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Epstein-Barr Virus (EBV) IgG EIA

Test Code: 30813

A special account is required to order pre-transplant testing. Contact Client Services or your account executive to set up a pre-transplant account to order this assay. Specimens should not be collected until after account has been created.

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Clinical Utility

For the qualitative and semi-quantitative detection of human IgG antibodies to Epstein-Barr (EB) viral capsid antigen (VCA) in human serum by enzyme immunoassay. The test may be used in conjunction with other serologicals, as an aid in the diagnosis of infectious mononucleosis. These reagents have not received FDA clearance for use in testing blood or plasma donors. 

About Epstein-Barr Virus

Epstein-Barr virus (EBV) is the etiological agent of infectious mononucleosis (IM).1 The designation of infectious mononucleosis classically refers to an Epstein-Barr virus-induced illness in young adults characterized by reactive blood smears, exudative pharyngitis, prominent cervical lymphadenopathy, and serologically detectable heterophile antibodies. These clinical manifestations can also be caused by a number of other pathogenic agents including cytomegalovirus, Toxoplasma gondii, rubella virus, hepatitis virus, human immunodeficiency virus (HIV), and uncommonly by drugs such as Halothane, Hydantoin, Dapasone, and Azulfidine. 2,3,4

Diagnosis of acute EBV IM is generally confirmed by a positive heterophile antibody test. The severity of the disease, however, is not indicated by the relative titer of heterophile antibodies.5 In addition, difficulties in diagnosis arise when the heterophile antibody test is negative or when the clinical manifestations are atypical or unusually severe.

Heterophile-negative IM occurs in 10 to 20 percent of adults, and in even greater percentage of children. 6,7 IM diagnosis in these individuals may be confirmed by the detections and identification of antibodies to specific EB antigens which include: viral capsid antigen (VCA), early antigens, diffuse and restricted (EA-D and EA-R), and Epstein-Barr nuclear antigen (EBNA).

IgG antibodies to VCA may be present early during EBV infection, but they persist indefinitely after the occurrence of clinical disease and may merely indicate EBV infection at some time in the past. IgM antibodies to VCA, on the other hand, are present in the circulation 1 to 6 weeks after the onset of EBV illness and usually disappear in 3 to 6 months. Thus the presence of VCA IgM usually suffices for the diagnosis of acute IM. Further verification may be obtained by testing for presence of antibodies directed against the other EBV-specific antigens, early antigen and EBNA. Heterophile antibody negative sera demonstrating VCA IgM and transient levels of antibody to early antigen are considered diagnostic for acute IM. In contrast, antibodies to EBNA appear late during IM infections, and IgG antibodies to EBNA may persist for years, even for life, and are indicative of the convalescent phase of IM infection.

Procedure

Diluted samples are incubated in VCA antigen-coated wells. VCA IgG antibodies (if present) are immobilized in the wells. Residual sample is eliminated by washing and draining, and conjugates (enzyme labeled antibodies to human IgG) is added and incubated. If IgG antibodies to VCA are present, the conjugate will be immobilized in the wells. Residual conjugate in eliminated by washing and draining, and the substrate is added and incubated. In the presence of the enzyme, the substrate in converted to a yellow end product which is read photometrically.

Test performed by VRL Eurofins, 6933 S. Revere Parkway, Centennial, CO 80112. This test has not been cleared or approved for diagnostic use by the U.S. Food and Drug Administration. See package insert for more information.

Within 24 hours from receipt of specimen (Monday - Friday).

Specimen Type Order Code CPT Code NY Approved Volume Assay Range Special Instructions
Serum 30813 86665 Yes

100 µL (min 25 µL)

Qualitative

  • Collect whole blood in an gold, red, or red/gray tiger top tube. Do not freeze whole blood.
  • Sample sent in original vacutainer tube can be shipped at refrigerated temperature, must be received within 2 days.
  • If not shipping in original container, centrifuge and transfer 100 µL (min 25 µL) serum to screw top tube. Specimens shipped at refrigerated temperature must be received within 2 days of collection, or frozen.
Shipping

All specimens must be labeled with patient's name and collection date. A Viracor/VRL Eurofins Pre-Transplant test requisition form must accompany each specimen. Multiple tests can be run on one specimen. Ship specimens FedEx Priority Overnight® to: VRL Eurofins, 6933 S. Revere Parkway, Centennial, CO 80112.

Causes for Rejection

Whole blood frozen, specimens beyond their acceptable length of time from collection as listed in the specimen handling, or specimen types other than those listed.

 

Specimens are approved for testing in New York only when indicated in the Specimen Information field above. The CPT codes provided are based on VRL Eurofins' interpretation of the American Medical Association's Current Procedural Terminology (CPT) codes and are provided for informational purposes only. CPT coding is the sole responsibility of the billing party. Questions regarding coding should be addressed to your local Medicare carrier. VRL Eurofins assumes no responsibility for billing errors due to reliance on the CPT codes illustrated in this material.

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