Epstein-Barr virus DNA in body fluids

Advances in polymerase chain reaction technology have greatly simplified the ability to detect and monitor Epstein-Barr virus DNA copy number in a variety of settings. An initial focus on cell-associated viruses by many investigators has shown some interesting results regarding the dynamics of Epstein-Barr virus infection. Several findings are unexpected. A relation between HIV load or CD4 T-cell counts and Epstein-Barr virus copy number is not seen. Furthermore, highly active antiretroviral treatment therapy in HIV patients that results in a rise of CD4 T cells may sometimes be associated with a rise in cell-associated Epstein-Barr virus load. Detection of Epstein-Barr virus in spinal fluid is useful in the diagnosis of primary central nervous system lymphoma, and monitoring of Epstein-Barr virus DNA copy number in spinal fluid may be useful in assessing response. Cell-free DNA in serum or plasma is emerging as a useful diagnostic tool in several settings. Fetal DNA can be detected in maternal serum or plasma. Tumor DNA can be detected in serum or plasma in association with a variety of cancers. Epstein-Barr virus DNA in serum or plasma has been found in infectious mononucleosis, nasopharyngeal carcinoma, posttransplant lymphoma, and nasal lymphoma. In each of these malignancies, its detection or quantification has been shown to be of prognostic significance. The utility of Epstein-Barr virus DNA detection and quantification in the serum or plasma of patients with HIV malignancies has yet to be determined but holds great promise.