Serological diagnosis of Epstein-Barr virus infection: Problems and solutions.
Serological diagnosis of Epstein-Barr virus infection: Problems and solutions.
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DOI：
10.5501/wjv.v1.i1.31
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发表时间：
2012-02-12
期刊：
影响因子：
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通讯作者：
Clerici, Pierangelo
中科院分区：
文献类型：
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作者：
De Paschale, Massimo;Clerici, Pierangelo
EBV抗原特异性抗体的血清学检测常用于确定感染状态和鉴别诊断引起单核细胞增多症的其他病原体。仅使用三个参数[病毒衣壳抗原（VCA） IgG， VCA IgM和EBV核抗原(EBNA)-1 IgG]，通常可以区分急性感染和过去感染：存在VCA IgM和VCA IgG而没有EBNA-1 IgG表明急性感染，而存在VCA IgG和EBNA-1 IgG而没有VCA IgM是过去感染的典型。然而，血清学结果有时可能难以解释，因为在急性或过去感染的情况下，VCA IgG可能不存在VCA IgM或EBNA-1 IgG，或者在最近感染的情况下或在重新激活的过程中，所有这三个参数可能同时检测到。分离的EBNA-1 IgG的谱也可能产生一些疑问。为了正确解释这些模式，有必要确定IgG的亲和力，通过免疫印迹法鉴定抗ebv IgG和IgM抗体，并利用分子生物学方法寻找嗜异性抗体、抗ea (D)抗体或病毒基因组。这些检查可以确定感染的状态，并解决常规实验室操作中可能出现的任何问题。
Serological tests for antibodies specific for Epstein-Barr virus (EBV) antigens are frequently used to define infection status and for the differential diagnosis of other pathogens responsible for mononucleosis syndrome. Using only three parameters [viral capsid antigen (VCA) IgG, VCA IgM and EBV nuclear antigen (EBNA)-1 IgG],it is normally possible to distinguish acute from past infection: the presence of VCA IgM and VCA IgG without EBNA-1 IgG indicates acute infection, whereas the presence of VCA IgG and EBNA-1 IgG without VCA IgM is typical of past infection. However, serological findings may sometimes be difficult to interpret as VCA IgG can be present without VCA IgM or EBNA-1 IgG in cases of acute or past infection, or all the three parameters may be detected simultaneously in the case of recent infection or during the course of reactivation. A profile of isolated EBNA-1 IgG may also create some doubts. In order to interpret these patterns correctly, it is necessary to determine IgG avidity, identify anti-EBV IgG and IgM antibodies by immunoblotting, and look for heterophile antibodies, anti-EA (D) antibodies or viral genome using molecular biology methods. These tests make it possible to define the status of the infection and solve any problems that may arise in routine laboratory practice.