Role of anti-EA-(D) IgM and anti-EA-(D) IgG tests in patients with primary EBV infection, lymphomas and immunosuppression

Purpose: The EA (early antigen) is expressed during the lytic phase of the EBV life cycle, together with VCA (viral capsid antigen) and MA (membrane antigen). Antibodies to EA (D) IgG occur in the course of primary infection, but not in all patients. The titers increase in the first 3-4 weeks and us...

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Main Authors: Tsvetelina Kostadinova, Liliya Ivanova, Tatina Todorova, Zhivka Stoykova, Denitsa Tsaneva, Gabriela Tsankova
Format: Article
Language:English
Published: Peytchinski Publishing 2018-12-01
Series:Journal of IMAB
Subjects:
Online Access:https://www.journal-imab-bg.org/issues-2018/issue4/JofIMAB-2018-24-4p2267-2271.pdf
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author Tsvetelina Kostadinova
Liliya Ivanova
Tatina Todorova
Zhivka Stoykova
Denitsa Tsaneva
Gabriela Tsankova
author_facet Tsvetelina Kostadinova
Liliya Ivanova
Tatina Todorova
Zhivka Stoykova
Denitsa Tsaneva
Gabriela Tsankova
author_sort Tsvetelina Kostadinova
collection DOAJ
description Purpose: The EA (early antigen) is expressed during the lytic phase of the EBV life cycle, together with VCA (viral capsid antigen) and MA (membrane antigen). Antibodies to EA (D) IgG occur in the course of primary infection, but not in all patients. The titers increase in the first 3-4 weeks and usually last about 3-4 months. Their presence is also associated with reactivation of the infection due to impaired immune control of the viral replication. The aim of this study was to compare the primary immune response against the major antigens (VCA) and EA (D) in patients with clinically proven primary infection and to define the antibody response to the EA (D) antigen as a marker for reactivation in patients at risk. Materials/Methods: We examined 86 persons with lymphomas, incl. Hodgkin's lymphoma and non-Hodgkin's lymphoma, immunosuppressed patients, mainly with AML (acute myeloid leukemia) and primary infection (infectious mononucleosis, IM) patients. We used an indirect ELISA for anti-EA (D) IgM/IgG and anti-VCA IgM/IgG (Euroimmun, Germany). Results: Patients with аnti-EA(D) IgM were 29.1% (95% CI:19.8% - 39.9%, n=25) while patients with аnti-EA(D) IgG were 23.3% (95% CI:14.8%-33.6%, n=20) (p>0.05). As expected, younger individuals with IM diagnosis predominated among the positive patients. We found isolated аnti-EA(D) IgM in four persons (with lymphoma and immunosuppression) and isolated аnti-EA(D) IgG in five patients. Conclusion: The routine diagnostic tests used to detect antibodies to VCA have a much better diagnostic value in defining a primary infection. Use of antibodies against EA (D) in case of isolated anti-VCA IgM and anti-VCA IgG needs further evaluation. Use of anti-EA (D) IgG as a reactivation marker should be compared with Real-time PCR results.
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spelling doaj.art-f81f519ca35847fdbe9a4e0eda3779c32022-12-21T21:46:19ZengPeytchinski PublishingJournal of IMAB1312-773X2018-12-012442267227110.5272/jimab.2018244.2267Role of anti-EA-(D) IgM and anti-EA-(D) IgG tests in patients with primary EBV infection, lymphomas and immunosuppressionTsvetelina Kostadinova0Liliya Ivanova1Tatina Todorova2Zhivka Stoykova3Denitsa Tsaneva4Gabriela Tsankova5Section Medical Lab Technicians, Medical College, Medical University, Varna, Bulgaria.Department of Microbiology and Virology, Faculty of Medicine, Medical University, Varna, Bulgaria.Department of Preclinical and Clinical Sciences, Faculty of Pharmacy, Medical University, Varna, Bulgaria.Department of Microbiology and Virology, Faculty of Medicine, Medical University, Varna, Bulgaria.Department of Microbiology and Virology, Faculty of Medicine, Medical University, Varna, Bulgaria.Department of Preclinical and Clinical Sciences, Faculty of Pharmacy, Medical University, Varna, Bulgaria.Purpose: The EA (early antigen) is expressed during the lytic phase of the EBV life cycle, together with VCA (viral capsid antigen) and MA (membrane antigen). Antibodies to EA (D) IgG occur in the course of primary infection, but not in all patients. The titers increase in the first 3-4 weeks and usually last about 3-4 months. Their presence is also associated with reactivation of the infection due to impaired immune control of the viral replication. The aim of this study was to compare the primary immune response against the major antigens (VCA) and EA (D) in patients with clinically proven primary infection and to define the antibody response to the EA (D) antigen as a marker for reactivation in patients at risk. Materials/Methods: We examined 86 persons with lymphomas, incl. Hodgkin's lymphoma and non-Hodgkin's lymphoma, immunosuppressed patients, mainly with AML (acute myeloid leukemia) and primary infection (infectious mononucleosis, IM) patients. We used an indirect ELISA for anti-EA (D) IgM/IgG and anti-VCA IgM/IgG (Euroimmun, Germany). Results: Patients with аnti-EA(D) IgM were 29.1% (95% CI:19.8% - 39.9%, n=25) while patients with аnti-EA(D) IgG were 23.3% (95% CI:14.8%-33.6%, n=20) (p>0.05). As expected, younger individuals with IM diagnosis predominated among the positive patients. We found isolated аnti-EA(D) IgM in four persons (with lymphoma and immunosuppression) and isolated аnti-EA(D) IgG in five patients. Conclusion: The routine diagnostic tests used to detect antibodies to VCA have a much better diagnostic value in defining a primary infection. Use of antibodies against EA (D) in case of isolated anti-VCA IgM and anti-VCA IgG needs further evaluation. Use of anti-EA (D) IgG as a reactivation marker should be compared with Real-time PCR results.https://www.journal-imab-bg.org/issues-2018/issue4/JofIMAB-2018-24-4p2267-2271.pdfEpstein-Barr virusanti-ЕА(D)IgM/IgGanti-VCA IgМ/IgGinfectious mononucleosislymphomasimmunosuppression
spellingShingle Tsvetelina Kostadinova
Liliya Ivanova
Tatina Todorova
Zhivka Stoykova
Denitsa Tsaneva
Gabriela Tsankova
Role of anti-EA-(D) IgM and anti-EA-(D) IgG tests in patients with primary EBV infection, lymphomas and immunosuppression
Journal of IMAB
Epstein-Barr virus
anti-ЕА(D)IgM/IgG
anti-VCA IgМ/IgG
infectious mononucleosis
lymphomas
immunosuppression
title Role of anti-EA-(D) IgM and anti-EA-(D) IgG tests in patients with primary EBV infection, lymphomas and immunosuppression
title_full Role of anti-EA-(D) IgM and anti-EA-(D) IgG tests in patients with primary EBV infection, lymphomas and immunosuppression
title_fullStr Role of anti-EA-(D) IgM and anti-EA-(D) IgG tests in patients with primary EBV infection, lymphomas and immunosuppression
title_full_unstemmed Role of anti-EA-(D) IgM and anti-EA-(D) IgG tests in patients with primary EBV infection, lymphomas and immunosuppression
title_short Role of anti-EA-(D) IgM and anti-EA-(D) IgG tests in patients with primary EBV infection, lymphomas and immunosuppression
title_sort role of anti ea d igm and anti ea d igg tests in patients with primary ebv infection lymphomas and immunosuppression
topic Epstein-Barr virus
anti-ЕА(D)IgM/IgG
anti-VCA IgМ/IgG
infectious mononucleosis
lymphomas
immunosuppression
url https://www.journal-imab-bg.org/issues-2018/issue4/JofIMAB-2018-24-4p2267-2271.pdf
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