title: Is there diagnostic value in detection of immunoglobulin g antibodies to the epstein-barr virus early antigen?
abstract: The Epstein-Barr virus early antigen (EBV EA) complex consists of multiple proteins with potential significance for diagnosis of EBV-related diseases. In many individuals, detection of antibody to the early antigen (EA) is a sign of active infection, but 20% of healthy people may have this antibody for years. We studied the role of EA immunoglobulin G (IgG) in individuals with atypical antibody responses in the diagnosis of infectious mononucleosis (IM) and in EBV-infected transplant patients. EA IgG was present in 72% of confirmed IM patients. A trend was observed between high viral loads and the presence of EA IgG and between low viral loads and the absence of EA IgG in EBV-associated disease negative liver transplant recipients. Three assays that measure serum EA IgG were compared; enzyme-linked immunosorbent assay (ELISA), chemiluminescent immunoassay (CLIA), and immunoblot assay. The automated CLIA was found to be more accurate than the ELISA when using the immunoblot assay as a "gold standard" assay in the detection of EA IgG. There may be a potential role for EA IgG testing, together with EBV viral load, in the prediction of transplant recipients at risk of EBV-associated disease; however, EA IgG does not play a significant role in the differential diagnosis of EBV infection in immunocompetent individuals.
authors.affiliation: National Virus Reference Laboratory, University College Dublin , Belfield, Dublin, Ireland .
authors.forename: Andrea
authors.initials: A
authors.lastname: Crowley
authors.forename: Jeff
authors.initials: J
authors.lastname: Connell
authors.forename: Kirsten
authors.initials: K
authors.lastname: Schaffer
authors.forename: William
authors.initials: W
authors.lastname: Hall
authors.forename: Jaythoon
authors.initials: J
authors.lastname: Hassan
keywords: Epstein–Barr virus; early antigen; infectious mononucleosis; liver transplant