:10.5501/wjv.v1.i1.31.