TABLE 1.
Diagnostic methods for EBV detection
| Method | Analyte, antigen, or substrate | Comment |
|---|---|---|
| Serology | ||
| IFA | Cell lines like P3HR-1 and Raji | Classical method; gold standard; highly specific; staging of EBV infections possible with a single serum sample |
| Complement fixation reaction | Lysate of EBV-transformed cell lines | Less sensitive, less specific; not widely used; staging of EBV infections not possible with a single serum sample |
| EIA, ELISA, or chemoluminescence with coated beads | Lysate of EBV-transformed cell lines; EBV lysates; combination of lysates and recombinant proteins; recombinant proteins; synthetic peptides | Rapid, highly sensitive, suitable for automation; synthetic peptides as antigens less sensitive and less specific (due to cryptic epitopes in native molecules); with a single serum sample |
| Blot techniques (Western blot analysis or line blot assays) | Lysate of EBV-transformed cell lines; EBV lysates; recombinant proteins; combination of lysates and recombinant proteins | Highly specific; mostly a confirmatory method; staging of EBV infections possible with a single serum sample |
| IgG avidity determination, IFA, and/or ELISA or Western blot analysis | Titration of antibodies in the absence and presence of increasing amounts of urea or other chaotropic reagents | Rather special method used for confirmation of indeterminate results (Table 2) (antibodies in an acute EBV infecti on are of low avidity) |
| Heterophile antibody agglutination | Paul-Bunnell antigens; bovine erythrocytes | Less sensitive, less specific; 10-50% of children <4 years of age do not produce heterophile antibodies |
| Virus isolation | Lymphoblastoid cell lines from patient lymphocytes | Performed only in special laboratories; long-lasting test (up to 4-8 weeks) |
| Nucleic acid detection | ||
| PCR | Lymphocytes, plasma, serum, cerebrospinal fluid, tissue | Method of choice if EBV-associated meningoencepahlitis (from cerebrospinal fluid) is suspected; used to detect virus load and reactivation |
| In situ hybridization, in situ PCR | Tumor tissue; paraffin-embedded sections | Used to detect EBV-associated tumors |
| Virus antigens, immunhistochemistry and immunocytology | Tumor tissue; paraffin-embedded sections | Used to detect EBV-associated tumors |