[Epstein-Barr virus--significance of and possibilities in laboratory diagnosis]

The clinical symptoms of acute Epstein-Barr virus (EBV) serology infection may overlap with those of a variety of other infections and diseases; therefore, a significant EBV serology is of great importance for differential diagnosis. As the serological response after primary EBV infection may be highly variable, it is necessary to determine VCA-IgG, VCA-IgM and anti-EBNA-1 in parallel in all cases, in order to obtain conclusive results. Immunosuppressive disorders or treatment may lead to a specific loss of anti-EBNA-1 and thus mimic the serological situation of acute EBV infection. In these cases, determination of avidity of VCA-IgG may help to solve the problem. We also suggest to determine the EBV status, before the clinical significance of IgM directed against other viruses is being considered. This approach may help to distinguish clinical relevant IgM findings from IgM due to EBV-caused polyclonal stimulation.