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HelpTest Code LEBV Epstein-Barr Virus (EBV), Molecular Detection, PCR, Varies
Reporting Name
Epstein-Barr Virus PCRUseful For
Rapid qualitative detection of Epstein-Barr virus (EBV) DNA in specimens
Diagnosis of disease due to EBV
This test should not be used to screen asymptomatic patients.
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
VariesSpecimen Required
Necessary Information
Specimen source is required.
Specimen Required
Supplies: Sarstedt 5 mL Aliquot Tube (T914)
Specimen Type: Fluid
Sources: Spinal fluid, sterile body fluids (peritoneal fluid/ascites, pericardial fluid, pleural fluid/thoracentesis), amniotic, or ocular
Preferred: Sterile screw-cap 5-mL plastic vial
Acceptable: Sterile container
Specimen Volume: 0.5 mL
Collection Instructions: Do not centrifuge.
Supplies: Sarstedt 5 mL Aliquot Tube (T914)
Specimen Type: Fluid
Sources: Respiratory; bronchial washing, bronchoalveolar lavage, nasopharyngeal aspirate or washing, sputum, or tracheal aspirate
Container/Tube:
Preferred: Sterile screw-cap 5-mL plastic vial
Acceptable: Sterile container
Specimen Volume: 1.5 mL
Supplies:
-Culturette (BBL Culture Swab) (T092)
-M4-RT (T605)
-Bartels FlexTrans VTM-3 mL (T892)
-Jiangsu VTM-3 mL (T891)
Specimen Type: Swab
Sources: Eye and upper respiratory (nasal, throat)
Container/Tube: Multimicrobe media (M4-RT) and Eswabs
Collection Instructions: Place swab back into multimicrobe media (M4-RT, M4 or M5)
Specimen Type: Bone marrow
Container/Tube: Lavender top (EDTA) only
Specimen Volume: 0.5 mL
Additional Information: Clotted specimens will be rejected.
Supplies:
-M4-RT (T605)
-Bartels FlexTrans VTM-3 mL (T892)
-Jiangsu VTM-3 mL (T891)
Specimen Type: Tissue
Sources: Brain, colon, kidney, liver, lung, cornea, etc.
Preferred: Multimicrobe medium (M4-RT)
Acceptable: Sterile container containing 1-2 mL of sterile saline or multimicrobe medium (M4-RT, M4 or M5)
Specimen Volume: Entire collection
Collection Instructions: Submit only fresh tissue
Specimen Minimum Volume
Body Fluid, Ocular Fluid, Spinal Fluid: 0.3 mL
Respiratory Specimens: 1 mL
Tissue: 2 × 2-mm biopsy
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Varies | Refrigerated (preferred) | 7 days | |
| Frozen | 7 days |
Reference Values
Negative
Day(s) Performed
Monday through Friday
Test Classification
This test was developed using an analyte specific reagent. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
87798
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| LEBV | Epstein-Barr Virus PCR | 23858-4 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| SRC67 | Specimen Source | 31208-2 |
| 81239 | Epstein-Barr Virus PCR | 23858-4 |
Clinical Information
Epstein-Barr virus (EBV) is the causative agent of infectious mononucleosis, Burkitt lymphoma, and in Southern China, nasopharyngeal carcinoma. EBV-associated central nervous system (CNS) disease is most commonly associated with primary CNS lymphoma in patients with AIDS. In addition, CNS infection associated with the detection of EBV DNA can be seen in immunocompetent patients.
Interpretation
Detection of Epstein-Barr virus (EBV) DNA in cerebrospinal fluid (CSF) supports the clinical diagnosis of central nervous system (CNS) disease due to the virus. EBV DNA is not detected in CSF from patients without CNS disease caused by this virus.
Cautions
A negative result does not eliminate the possibility of Epstein-Barr virus (EBV) infection of the central nervous system.
This assay may detect viremia or viral shedding in asymptomatic individuals. However, this assay is only to be used for patients with a clinical history and symptoms consistent with EBV infection and must be interpreted in the context of the clinical picture.
Supportive Data
Thirty negative specimens of each matrix accepted for this assay were spiked with Epstein-Barr positive control plasmid at the approximate limit of detection (10-20 targets/mcL). The 30 spiked specimens of each type were run in a blinded manner along with 30 negative (nonspiked) specimens; 93% to 100% of the spiked specimens were positive and 100% of the nonspiked specimens were negative.
Analytical Sensitivity/Limit of Detection:
The 95% limit of detection (LOD) for this assay is less than 10 targets per microliter using plasmid and whole virus spiked into matrix. The LOD was confirmed in each matrix type that is accepted for testing with this assay.
Analytical Specificity:
No polymerase chain reaction (PCR) signal was obtained from extracts of 40 bacterial and viral isolates that could cause similar symptoms including herpes simplex virus (HSV) 1 and 2; cytomegalovirus (CMV); varicella zoster virus (VZV); and human herpesvirus (HHV) 6, HHV 7, and HHV 8.
Precision:
Interassay precision was 100% and intraassay precision was 100%.
Reportable Range:
This is a qualitative assay and results are reported as either negative or positive for targeted Epstein-Barr virus DNA.
Clinical Reference
1. Tachikawa N, Goto M, Hoshino Y, et al: Detection of Toxoplasma gondii, Epstein-Barr virus, and JC virus DNAs in the cerebrospinal fluid in acquired immunodeficiency syndrome patients with focal central nervous system complications. Intern Med. 1999;38(7):556-562. doi: 10.2169/internalmedicine.38.556
2. Antinori A, Cingolani A, De Luca A, et al: Epstein-Barr virus in monitoring the response to therapy of acquired immunodeficiency syndrome-related primary central nervous system lymphoma. Ann Neurol. 1999;45(2):259-261
3. Cingolani A, De Luca A, Larocca LM, et al: Minimally invasive diagnosis of acquired immunodeficiency syndrome-related primary central nervous system lymphoma. J Natl Cancer Inst. 1998;90(8):364-369. doi: 10.1093/jnci/90.5.364
4. Niller HH, Wolf H, Minarovits J: Regulation and dysregulation of Epstein-Barr virus latency: implications for the development of autoimmune disease. Autoimmunity. 2008:41(4):298-328. doi: 10.1080/08916930802024772
5. Studahl M, Hagberg L, Rekvdar E, Bergstrom T: Herpesvirus DNA detection in cerebrospinal fluid: difference in clinical presentation between alph-, beta-, and gamma-herpes viruses. Scand J Infect Dis. 2000;32(3):237-248. doi: 10.1080/00365540050165857
6. Lau AH, Soltys K, Sindhi RK, Bond G, Mazariegos GV, Green M: Chronic high Epstein-Barr viral load carriage in pediatric small bowel transplant recipients. Pediatr Transplant. 2010;14(4):549-553. doi: 10.1111/j.1399-3046.2009.01283.x
Method Description
Viral nucleic acid is extracted by the MagNA Pure automated instrument (Roche Applied Science) from clinical specimens. Primers are directed to the target gene (latent membrane protein). The LightCycler instrument amplifies and monitors by fluorescence the development of target nucleic acid sequences after the annealing step during polymerase chain reaction (PCR) cycling. This is an automated PCR system that can rapidly detect (30-40 minutes) amplicon development through stringent air-controlled temperature cycling in capillary cuvettes. The detection of amplified products is based on the fluorescence resonance energy transfer (FRET) principle. For FRET product detection, a hybridization probe with a donor fluorophore, fluorescein, on the 3' end is excited by an external light source and emits light that is absorbed by a second hybridization probe with an acceptor fluorophore, LC-Red 640, at the 5' end. The acceptor fluorophore then emits a light of a different wavelength that can be measured with a signal that is proportional to the amount of specific PCR product. Melting curve analysis is performed following PCR amplification. Starting at 45° C, the temperature in the thermal chamber is slowly raised to 80° C and the fluorescence is measured at frequent intervals. Analysis of the PCR amplification and probe melting curves is accomplished through the use of LightCycler software.(Espy MJ, Patel R, Paya C, Smith TF: Quantification of Epstein-Barr virus viral load in transplant patients by LightCycler PCR. Abstr Gen Meet Am Soc Microbiol 2001;May:20-24)
Report Available
2 to 3 daysSpecimen Retention Time
1 weekReject Due To
| Calcium alginate-tipped swab Wood swab Transport swab containing gel Formalin-fixed and paraffin-embedded tissues |
Reject |
NY State Approved
YesMethod Name
Real-Time Polymerase Chain Reaction (PCR)/DNA Probe Hybridization
Forms
If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.