Test Catalog

Test Id : EBVE

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Epstein-Barr Virus (EBV), IgG Antibody to Early Antigen, Serum

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

A third-order test in the diagnosis of infectious mononucleosis, especially in situations when initial testing results (heterophile antibody test) are negative and follow-up testing (viral capsid antigen: VCA IgG, VCA IgM, and Epstein-Barr nuclear antigen) yields inconclusive results

 

Aiding in the diagnosis of type 2 or type 3 nasopharyngeal carcinoma (NPC)

 

This test is not useful for screening patients for NPC.

Method Name
A short description of the method used to perform the test

Multiplex Flow Immunoassay

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

EBV EA IgG Ab, S

Aliases
Lists additional common names for a test, as an aid in searching

E. B. Virus (Early Antigen)

EA (Early Antigen)

Early Antigen

EBV EARLY AG(S)

Epstein Barr Virus Early Ag Ab

Epstein-Barr Virus (EBV) Early Antigen

Specimen Type
Describes the specimen type validated for testing

Serum

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Collection Instructions: Centrifuge and aliquot serum into a plastic vial.

Forms

If not ordering electronically, complete, print, and send Infectious Disease Serology Test Request (T916) with the specimen.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

0.4 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis Reject
Gross lipemia Reject
Heat-activated specimen Reject

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 14 days
Frozen 14 days

Useful For
Suggests clinical disorders or settings where the test may be helpful

A third-order test in the diagnosis of infectious mononucleosis, especially in situations when initial testing results (heterophile antibody test) are negative and follow-up testing (viral capsid antigen: VCA IgG, VCA IgM, and Epstein-Barr nuclear antigen) yields inconclusive results

 

Aiding in the diagnosis of type 2 or type 3 nasopharyngeal carcinoma (NPC)

 

This test is not useful for screening patients for NPC.

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Epstein-Barr virus (EBV), a member of the herpesvirus group, is the etiologic agent of infectious mononucleosis. EBV infections are difficult to diagnose in the laboratory since the virus does not grow in standard cell cultures. The majority of infections can be identified, by testing the patient's serum for heterophile antibodies (rapid latex slide agglutination test, eg, MONOS / Infectious Mononucleosis, Rapid Test, Serum). Heterophile antibodies usually appear within the first 3 weeks of illness but decline rapidly within a few weeks. However, this heterophile antibody fails to develop in about 10% of adults, more frequently in children, and almost uniformly in infants with primary EBV infections. Most of these heterophile antibody negative cases of infectious mononucleosis-like infections are due to cytomegalovirus, but in one series of 43 cases, EBV was the cause in 7. In cases where EBV is suspected but the heterophile antibody is not detected, an evaluation of EBV-specific antibodies (eg, IgM and IgG antibodies to EBV viral capsid antigen [VCA]) and antibodies to EBV nuclear antigen (EBNA) may be useful. The EBV enzyme immunoassays that detect antibodies to the EBV VCA and early antigen (EA) are more sensitive than heterophile antibody tests.

 

Infection with EBV usually occurs early in life. For several weeks to months after acute onset of the infection, it is spread by upper respiratory secretions that contain the virus. Among the clinical disorders due to EBV infection, infectious mononucleosis is the most common. Other disorders due to EBV infection include African-type Burkitt lymphoma and nasopharyngeal carcinoma (NPC). EBV infection may also cause lymphoproliferative syndromes, especially in patients with AIDS and in patients who have undergone kidney or bone marrow transplantation.

 

Using immunofluorescent staining techniques, 2 patterns of EA are seen: diffuse staining of both cytoplasm and nucleus (early antigen-diffuse: EA-D) and cytoplasmic or early antigen restricted (EA-R). Antibodies responsible for the diffuse staining pattern are seen in infectious mononucleosis and NPC and are measured in this assay.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Negative

Reference values apply to all ages.

Interpretation
Provides information to assist in interpretation of the test results

Generally, this antibody can only be detected during active Epstein-Barr virus (EBV) infection, such as in patients with infectious mononucleosis. Clinical studies have indicated that patients who have chronic active or reactivated EBV infection commonly have elevated levels of IgG-class antibodies to the early antigen (EA) of EBV.

 

IgG antibody specific for the diffuse early antigen of EBV is often found in patients with nasopharyngeal carcinoma (NPC). Of patients with type 2 or 3 NPC (World Health Organization classification), 94% and 83% respectively, have positive-antibody responses to EA. Only 35% of patients with type 1 NPC have a positive response. The specificity of the test is such that 82% to 91% of healthy blood donor controls and patients who do not have NPC have negative responses (9%-18% false-positive results). Although this level of specificity is useful for diagnostic purposes, the false-positive rate indicates that the test is not useful for NPC screening.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

This test detects the diffuse components of early antigen only.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Fields BN, Knipe DM: Epstein-Barr virus. In: Fields BN, Knipe DM, Howley PM, eds. Fields Virology. 4th ed. Lippincott Williams and Wilkins; 2001

2. Lennette ET: Epstein-Barr virus. In: Murray PR, Baron EJ, Pfaller MA, et al, eds. Manual of Clinical Microbiology. 6th ed. ASM Press; 1995:905-910

3. Fugl A, Andersen CL: Epstein-Barr virus and its association with disease - a review of relevance to general practice. BMC Fam Pract. 2019 May 14;20(1):62. doi: 10.1186/s12875-019-0954-3

Method Description
Describes how the test is performed and provides a method-specific reference

Testing is performed on the BioPlex 2200 System for the detection of the early antigen-diffuse (EA-D) antibody. An aliquot of the patient serum, sample diluent, and bead reagent are combined in a reaction vessel. After washing, antihuman-IgG antibody conjugated to phycoerythrin (PE) is added to the beads and incubated. Another wash step removes excess conjugate, and beads are subsequently resuspended in wash buffer. The bead mixture passes through a detector where the identity of each bead is determined by the bead's dye fluorescence. In addition, the amount of antibody captured by the antigen is measured by the fluorescence of the bound PE.(Package insert: BioPlex 2200 System EBV EA-D. Bio-Rad Laboratories; 03/2012)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Friday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

Same day/1 to 3 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

2 weeks

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

86663

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
EBVE EBV EA IgG Ab, S 22295-0
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
EBVE EBV EA IgG Ab, S 22295-0

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | PHP Pdf | CMS Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports