Diagnosis of Epstein-Barr Virus Infection (I)
photo source: http://bioweb.uwlax.edu/
In general, the best procedure for laboratory diagnosis of viral infections is isolation of the virus or any of its components or products. While acknowledging cell types naturally susceptible to infection by EBV in vitro is reduced to B cells, which are processed in a technologically complex and slow process, so that isolation is an imp procedure for most laboratories diagnostics.
The identification of either virus antigens has proved an adequate approximation. Finally, the detection of HBV DNA by the chain reaction of polymerase has shown a good performance comparative serological studies for the diagnosis of mononucleosis in the acute phase.
Given the drawbacks of direct diagnosis, EBV infections are made fundamentally by serology.
Since long before the description of the virus and its relationship with infectious mononucleosis, applied the Paul-Bunnell test for heterophil antibody identification (AH). These are IgM antibodies directed against antigens present on the surface of erythrocytes of different species and occurring in more than 80% of adult cases and less frequently (less than 50%) in children. However, and despite not correspond to a specific response against the virus, they are fairly specific for the disease caused by the virus.
Currently different approaches are used to detect HA, from the classical agglutination of erythrocytes from cows, sheep or horses, after differential absorption with guinea pig kidney extract until ELISA or agglutination of latex particles sensitized with membrane antigens of bovine erythrocytes, which offer greater ease in interpreting results. All have similar performance. There are some studies indicating that agglutination methods are more sensitive than immunoassays with a specificity equivalent.
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