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Development of a Diagnostic Algorithm for Epstein-Barr Virus-Related Diseases: A Retrospective Observational Study.
Jiaoyuan Li1, Hongyan Hou1, Juan Song2
1Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Journal of Medical Virology
|May 28, 2025
Summary
Epstein-Barr virus (EBV) DNA in plasma and PBMCs is highly detectable in patients with EBV-associated diseases. Plasma EBV DNA testing is recommended as a first-line diagnostic approach for high-risk individuals.
Area of Science:
- Virology
- Infectious Diseases
- Molecular Diagnostics
Background:
- Epstein-Barr virus (EBV) is associated with various human diseases.
- Accurate diagnosis and differentiation of EBV-related disorders are crucial for effective management.
- Understanding the molecular and serological characteristics of EBV in different disease contexts is essential.
Purpose of the Study:
- To investigate the molecular and serological features of EBV-associated diseases in China.
- To compare EBV DNA levels and antibody profiles across different EBV-related conditions.
- To evaluate the diagnostic utility of plasma and peripheral blood mononuclear cell (PBMC) EBV DNA detection.
Main Methods:
- A multi-center retrospective cohort study involving 746 patients with EBV-related diseases and 350 controls.
- Quantitative polymerase chain reaction (qPCR) for EBV DNA quantification in plasma and PBMCs.
- Chemiluminescence immunoassay for detecting four EBV-specific antibodies (VCA-IgM, EBNA-IgG).
Main Results:
- High EBV DNA positivity rates were observed in PBMCs (97.7%) and plasma (92.6%) of patients, significantly higher than in controls.
- EBV DNA positivity in PBMCs was nearly universal across most diseases, except nasopharyngeal carcinoma (87.4%).
- Plasma EBV DNA positivity varied by disease, while most groups showed low viral capsid antigen IgM and high EBV nuclear antigen IgG, except infectious mononucleosis.
Conclusions:
- EBV DNA in plasma is a valuable marker for distinguishing EBV-associated diseases from controls, with PBMC EBV DNA enhancing diagnostic accuracy.
- Distinct patterns of EBV DNA and antibody responses exist across different EBV-associated diseases.
- Plasma EBV DNA testing is recommended as a primary diagnostic tool, followed by PBMC testing if plasma results are negative, alongside comprehensive serological evaluation.
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