Test Id : SEBV
Epstein-Barr Virus (EBV) Antibody Profile, Serum
Useful For
Suggests clinical disorders or settings where the test may be helpful
Diagnosing infectious mononucleosis when a mononucleosis screening procedure is negative and infectious mononucleosis or a complication of Epstein-Barr virus infection is suspected
This assay is not intended for viral isolation or identification.
Profile Information
A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.
| Test Id | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| EBVM | EBV VCA IgM Ab, S | No | Yes |
| EBVG | EBV VCA IgG Ab, S | No | Yes |
| EBVNA | EBNA Ab, S | No | Yes |
Method Name
A short description of the method used to perform the test
Multiplex Flow Immunoassay (MFI) or 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.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Aliases
Lists additional common names for a test, as an aid in searching
Anti EBV Serology
E. B. (Epstein-Barr) Virus
EBNA (Epstein-Barr Nuclear Antigen)
EBV (Epstein-Barr Virus) Battery
EBV (Epstein-Barr Virus) Panel
EBV (Epstein-Barr Virus)
EBV Panel, Serum
Epstein Barr Virus
Epstein-Barr Virus AB
Epstein-Barr Virus Battery
Epstein-Barr Virus Panel
VCA (Viral Capsid Antigen) IgG and IgM
Viral Capsid Antigen (VCA) Titer
Infectious Mononucleosis
EBV Ab, Serum
SEBV
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.
0.6 mL
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
| Heat-inactivated 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 | Refrigerated (preferred) | 14 days | |
| Frozen | 14 days |
Useful For
Suggests clinical disorders or settings where the test may be helpful
Diagnosing infectious mononucleosis when a mononucleosis screening procedure is negative and infectious mononucleosis or a complication of Epstein-Barr virus infection is suspected
This assay is not intended for viral isolation or identification.
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. EBV infections are difficult to diagnose in the laboratory since the virus does not grow in standard cell cultures. The majority of infections can be recognized, however, by testing the patient's serum for heterophile antibodies (rapid latex slide agglutination test, eg, MONOS / Infectious Mononucleosis, Rapid Test, Serum), which usually appear within the first 3 weeks of illness but then decline rapidly within a few weeks. The heterophile antibody, however, fails to develop in about 10% of adults, more frequently in children, and almost uniformly in infants with primary EBV infections. Most of these heterophile antibody-negative cases of infectious mononucleosis-like infections are due to cytomegalovirus, but in a series of 43 cases, EBV was the cause in 7. In cases where EBV is suspected but the heterophile antibody is not detected, an evaluation of the EBV-specific antibody profile (eg, EBV viral capsid antigen [VCA] IgM, EBV VCA IgG, and EBV nuclear antigen [EBNA]) may be useful.
Infection with EBV usually occurs early in life. For several weeks to months after acute onset of the infection, it is spread by upper respiratory secretions that contain the virus. Among the clinical disorders due to EBV infection, infectious mononucleosis is the most common. Other disorders due to EBV infection have been recognized for several years, including African-type Burkitt lymphoma and nasopharyngeal carcinoma. EBV infection may also cause lymphoproliferative syndromes, especially in patients who have undergone kidney or bone marrow transplantation and in those who have AIDS.
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.
Epstein-Barr Virus (EBV) VIRAL CAPSID ANTIGEN (VCA) IgM ANTIBODY
Negative
Epstein-Barr Virus (EBV) VIRAL CAPSID ANTIGEN (VCA) IgG ANTIBODY
Negative
EPSTEIN-BARR NUCLEAR ANTIGEN (EBNA) ANTIBODIES
Negative
Interpretation
Provides information to assist in interpretation of the test results
The test has 3 components: viral capsid antigen (VCA) IgG, VCA IgM, and Epstein-Barr nuclear antigen (EBNA). Presence of VCA IgM antibodies indicates recent primary infection with Epstein-Barr virus (EBV). The presence of VCA IgG antibodies indicates infection sometime in the past. Antibodies to EBNA develop 6 to 8 weeks after primary infection and are detectable for life. Over 90% of the normal adult population has IgG class antibodies to VCA and EBNA. Few patients who have been infected with EBV will fail to develop antibodies to the EBNA (approximately 5%-10%).
Table. Possible Results
| VCA IgG | VCA IgM | EBNA IgG | Interpretation |
| - | - | - | No previous exposure |
| + | + | - | Recent infection |
| + | - | + | Past infection |
| + | - | - | See note* |
| + | + | + | Past infection |
*Results indicate infection with EBV at some time (VCA IgG positive). However, the time of the infection cannot be predicted (ie, recent or past) since antibodies to EBNA usually develop after primary infection (recent) or, alternatively, approximately 5% to 10% of patients with EBV never develop antibodies to EBNA (past).
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Specimens collected too early during the course of the disease may not contain detectable antibody to Epstein-Barr virus (EBV). Another specimen collected 1 to 2 weeks later may be required.
Test results should be evaluated in relation to patient symptoms, clinical history, and other laboratory findings.
The timing of the appearance of IgG antibodies to viral capsid antigen (VCA) or Epstein-Barr nuclear antigen (EBNA) or IgM antibodies to VCA is subject to variations among individuals and serological assays.
This assay's performance characteristics with immunosuppressed individuals, newborns, cord blood, or matrices other than human serum have not been established.
Assay performance characteristics have not been established for the diagnosis of nasopharyngeal carcinoma, Burkitt lymphoma, and other EBV-associated lymphomas.
Anti-VCA-specific IgG may compete with IgM for binding sites, leading to false-negative results. Rheumatoid factor (RF), in the presence of specific IgG, may contribute to false-positive results. The absorbent in the VCA IgM diluent is intended to neutralize the effects of RF and specific IgG. Studies have shown that the absorbent was able to neutralize up to 98% of the activity in a specimen known to contain 3328 IU/mL of RF activity.
Testing for VCA IgM should not be performed as a screening procedure on the general population. The predictive value of positive or negative results depends on the pretest likelihood of Epstein-Barr-associated disease being present. Testing should only be performed when clinical evidence suggests the diagnosis of this syndrome.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. Knipe DM, Howley PM, Griffin DE, et al, eds. Fields' Virology. 5th ed. Lippincott Williams and Wilkins; 2007
2. Linde A, Falk KI. Epstein-Barr virus. In: Manual of Clinical Microbiology. Barron EJ, Jorgensen JH, Landry ML, eds. 9th ed. ASM Press; 2007:1564-1573
3. Johannsen EC, Kaye KM. Epstein-Barr virus (infectious mononucleosis, Epstein-Barr virus-associated malignant diseases, and other diseases). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020:1872-1890
Method Description
Describes how the test is performed and provides a method-specific reference
Testing is performed on the BioPlex 2200 System. For the detection of viral capsid antigen (VCA)-IgG antibody and Epstein-Barr nuclear antigen (EBNA) antibody, an aliquot of the patient serum, sample diluent, and bead reagent are combined in a reaction vessel. After washing, antihuman-IgG antibody conjugated to phycoerythrin (PE) is added to the beads and incubated. Another wash step removes excess conjugate, and beads are subsequently resuspended in wash buffer. The bead mixture passes through a detector where the identity of each bead is determined by the bead's dye fluorescence. In addition, the amount of antibody captured by the antigen is measured by the fluorescence of the bound PE.
For the detection of VCA-IgM antibody, the patient sample is combined with diluent containing antihuman IgG and bead reagent. The antihuman IgG is incorporated in the mix because any anti-VCA-specific IgG present may compete with the IgM for binding sites, leading to false-negative VCA-IgM results. After a wash cycle, antihuman-IgM antibody conjugated to PE is added. Detection of anti-VCA-specific IgM is performed as described above for the VCA IgG assay.(Package inserts: BioPlex 2200 System EBV IgG and EBV IgM, Bio-Rad Laboratories Clinical Diagnostics Group, Hercules CA, 2012)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
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.
Monday through Saturday
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.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
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.
CPT codes are provided by the performing laboratory.
86664-EBNA
86665 x 2-VCA, IgG and IgM
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 |
|---|---|---|
| SEBV | EBV Ab Profile, S | 87554-2 |
| 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.
|
|---|---|---|
| EBVG | EBV VCA IgG Ab, S | 24114-1 |
| EBVM | EBV VCA IgM Ab, S | 24115-8 |
| EBNA | EBNA Ab, S | 22296-8 |
| INT73 | Interpretation | 69048-7 |