Test Catalog

Test Id : EAEBV

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Epstein-Barr Virus Early Antigen, IgG, Serum

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

Diagnosis of Epstein Barr virus (EBV) infectious mononucleosis in cases when heterophile antibody test results are negative and EBV-specific serologic testing is inconclusive

 

Aiding in the diagnosis of type 2 or type 3 nasopharyngeal carcinoma (NPC)

 

This test is not useful for screening patients for NPC.

Method Name
A short description of the method used to perform the test

Enzyme-Linked Immunosorbent Assay (ELISA)

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

EBV EA IgG, S

Aliases
Lists additional common names for a test, as an aid in searching

E. B. Virus (Early Antigen)

EA (Early Antigen)

Early Antigen

EBV EARLY AG(S)

Epstein Barr Virus Early Ag Ab

Epstein-Barr Virus (EBV) Early Antigen

EAEBV

Specimen Type
Describes the specimen type validated for testing

Serum

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Collection Instructions: Centrifuge and aliquot serum into a plastic vial.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.

0.4 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis Reject
Gross lipemia Reject
Heat-activated specimen Reject

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Serum Frozen (preferred) 14 days
Refrigerated 48 hours

Useful For
Suggests clinical disorders or settings where the test may be helpful

Diagnosis of Epstein Barr virus (EBV) infectious mononucleosis in cases when heterophile antibody test results are negative and EBV-specific serologic testing is inconclusive

 

Aiding in the diagnosis of type 2 or type 3 nasopharyngeal carcinoma (NPC)

 

This test is not useful for screening patients for NPC.

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Epstein-Barr virus (EBV), a member of the herpesvirus group, is the etiologic agent of infectious mononucleosis. Infection with EBV usually occurs early in life. For several weeks to months after acute onset of the infection, EBV is spread by upper respiratory secretions that contain the virus. Among the EBV-associated clinical manifestations, infectious mononucleosis (IM) is the most common. EBV infection can be severe in immunosuppressed patients who may develop lymphoproliferative syndromes, especially in patients with advanced HIV and in patients who have undergone kidney or bone marrow transplantation. Other rare manifestations include African-type Burkitt lymphoma and nasopharyngeal carcinoma (NPC).

 

EBV does not grow in standard cell cultures and molecular testing is the primary means of diagnosis and monitoring response to therapy in immunosuppressed patients. Serologic testing for EBV remains important for diagnosis of infectious mononucleosis in otherwise healthy individuals and for pre-transplant or pre-immunosuppression screening purposes.

 

The majority of infections in healthy individuals can be identified by testing patient sera for heterophile antibodies using a rapid latex slide agglutination test (MONOS / Infectious Mononucleosis, Rapid Test, Serum). Heterophile antibodies usually appear within the first 3 weeks of illness but decline rapidly within thereafter. However, heterophile antibodies fail to develop in about 10% of adults and in more than 75% of infants and young children under the age of 4. In cases where EBV is suspected but the heterophile antibody is not detected or if confirmation is needed, or if patients are undergoing pre-immunosuppression screening, evaluation of EBV-specific antibodies, including assessment for IgM and IgG against the EBV viral capsid antigen (VCA) and IgG against the EBV nuclear antigen (EBNA) is useful.

 

The EBV early antigen (EA) has two forms, including the diffuse (ie, present in cytoplasm and nucleus of infected cells [EA-D]) and restricted (ie, present only in the cytoplasm of infected cells [EA-R]) forms. Generally, IgG antibodies to the EA, specifically the EA-D form, are only detected during active EBV infection, such as in patients with IM.

 

Additionally, IgG antibodies to EA-D are also found in patients with NPC. Of patients with type 2 or 3 NPC (World Health Organization classification), 94% and 83% respectively, have positive antibody responses to EA. Only 35% of patients with type 1 NPC have a positive response. The specificity of the test is such that 82% to 91% of healthy blood donor controls and patients who do not have NPC have negative responses (9%-18% false-positive results). Although this level of specificity is useful for diagnostic purposes, the false-positive rate indicates that the test is not useful for NPC screening.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Negative

Reference values apply to all ages.

Interpretation
Provides information to assist in interpretation of the test results

Positive - IgG antibodies specific to EBV early antigen detected.

Equivocal - Recommend follow-up testing in 10-14 days if clinically indicated

Negative - No IgG to EBV early antigen detected.

 

Do not make a diagnosis based on ZEUS ELISA EBV-EA IgG Test System alone. Interpret test results for anti-EBV-early antigen (EA) in conjunction with the clinical evaluation and the results of other diagnostic procedures. Consider test results for VCA and EBNA when evaluating patient specimens for EBV serological status.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

This test detects both restricted (R) and diffuse (D) forms the Epstein Barr virus (EBV) early antigen. The test system is not designed to differentiate between antibodies to the R and D components.

 

False negative results may occur in immunosuppressed patients.

 

The performance characteristics of this assay have not been established for Burkitt’s Lymphoma, nasopharyngeal carcinoma, and lymphoproliferative disorders.

 

The performance has been established for the aid in the diagnosis of EBV-associated infectious mononucleosis.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Fields BN, Knipe DM. Epstein-Barr virus. In: Fields BN, Knipe DM, Howley PM, eds. Fields Virology. 4th ed. Lippincott Williams and Wilkins; 2001

2. Lennette ET. Epstein-Barr virus. In: Murray PR, Baron EJ, Pfaller MA, et al, eds. Manual of Clinical Microbiology. 6th ed. ASM Press; 1995:905-910

3. Fugl A, Andersen CL. Epstein-Barr virus and its association with disease - a review of relevance to general practice. BMC Fam Pract. 2019;20(1):62. doi:10.1186/s12875-019-0954-3

Method Description
Describes how the test is performed and provides a method-specific reference

The ZEUS ELISA EBV-EA IgG Test System is designed to detect IgG class antibodies to Epstein-Barr Virus early antigen in human sera. Creation of the sensitized wells of the plastic microwell strips occurred using passive adsorption with EBV-EA antigen. The test procedure involves three incubation steps: 1. Test sera (properly diluted) are incubated in antigen coated microwells. Any antigen specific antibody in the sample will bind to the immobilized antigen. The plate is washed to remove unbound antibody and other serum components. 2. Peroxidase Conjugated goat anti-human IgG is added to the wells and the plate is incubated. The Conjugate will react with IgG antibody immobilized on the solid phase in step 1. The wells are washed to remove unreacted Conjugate. 3. The microwells containing immobilized peroxidase Conjugate are incubated with peroxidase Substrate Solution. Hydrolysis of the Substrate by peroxidase produces a color change. After a period of time, the reaction is stopped, and the color intensity of the solution is measured photometrically. The color intensity of the solution depends upon the antibody concentration in the original test sample.(Package insert: EBV-EA IgG Test System. Zeus Scientific, Inc.; 02/16/2022)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Tuesday; Thursday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

Same day/1 to 5 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

2 weeks

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

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Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

86663

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
EAEBV EBV EA IgG, S 40752-8
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
EBVEA EBVEA IgG, S 40752-8

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports

Test Update Resources

Change Type Effective Date
New Test 2024-10-22