Acta Microbiologica et Immunologica Hungarica
Volume/Issue:
Volume 58: Issue 4
The role of IgG avidity determination in diagnosis of Epstein-Barr virus infection in immunocompetent and immunocompromised patients
Authors: Tatjana Vilibic-Cavlek 1 , Suncanica Ljubin-Sternak 1 , Ljiljana Kos 2 , and Gordana Mlinaric-Galinovic 1
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  • 1 Croatian National Institute of Public Health and School of Medicine University of Zagreb Department of Virology Zagreb Croatia
  • 2 University of Applied Health Studies Ljiljana Kos, BSc Zagreb Croatia
DOI:
https://doi.org/10.1556/amicr.58.2011.4.10
Page Count:
351–357
Publication Date:
01 Dec 2011
Online Publication Date:
29 Dec 2011
Article Category:
Research Article
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There is a high degree of variability in the serologic response to Epstein-Barr virus (EBV) infection, especially in viral capsid antigen (VCA)-IgM antibodies. Therefore, additional tests are needed to confirm primary infection.We evaluated the value of IgG avidity determination in diagnosis of EBV infection in immunocompetent and immunocompromised patients.A total of 236 serum samples from immunocompetent patients with symptoms suggestive of EBV infection were tested for the presence of VCA-IgM/IgG antibodies and IgG avidity. Using IgG avidity, acute primary infection was confirmed in 56.7% of the immunocompetent patients with positive and in 1.8% of patients with negative VCA-IgM. Recent primary infection was documented in 8.9% of the IgM positive and 3.5% of the IgM negative patients. In patients with indeterminate serology (equivocal IgM), 6.7% were classified by avidity index (AI) as acute primary infection, 10.0% as post-acute and 83.3% as past infection cases.Concerning the 32 immunocompromised patients, recent primary infection was documented in 3 of the 14 IgM positive patients. High AI was detected in 11 of these patients, indicating an IgM response due to reactivation.Determination of IgG avidity in combination with classical serologic markers seems to be a reliable method to confirm primary infection both in immunocompetent and immunocompromised patients. It may be especially useful to differentiate cases of primary infection in patients with undetectable VCA-IgM antibodies or indeterminate routine EBV serology.

  • Macsween, K. F., Crawford, D. H.: Epstein-Barr virus-recent advances. Lancet Infect. Dis. 3, 131–140 (2003).

    Crawford D. H. , 'Epstein-Barr virus-recent advances ' (2003 ) 3 Lancet Infect. Dis. : 131 -140.

    • Search Google Scholar

  • Hess, R. D.: Routine Epstein-Barr virus diagnostics from the laboratory perspective: Still challenging after 35 years. J. Clin. Microbiol. 42(8), 3381–3387 (2004).

    Hess R. D. , 'Routine Epstein-Barr virus diagnostics from the laboratory perspective: Still challenging after 35 years ' (2004 ) 42 J. Clin. Microbiol. : 3381 -3387.

    • Search Google Scholar

  • Young, L. S., Rickinson, A. B.: Epstein-Barr virus: 40 years on. Nat. Rev. Cancer 4, 757–768 (2004).

    Rickinson A. B. , 'Epstein-Barr virus: 40 years on ' (2004 ) 4 Nat. Rev. Cancer : 757 -768.

  • Brady, G., Macarhtur, G. J., Farrell, P. J.: Epstein-Barr virus and Burkitt lymphoma. Postgrad. Med. J. 84, 372–377 (2008).

    Farrell P. J. , 'Epstein-Barr virus and Burkitt lymphoma ' (2008 ) 84 Postgrad. Med. J. : 372 -377.

    • Search Google Scholar

  • Rickinson, A. B., Kieff, E.: Epstein-Barr virus. In: Knipe, D. M., Howley, P. M. (eds): Fields Virology. Williams & Wilkins, Philadelphia, 2007, pp. 2607–2700.

    Kieff E. , '', in Fields Virology , (2007 ) -.

  • Klein, E., Kis, L. L., Takahara, M.: Pathogenesis of Epstein-Barr virus (EBV)-carrying lymphomas. Acta Microbiol. Immunol. Hung. 53(4), 441–457 (2006).

    Takahara M. , 'Pathogenesis of Epstein-Barr virus (EBV)-carrying lymphomas ' (2006 ) 53 Acta Microbiol. Immunol. Hung. : 441 -457.

    • Search Google Scholar

  • De Ory, F., Antonaya, J., Fernandez, J. V., Echevarria, J. M.: Application of low-avidity immunoglobulin G studies to diagnosis of Epstein-Barr virus infectious mononucleosis. J. Clin. Microbiol. 31(6), 1669–1671 (1993).

    Echevarria J. M. , 'Application of low-avidity immunoglobulin G studies to diagnosis of Epstein-Barr virus infectious mononucleosis ' (1993 ) 31 J. Clin. Microbiol. : 1669 -1671.

    • Search Google Scholar

  • Vetter, V., Kreutzer, L., Bauer, G.: Differentiation of primary from secondary anti-EBNA-1-negative cases by determination of avidity of VCA-IgG. Clin. Diagn. Virol. 2, 29–40 (1994).

    Bauer G. , 'Differentiation of primary from secondary anti-EBNA-1-negative cases by determination of avidity of VCA-IgG ' (1994 ) 2 Clin. Diagn. Virol. : 29 -40.

    • Search Google Scholar

  • Gray, J. J.: Avidity of EBV-VCA specific IgG antibodies: Distinction between recent primary infection, past infection and reactivation. J. Virol. Methods 52, 95–104 (1995).

    Gray J. J. , 'Avidity of EBV-VCA specific IgG antibodies: Distinction between recent primary infection, past infection and reactivation ' (1995 ) 52 J. Virol. Methods : 95 -104.

    • Search Google Scholar

  • Robertson, P., Beynon, S., Whybin, R., Brennan, C., Vollmer-Conna, U., Hickie, I., Lloyd, A.: Measurement of EBV-IgG anti-VCA avidity aids the early and reliable diagnosis of primary EBV infection. J. Med. Virol. 70, 617–623 (2003).

    Lloyd A. , 'Measurement of EBV-IgG anti-VCA avidity aids the early and reliable diagnosis of primary EBV infection ' (2003 ) 70 J. Med. Virol. : 617 -623.

    • Search Google Scholar

  • Sener, A. G., Afsar, I., Pinar, E.: Evaluation of Epstein-Barr virus antibodies, anti-VCA avidity by immunofluorescence and immunoblot assays for assessment of Epstein-Barr virus immunologic state. J. Virol. Methods 159, 300–302 (2009).

    Pinar E. , 'Evaluation of Epstein-Barr virus antibodies, anti-VCA avidity by immunofluorescence and immunoblot assays for assessment of Epstein-Barr virus immunologic state ' (2009 ) 159 J. Virol. Methods : 300 -302.

    • Search Google Scholar

  • Schillinger, M., Kampmann, M., Henninger, K., Murray, G., Hanselmann, I., Bauer, G.: Variability of humoral immune response to acute Epstein-Barr virus (EBV) infection: Evaluation of the significance of serological markers. Med. Microbiol. Lett. 2, 296–303 (1993).

    Bauer G. , 'Variability of humoral immune response to acute Epstein-Barr virus (EBV) infection: Evaluation of the significance of serological markers ' (1993 ) 2 Med. Microbiol. Lett. : 296 -303.

    • Search Google Scholar

  • Aalto, S. M., Linnavuori, K., Peltola, H., Vuori, E., Weissbrich, B., Schubert, J., Hedman, L., Hedman, K.: Immunoreactivation of Epstein-Barr virus due to cytomegalovirus primary infection. J. Med. Virol. 56, 186–191 (1998).

    Hedman K. , 'Immunoreactivation of Epstein-Barr virus due to cytomegalovirus primary infection ' (1998 ) 56 J. Med. Virol. : 186 -191.

    • Search Google Scholar

  • Schubert, J., Zens, W., Weissbrich, B.: Comparative evaluation of the use of immunoblots and of IgG avidity assays as confirmatory tests for the diagnosis of acute EBV infections. J. Clin. Virol. 11, 161–172 (1998).

    Weissbrich B. , 'Comparative evaluation of the use of immunoblots and of IgG avidity assays as confirmatory tests for the diagnosis of acute EBV infections ' (1998 ) 11 J. Clin. Virol. : 161 -172.

    • Search Google Scholar
Cover Acta Microbiologica et Immunologica Hungarica
Acta Microbiologica et Immunologica Hungarica A Quarterly of the Hungarian Academy of Sciences
Print ISSN:
1217-8950
Online ISSN:
1588-2640
Keywords:
Epstein-Barr virus; serology; IgG avidity

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