Evaluation of an immunofiltration assay that detects immunoglobulin M antibodies against the ZEBRA protein for the diagnosis of Epstein-Barr virus infectious mononucleosis in immunocompetent patients

Clin Vaccine Immunol. 2009 Jun;16(6):885-8. doi: 10.1128/CVI.00123-09. Epub 2009 Apr 29.

Abstract

The performance of an immunofiltration assay (IMFA) that detects immunoglobulin M (IgM) antibodies to the Epstein-Barr virus (EBV) ZEBRA (BamHI Z EBV replication activator) protein was evaluated for the diagnosis of EBV infectious mononucleosis (IM) in immunocompetent patients. The test panel consisted of 47 sera displaying an EBV-specific antibody profile compatible with an acute primary EBV infection from patients with clinical and biological features of EBV IM, 20 sera from healthy individuals either with a past EBV infection or who were EBV seronegative, 20 sera displaying an equivocal EBV antibody pattern (viral capsid antigen IgG positive [VCA IgG+], VCA IgM+, and EBV nuclear antigen-1 IgG+), and 15 sera obtained from patients with a mononucleosis-like syndrome owing to cytomegalovirus, human herpesvirus 6, or parvovirus B19. Overall, the sensitivity and the specificity of the assay were found to be 92.5%, and 97.3%, respectively. The sensitivity of the assay for the diagnosis of heterophile antibody-negative EBV IM was 86.2%. The IMFA is rapid, easy to perform, and, thus, suitable for point-of-care testing, and it may be used as a first-line test for the diagnosis of acute EBV IM in immunocompetent patients.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antibodies, Viral / blood*
  • Child
  • Child, Preschool
  • Female
  • Herpesvirus 4, Human / immunology*
  • Humans
  • Immunoassay / methods
  • Immunoglobulin M / blood*
  • Infant
  • Infectious Mononucleosis / diagnosis*
  • Male
  • Middle Aged
  • Sensitivity and Specificity
  • Trans-Activators / immunology*
  • Young Adult

Substances

  • Antibodies, Viral
  • BZLF1 protein, Herpesvirus 4, Human
  • Immunoglobulin M
  • Trans-Activators