Compact Epstein-Barr virus diagnosis based on a defined antigen mix and specific IgA

An ELISA was evaluated to measure EBV-specific IgM, IgG and IgA using a test plate coated with a controlled mix of EA, VCA and EBNA. Using the IgM version, the multi-reactive surface reduced false-negative findings in cases of infectious mononucleosis (sensitivity 98%), but was confronted with polyclonal IgM responses (specificity 85% to 95% depending on the population). For the IgG version, a national research standard was involved, and in combination with the IgA estimation, a new diagnostic strategy became possible for chronic EBV infections and reactivations. Patients screened by enhanced IgG (> 650 U/ml) were confirmed by an elevated IgA signal (> 0.6 A), with an efficacy of 95%. A raised virus-specific IgA response was not observed in cases of infectious mononucleosis, but was seen for healthy HIV-positive persons. Superior to the traditional antibody puzzle for EBV diagnosis, it will now become possible, using this compact diagnostic concept, to reduce laboratory expenses without loss of reliable results.