title: Detection of EBV-DNA in serum samples of an immunosuppressed child during a three years follow-up: association of clinical and PCR data with active infection.
abstract: Twenty-four whole blood and serum samples were drawn from an eight year-old heart transplant child during a 36 months follow-up. EBV serology was positive for VCA-IgM and IgG, and negative for EBNA-IgG at the age of five years old when the child presented with signs and symptoms suggestive of acute infectious mononucleosis. After 14 months, serological parameters were: positive VCA-IgG, EBNA-IgG and negative VCA-IgM. This serological pattern has been maintained since then even during episodes suggestive of EBV reactivation. PCR amplified a specific DNA fragment from the EBV gp220 (detection limit of 100 viral copies). All twenty-four whole blood samples yielded positive results by PCR, while 12 out of 24 serum samples were positive. We aimed at analyzing whether detection of EBV-DNA in serum samples by PCR was associated with overt disease as stated by the need of antiviral treatment and hospitalization. Statistical analysis showed agreement between the two parameters evidenced by the Kappa test (value 0.750; p < 0.001). We concluded that detection of EBV-DNA in serum samples of immunosuppressed patients might be used as a laboratory marker of active EBV disease when a Real-Time PCR or another quantitative method is not available.
authors.affiliation: Laboratory of medical Investigation (LIM/36), Department of Pediatrics, School of Medicine, University of São Paulo, SP, Brazil. tsokay@icr.hcnet.usp.br
authors.forename: Thelma Suely
authors.initials: TS
authors.lastname: Okay
authors.forename: Gilda Maria Barbaro
authors.initials: GM
authors.lastname: Del Negro
authors.forename: Lídia
authors.initials: L
authors.lastname: Yamamoto
authors.forename: Roberto
authors.initials: R
authors.lastname: Raiz Júnior
mesh_terms: D000956:Antigens, Viral / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D036022:Capsid Proteins / Q000097:blood*; D002648:Child; D004279:DNA, Viral / Q000097:blood*; D005500:Follow-Up Studies; D016027:Heart Transplantation; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000276:immunology*; D006801:Humans; D016867:Immunocompromised Host; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D007244:Infectious Mononucleosis / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D008297:Male; D016133:Polymerase Chain Reaction
chemical_list: D000956:Antigens, Viral; D015415:Biomarkers; D036022:Capsid Proteins; D004279:DNA, Viral; C041788:Epstein-Barr viral capsid antigen; D007074:Immunoglobulin G; D007075:Immunoglobulin M