Epstein-Barr Virus 감염 진단을 위한 특이 항체검사법과 중합효소연쇄반응법의 임상적 유용성

Abstract

Background : Epstein-Barr virus (EBV)-specific Ab ELISA using recombinant antigens is the most widely used method in the diagnosis of EBV infection. Recently sensitivity and specificity were greatly improved. But still the early antigen (EA)-IgM is too sensitive for discriminating the true EBV infection from secondary reactivation by other infectious agents or autoimmune diseases. So we compared EBV-specific panel test with PCR genotyping. Methods : We studied 944 patients in Yonsei University Medical College Hospital who were suspected to have EBV infection. EBV-specific Ab panel test including EA-IgM, EA-IgG, EBNA-IgG was performed and EBV PCR was also performed in 151 randomly selected patients. The test results were classified into 9 stages by optical density. EBNA 2 region was amplified by PCR using DNAs isolated from peripheral blood mononuclear cells. Results : The seronegative rate was 9.9% given the EBV Ab panel results. Seronegative/primary infection was high in the pediatric group, past infection was high in the adult group, and reactivation was high in the ICU/transplanted group. The overall positive rate of EBV PCR in 151 patients was 35.8%, of which type 1 genotype was 55.6%, type 2 was 20.4%, and coinfection of type 1 and 2 was 24.1%. PCR results were all negative in seronegative group. PCR positive rates of primary infection and reactivation were high (41.7%, 43.5%, respectively). Conclusions : EBV Ab panel and EBV PCR showed good correlation. EBV panel test was useful in the screening and staging of EBV infection. EBV PCR genotyping was also needed in confirming and determining prognosis of EBV infection especially in an immunocompromised host. (Korean J Clin Pathol 2000; 20: 320-9)