head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing
ISSN: 1312-773X (Online)
Issue: 2018, vol. 24, issue4
Subject Area: Medicine
DOI: 10.5272/jimab.2018244.2267
Published online: 06 December 2018

Original article

J of IMAB. 2018 Oct-Dec;24(4):2267-2271
Role of anti-EA-(D) IgM and anti-EA-(D) IgG tests in patients with primary EBV infection, lymphomas and immunosuppression
Tsvetelina Kostadinova1ORCID logo Corresponding Autoremail, Liliya Ivanova2,3, Tatina Todorova4ORCID logo, Zhivka Stoykova2,3ORCID logo, Denitsa Tsaneva2ORCID logo, Gabriela Tsankova4ORCID logo,
1) Section Medical Lab Technicians, Medical College, Medical University, Varna, Bulgaria.
2) Department of Microbiology and Virology, Faculty of Medicine, Medical University, Varna, Bulgaria.
3) Laboratory of Clinical Virology, University Hospital St. Marina, Varna, Bulgaria.
4) Department of Preclinical and Clinical Sciences, Faculty of Pharmacy, Medical University, Varna, Bulgaria.

Purpose: The EA (early antigen) is expressed during the lytic phase of the EBV life cycle, together with VCA (viral capsid antigen) and MA (membrane antigen). Antibodies to EA (D) IgG occur in the course of primary infection, but not in all patients. The titers increase in the first 3-4 weeks and usually last about 3-4 months. Their presence is also associated with reactivation of the infection due to impaired immune control of the viral replication. The aim of this study was to compare the primary immune response against the major antigens (VCA) and EA (D) in patients with clinically proven primary infection and to define the antibody response to the EA (D) antigen as a marker for reactivation in patients at risk.
Materials/Methods: We examined 86 persons with lymphomas, incl. Hodgkin's lymphoma and non-Hodgkin's lymphoma, immunosuppressed patients, mainly with AML (acute myeloid leukemia) and primary infection (infectious mononucleosis, IM) patients. We used an indirect ELISA for anti-EA (D) IgM/IgG and anti-VCA IgM/IgG (Euroimmun, Germany).
Results: Patients with аnti-EA(D) IgM were 29.1% (95% CI:19.8% - 39.9%, n=25) while patients with аnti-EA(D) IgG were 23.3% (95% CI:14.8%-33.6%, n=20) (p>0.05). As expected, younger individuals with IM diagnosis predominated among the positive patients. We found isolated аnti-EA(D) IgM  in four persons (with lymphoma and immunosuppression) and isolated аnti-EA(D) IgG in five patients.
Conclusion: The routine diagnostic tests used to detect antibodies to VCA have a much better diagnostic value in defining a primary infection. Use of antibodies against EA (D) in case of isolated anti-VCA IgM and anti-VCA IgG needs further evaluation. Use of anti-EA (D) IgG as a reactivation marker should be compared with Real-time PCR results.

Keywords: Epstein-Barr virus, anti-ЕА(D)IgM/IgG, anti-VCA IgМ/IgG, infectious mononucleosis, lymphomas, immunosuppression,

pdf - Download FULL TEXT /PDF 849 KB/
Please cite this article as: Kostadinova T, Ivanova L, Todorova T, Stoykova Z, Tsaneva D, Tsankova G. Role of anti-EA-(D) IgM and anti-EA-(D) IgG tests in patients with primary EBV infection, lymphomas and immunosuppression. J of IMAB. 2018 Oct-Dec;24(4):2267-2271. DOI: 10.5272/jimab.2018244.2267

Corresponding AutorCorrespondence to: Tsvetelina Kostudinova Popova, Education and Research Sectors of Medical Laboratory Assistant, Medical College, Medical University- Varna; 84, Tsar Osvoboditel Blvd., Varna, Bulgaria; E-mail: ckostadinova@abv.bg

1. De Paschale M, Clerici P. Serological diagnosis of Epstein-Barr virus infection: Problems and solutions. World J Virol. 2012 Feb 12;1(1):31-43. [PubMed] [Crossref]
2. Klutts JS, Ford BA, Perez NR, Gronowski AM. Evidence-based approach for interpretation of Epstein-Barr virus serological patterns. J Clin Microbiol. 2009 Oct;47(10):3204-10. [PubMed] Crossref]
3. Hess RD.  Routine Epstein-Barr Virus Diagnostics from the Laboratory Perspective: Still Challenging after 35 Years. J Clin Microbiol. 2004 Aug; 42(8):3381-7. [PubMed] [Crossref]
4. Chan KH, Ng MH, Seto WH, Peiris JSM.  Epstein-Barr Virus (EBV) DNA in Sera of Patients with Primary EBV Infection. J. Clin. Microbiol. 2001 Nov; 39 (11): 4152–4154. [Crossref]
5. Levin LI, Chang ET, Ambinder RF, Lennette ET, Rubertone MV, Mann RB, et al. Atypical prediagnosis Epstein-Barr virus serology restricted to EBV-positive Hodgkin lymphoma. Blood. 2012 Nov;120(18):3750-5. [PubMed] [Crossref]
6. Obel N, Hoier-Madsen M, Kangro H. Serological and clinical findings in patients with serological evidence of reactivated Epstein-Barr virus infection. APMIS. 1996 Jun;104(6):424-8. [PubMed]
7. Gulley ML, Tang W. Laboratory assays for Epstein-Barr virus-related disease. J Mol Diagn. 2008 Jul;10(4):279-92. [PubMed] [Crossref].

Received: 23 May 2018
Published online: 06 December 2018

back to Online Journal