Related tests: Full blood count, AST, ALT
Clinical significance
The Epstein-Barr virus belongs to the Herpesviridae family and is a common human pathogen.
The infection is transmitted through saliva and causes infectious mononucleosis, a self-limiting infection characterised by fever, general malaise and swollen lymph nodes in the neck. Typically, the full blood count shows an increase in lymphocytes with a monocyte-like appearance (hence the misleading term mononucleosis); a temporary hepatitis with a slight rise in transaminases is often present.
For serological diagnosis, class G (IgG) and class M (IgM) antibodies against the viral capsid antigen (VCA) are measured. During acute infection, specific class M antibodies (IgM) rise, followed by IgG, which remain for life.
Clinical indications
Suspected infection, differential diagnosis of swollen lymph nodes in the neck.
Sample type
The patient must have a blood sample taken.
Preparation
You must fast for at least 8 hours; a small amount of water is allowed.
Notes
VCA-IgG absent, VCA-IgM absent: no exposure. If there is clinical uncertainty, patients should be monitored over time.
VCA-IgG present, VCA-IgM absent: past infection.
VCA-IgG absent, VCA-IgM present: acute infection at a very early stage.
VCA-IgG present, VCA-IgM present: acute or at least recent infection
The Epstein-Barr virus may cross-react with other herpesviruses.