THE ROLE OF anti-EBNA1 IgG DETERMINATION IN EBV DIAGNOSTICS

Abstract

Purpose: In Bulgaria, the diagnosis of Epstein-Barr virus (EBV) infection is performed via ELISA testing of IgM and IgG against viral capsid antigen (anti-VCA IgM and anti-VCA IgG). With the current study, we try to answer is there any benefit of determination of IgG against the nuclear antigen of EBV (anti-EBNA-1 IgG) in the laboratory practice. Material/Methods: The prospective study included 82 serum/plasma samples tested for anti-VCA IgМ, anti-VCA IgG, anti-EBNA1 IgG and anti-VCA IgG avidity in ELISA (Euroimmun, Luebeck, Germany). Quantitative variables were reported as mean, and standard deviation (mean±SD) and the qualitative variables were reported as a number and a relative proportion (%). Results: Anti-EBNA1 IgG positive patients were 74.4% (95% CI:63.6% - 83.4%) of all tested individuals. Their mean age was significantly higher (30.5;SD±20.5)of this of patients without anti-EBNA1 IgG (14.5; SD±14.1) (p < 0.05).The first group of patients (with infectious mononucleosis, anti-VCA Ig M negative) had the highest number of anti-EBNA1 IgG negative results. Negative for аnti-EBNA 1 IgG were 12% of patients with Hodgkin's lymphoma. Conclusion: Determination of anti-EBNA1 IgG together with anti-VCA should be considered in the initial serological testing in EBV diagnostics. As different immune responses against the EBNA1 antigen exist, clinicians should interpret the results carefully with regard to the clinical symptoms, the immune status and the laboratory markers. We found anti-EBNA1 IgG ELISA tests exceptionally useful to distinguish primary and past infections in anti-VCA IgM(+)/anti-VCA IgG (+) patients.

Keywords

• Epstein-Barr virus
• anti-EBNA1 IgG
• anti-VCA IgG avidity
• Infectious mononucleosis
• Hodgkin's lymphoma