Epstein-Barr Virus (EBV) PCR (Quantitative) - blood specimen
- LIS Mnemonic: EBVPCR
Collect
Lavendar (EDTA)
Volume Required
4-7 ml whole blood
Minimum Required
4 ml whole blood
Transport
Transport blood in a timely fashion (preferably within 8 hours of collection) at room temperature to the Clinical Virology Laboratory.
Stability
N/A
Processing
Whole blood in an EDTA-anticoagulated tube is the preferred specimen source. Thoroughly mix the blood by gently inverting the collection tube 6-12 times before sending to the laboratory. Other acceptable specimens include body fluids, tissue submitted in viral transport medium, and CSF.
Unacceptable conditions
Clotted specimens
Days Performed
Daily
Reported
Same day
Reflex Testing
When monitoring the blood of immunocompromised patients for EBV over time, a quantitative PCR assay will be automatically performed on all patients whose blood has been previously positive for EBV by qualitative and/or quantitative PCR testing.
CPT
87798
Methodology
Amplification and detection of EBV DNA of the nonglycosylated membrane protein BNRF1 p143 gene using TaqMan real-time PCR technology. This test is performed pursuant to an agreement with Roche Molecular Systems, Inc.
Disease Information
Utility:
EBV is the primary cause of infectious mononucleosis with symptoms of fever, exudative pharyngitis, lymphadenopathy, enlarged liver and spleen, and an atypical lymphocytosis. Infections with EBV can lead to hepatitis, pneumonia, myocarditis, neurologic syndromes, hemolytic anemia, thrombocytopenia, and hemophagocyctic syndrome. The virus is also associated with posttransplantation lymphoproliferative disorders (PTLD), Burkitt lymphoma, X-linked lymphoproliferative syndrome, nasopharyngeal carcinoma, and lymphomas of the CNS. The diagnosis of EBV infection is increasingly being made by PCR, and EBV DNA has been detected in specimens from solid-organ and bone marrow transplant recipients and HIV-infected patients with lymphoproliferative disorders; individuals with infectious mononucleosis, and in patients with other manifestations of primary or recurrent EBV infections. Quantitative PCR assays should be used in immunocompromised patients to associate infection with disease, predict and monitor disease progression, assess efficacy of antiviral therapy, and to facilitate our understanding of the pathogenesis of EBV. In these patients, viremia is considered to be the best predictor of disease, and quantitative measures of EBV DNA in blood is useful for the continued surveillance and management of transplant patients.
Interpretation
If positive, quantity of Epstein-Barr virus DNA is reported in copies/ml and log10 values. Dynamic range of the assay is 818 copies/ml to 400 million copies/ml or 3.00 log10 copies/ml to 8.60 log10 copies/ml.
Reference Values
Negative or quantity of Epstein-Barr virus DNA is less than the lower limit of detection
Remarks
Quantitative viral load results are best reflected when reported using log transformed units of copies/ml of nucleic acid. Logarithmic expression best reflects the process of viral replication and is less subject to over-interpretation of minor (non-clinically significant) changes. For this reason, all viral load results are reported not only as copies/ml but log10 copies/ml of nucleic acid.
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