Molecular diagnosis of Epstein-Barr virus infections

Epstein-Barr virus (EBV) is an ubiquitous virus infecting the majority of people worldwide. Primary infection is usually sub clinical, except in a number of cases when it causes infectious mononucleosis. This diagnosis is usually based on serology, however, this may not always be conclusive. In these cases, additional EBV PCR can be a helpful tool. Latently present in memory B lymphocytes, EBV can be encountered throughout the body. However, presence in cell free serum or plasma is rare and can be a sign of virus reactivation. EBV is etiologically linked to a number of malignancies, such as nasopharyngeal lymphoma, Hodgkin lymphoma and post-transplant lymphoproliferative disease. Here, knowledge about presence and load of EBV in both target organ and serum is helpful for diagnosing, staging, prognosis and subsequent monitoring of the effect of therapy. Debate is still going on as to which substrate is preferred for analysis, what gene target to use for PCR and which cut-off values to use for diagnosis and start of pre-emptive therapy.