title: Diagnostic importance of heterophile antibodies and immunoglobulins IgA, IgE, IgM and low-avidity IgG against Epstein-Barr virus capsid antigen in children.
abstract: The use of several serological markers in diagnostics of acute Epstein-Barr virus (EBV) infection in children and adolescents is recommended. We investigated the sera of 299 individuals with clinically suspect infectious mononucleosis for heterophile antibodies and EBV viral capsid antigen (VCA)-specific immunoglobulins IgA, IgE, IgM and low-avidity IgG. Heterophile antibodies were positive in 26%, VCA-specific IgA in 30%, IgE in 35%, IgM in 32% and low-avidity IgG in 37% of cases. The acute EBV infection defined as a case having either positive IgM or heterophile antibodies was present in 40% of persons. Compared with regard to this criterion the sensitivity, specificity, and positive and negative predictive values of individual tests were as follows: heterophile antibodies-66, 100, 100 and 82%; IgA-53, 84, 69 and 73%; IgE-54, 78, 62 and 72%; IgM-81, 100, 100 and 89% low-avidity IgG-66, 82, 71 and 78%. All markers except heterophile antibodies were positive even infants aged below 2 years. We consider the detection of low-avidity IgG and VCA-specific IgE an useful adjunct for the diagnostics of acute EBV infection in children.
authors.affiliation: Department of Microbiology, Masaryk University School of Medicine, Brno, Czech Republic.
authors.forename: M
authors.initials: M
authors.lastname: Votava
authors.forename: D
authors.initials: D
authors.lastname: Bartosová
authors.forename: A
authors.initials: A
authors.lastname: Krchnáková
authors.forename: K
authors.initials: K
authors.lastname: Crhová
authors.forename: L
authors.initials: L
authors.lastname: Kubinová
mesh_terms: D000293:Adolescent; D000910:Antibodies, Heterophile / Q000097:blood*; D000914:Antibodies, Viral / Q000097:blood*; D000956:Antigens, Viral / Q000276:immunology*; D002213:Capsid / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D006566:Herpesviridae Infections / Q000097:blood / Q000276:immunology / Q000821:virology*; D004854:Herpesvirus 4, Human / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007073:Immunoglobulin E / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D007136:Immunoglobulins / Q000097:blood*; D007223:Infant; D014412:Tumor Virus Infections / Q000097:blood / Q000276:immunology / Q000821:virology*
chemical_list: D000910:Antibodies, Heterophile; D000914:Antibodies, Viral; D000956:Antigens, Viral; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D007136:Immunoglobulins; D007073:Immunoglobulin E