Assessment of serological markers for EpsteinBarr virus in patients for transplantation
Abstract number: R2341
Genova-Kalou P., Ivanova G., Toshev A.
Objectives: Viral infections constitute the single greatest cause of infectious-disease related morbidity and mortality in organ transplant recipients. Cytomegalovirus (CMV), which frequently causes latent asymptomatic infection in healthy adults, may evade immune surveillance in immune compromised patients, as well as in renal transplant recipients and to start to replicate. EpsteinBarr virus (EBV) infection sometimes results in clinical symptoms (fever, leucopenia, pharyngitis, hepatitis, lymphadenopathy) and eventually may lead to uncontrolled proliferation of B cells terminating in post-transplant lymphoproliferative disease (PTLD). The risk of PTLD is mostly determined by the prevalence of anti-EBV sero-positivity in transplanted patients.
Methods: This prompted us to investigate the serum samples submitted to our laboratory from 25 post transplanted patients (1835 years old) and 30 healthy blood donors (2042 years old). Serum samples were collected from all patients before transplantation and at three months after transplantation. Sera were stored at -70°C. The samples were tested for EBV- and CMV-specific serology, including VCA IgM, VCA IgG, early antigen (EA) and EBNA antibody. The levels of antibodies were determined using commercially available sensitive enzyme-linked immunosorbent assay (ELISA) method.
Results: Antibody avidity test results were added to provide an expanded serological profile in which patients with low antibody affinity were defined as having primary infections while those with high antibody affinity were regarded as having past infections. 25 samples (48.2%) were found to be seropositive. Recent infection was diagnosed in 32.6% of patients while prior infection in 15.6%. Past infection was diagnosed by detecting VCA IgM antibodies in 20.5% of the examined samples. Our results confirm the thesis that VCA IgM in the absence of antibody to EB nuclear antigen (EBNA) is regarded as suggestive of acute primary EBV infection because EBNA antibodies develop only in late convalescence.
Conclusions: In conclusion, specific serological anti-EBV IgG markers (EBNA and EA) must be used for the serological diagnosis of EBV infectious mononucleosis. In order to obtain the highest sensitivity, VCA IgM, VCA IgG, EBNA and EA antibodies need to be measured.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
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