Determination of Epstein-Barr virus (EBV) load by RT-PCR and cellular dilution

Epstein-Barr virus (EBV) is a ubiquitous human herpesvirus which establishes life-long latency in the B-lymphocytes of infected individuals. Epstein-Barr virus is associated with Hodgkin's disease, AIDS-associated lymphoma and post-transplant lymphoproliferative disease (PTLD). In PTLD, the onset of malignancy correlates with a rise in EBV load. The relationship between malignancy and EBV load in other EBV-associated malignancies is not known. Epstein-Bar virus latency is associated with the expression of a limited set of viral transcripts. The most numerous of these are the EBERs (Epstein-Barr early RNAs). The high copy number of the EBERs in each latently infected cell led the author to combine serial dilution of lymphocytes with reverse transcriptase polymerase chain reaction (RT-PCR) for EBER-1 as a means to rapidly quantitate EBV load. The highest viral load was seen in a bone marrow transplant patient, where one in 3906 lymphocytes harboured EBV. Elevated viral load was seen in two solid-organ transplant patients. Viral loads in healthy volunteers ranged from less than one in 1x10(6) to one in 6.25x10(4). Reverse transcriptase polymerase chain reaction for EBER-1 in serial lymphocyte dilutions should allow the relationship of EBV load and malignancy to be examined in a number of disease settings and should also provide a quantitative picture of the impact of anti-viral therapy.