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Test ID EBVQN Epstein-Barr Virus DNA Detection and Quantification, Plasma


Shipping Instructions


1. Ship specimen frozen on dry ice only.

2. If shipment will be delayed for more than 24 hours, freeze plasma at -20 to -80° C (up to 84 days) until shipment on dry ice.



Specimen Required


Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Collection Container/Tube: Lavender top (EDTA)

Submission Container/Tube: Plastic vial

Specimen Volume: 1.5 mL

Collection Instructions:

1. Centrifuge blood collection tube per manufacturer's instructions (eg, centrifuge within 2 hours of collection for BD Vacutainer tubes).

2. Aliquot plasma into plastic vial.


Useful For

Diagnosis of Epstein-Barr virus (EBV)-associated infectious mononucleosis in individuals with equivocal or discordant EBV serologic marker test results

 

Diagnosis of posttransplant lymphoproliferative disorders (PTLD), especially in EBV-seronegative organ transplant recipients receiving antilymphocyte globulin for induction immunosuppression and OKT-3 treatment for early organ rejection

 

Monitoring progression of EBV-associated PTLD in organ transplant recipients

 

This test should not be used to screen asymptomatic patients.

Method Name

Real-Time Polymerase Chain Reaction (RT-PCR)

Reporting Name

EBV DNA Detect/Quant, P

Specimen Type

Plasma EDTA

Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Plasma EDTA Frozen (preferred) 84 days
  Refrigerated  6 days

Clinical Information

Primary infection with Epstein-Barr virus (EBV), a DNA virus in the Herpesviridae family, may cause infectious mononucleosis resulting in a benign lymphoproliferative condition characterized by fever, fatigue, sore throat, and lymphadenopathy. Infection occurs early in life, and, by 10 years of age, 70% to 90% of children have been infected with this virus. Usually, infection in children is asymptomatic or mild and may be associated with minor illnesses such as upper respiratory tract infection, pharyngitis, tonsillitis, bronchitis, and otitis media.

 

The target cell for EBV infection is the B lymphocyte. Immunocompromised individuals lacking antibody to EBV are at risk for acute EBV infection that may cause lymphoproliferative disorders in organ transplant recipients (posttransplant lymphoproliferative disorders: PTLD) and AIDS-related lymphoma. The incidence of PTLD ranges from 1% for kidney transplant recipients to as high as 9% for heart/lung transplants and 12% for pancreas transplant patients.

 

EBV DNA can be detected in the blood of patients with this viral infection, and increasing serial levels of EBV DNA in plasma have been shown to correlate highly with subsequent (in 3-4 months) development of PTLD in susceptible patients. Organ transplant recipients who are seronegative (at risk for primary EBV infection) for EBV (most often children) who receive antilymphocyte globulin for induction immunosuppression and OKT-3 treatment for early organ rejection are at highest risk for developing PTLD when compared to immunologically normal individuals with prior EBV infection.

Reference Values

Undetected

Interpretation

The quantification range of this assay is 35 to 100,000,000 IU/mL (1.54 log to 8.00 log IU/mL), with a limit of detection (95% detection rate) at 19 IU/mL.

 

Increasing levels of Epstein-Barr virus (EBV) DNA in serial plasma specimens of a given organ transplant recipient may indicate possible development of posttransplant lymphoproliferative disorder (PTLD).

 

An "Undetected" result indicates that EBV DNA is not detected in the plasma specimen (see Cautions). If clinically indicated, repeat testing in 1 to 2 months is recommended.

 

A result of "<35 IU/mL" indicates that the EBV DNA level present in the plasma specimen is below 35 IU/mL (1.54 log IU/mL), and the assay cannot accurately quantify the EBV DNA present below this level.

 

A quantitative value (reported in IU/mL and log IU/mL) indicates the EBV DNA level (ie, viral load) present in the plasma specimen.

 

A result of ">100,000,000 IU/mL" indicates that the EBV DNA level present in the plasma specimen is above 100,000,000 IU/mL (8.00 log IU/mL), and this assay cannot accurately quantify the EBV DNA present above this level.

 

An "Inconclusive" result indicates that the presence or absence of EBV DNA in the plasma specimen could not be determined with certainty after repeat testing in the laboratory, possibly due to polymerase chain reaction inhibition or presence of interfering substance. Submission of a new specimen for testing is recommended if clinically indicated.

Clinical Reference

1. San-Juan R, Comoli P, Caillard S, et al: Epstein-Barr virus-related post-transplant lymphoproliferative disorder in solid organ transplant recipients. Clin Microbiol Infect. 2014 Sep;20(Suppl 7):109-118. doi: 10.1111/1469-0691.12534

2. Jiang SY, Yang JW, Shao JB, Liao XL, Lu ZH, Jiang H: Real-time polymerase chain reaction for diagnosing infectious mononucleosis in pediatric patients: A systematic review and meta-analysis. J Med Virol. 2016 May;88(5):871-876. doi: 10.1002/jmv.24402

3. Allen UD, Preiksaitis JK, AST Infectious Diseases Community of Practice: Post-transplant lymphoproliferative disorders, Epstein-Barr virus infection, and disease in solid organ transplantation: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant. 2019 Sep;33(9):e13652. doi: 10.1111/ctr.13652

4. Kimura H, Kwong YL: EBV Viral Loads in diagnosis, monitoring, and response assessment. Front Oncol. 2019 Feb 12;9:62. doi: 10.3389/fonc.2019.00062

Day(s) Performed

Monday through Saturday

Report Available

1 to 3 days

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

87799

LOINC Code Information

Test ID Test Order Name Order LOINC Value
EBVQN EBV DNA Detect/Quant, P 43730-1

 

Result ID Test Result Name Result LOINC Value
615297 EBV DNA Detect/Quant, P 43730-1