title: Plasma Epstein Barr viral load in adult-onset Hodgkin lymphoma in South India.
abstract: OBJECTIVE
  Epstein Barr Virus (EBV) DNA load is increasingly being used as a noninvasive biomarker for detecting EBV association in lymphomas. Since there is a need of data from India, we undertook to prospectively evaluate plasma EBV DNA load as a marker of EBV association in newly diagnosed adult-onset Hodgkin lymphoma (HL).
  
  
  METHODS
  EBV DNA was quantified using real-time polymerase chain reaction. In a subset of patients, an assay was validated qualitatively with EBV latent membrane protein-1 (LMP1) immunohistochemistry (IHC). Wherever possible, follow-up plasma samples post three cycles of chemotherapy were obtained.
  
  
  RESULTS
  Over a period of 10 months, 33 newly diagnosed adult-onset HL were enrolled in the study. Pretherapy plasma EBV DNA was detectable in ∼49% (16/33) patients (viral loads range, 1.0-51.2×10(3)copies/mL) and undetectable in 30 voluntary blood donors. LMP1 IHC was positive in 56% of cases tested (14/25). Sensitivity and specificity of plasma EBV DNA with respect to LMP1 IHC were 86% and 100%, respectively. Of the eight patients in whom follow-up plasma was available, in five EBV baseline-positive patients EBV load reverted to negative postchemotherapy and corroborated with clinical remission.
  
  
  CONCLUSIONS
  Plasma EBV DNA load estimation may be useful in detecting EBV-association and possibly monitoring the response to therapy in EBV-related HL especially in our country where EBV association of HL is higher than in developed nations.
authors.affiliation: Department of Microbiology, Kidwai Memorial Institute of Oncology, Bangalore, India. Electronic address: mahuasinha@gmail.com.
authors.forename: Mahua
authors.initials: M
authors.lastname: Sinha
authors.affiliation: Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, India.
authors.forename: Clementina Rama
authors.initials: CR
authors.lastname: Rao
authors.affiliation: Department of Microbiology, Kidwai Memorial Institute of Oncology, Bangalore, India.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Shafiulla
authors.affiliation: Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, India.
authors.forename: Bharatnur
authors.initials: B
authors.lastname: Shankaranand
authors.affiliation: Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, India.
authors.forename: Belathur K
authors.initials: BK
authors.lastname: Viveka
authors.affiliation: Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, India.
authors.forename: Kuntegowdanahalli C
authors.initials: KC
authors.lastname: Lakshmaiah
authors.affiliation: Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, India.
authors.forename: Linu Abraham
authors.initials: LA
authors.lastname: Jacob
authors.affiliation: Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, India.
authors.forename: Govind K
authors.initials: GK
authors.lastname: Babu
authors.affiliation: Department of Microbiology, Kidwai Memorial Institute of Oncology, Bangalore, India.
authors.forename: Rudrapatna S
authors.initials: RS
authors.lastname: Jayshree
mesh_terms: D000328:Adult; D000368:Aged; D004279:DNA, Viral / Q000097:blood / Q000302:isolation & purification; D020031:Epstein-Barr Virus Infections / Q000097:blood / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D004854:Herpesvirus 4, Human / Q000302:isolation & purification* / Q000502:physiology; D006689:Hodgkin Disease / Q000097:blood / Q000150:complications* / Q000453:epidemiology / Q000821:virology*; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019562:Viral Load; D014763:Viral Matrix Proteins / Q000097:blood / Q000302:isolation & purification; D055815:Young Adult
chemical_list: D004279:DNA, Viral; C037662:EBV-associated membrane antigen, Epstein-Barr virus; D014763:Viral Matrix Proteins
keywords: Epstein–Barr Virus; Hodgkin lymphoma; LMP1 immunohistochemistry; Real-time PCR; Viral load