Background
Epstein-Barr virus (EBV) affects most of the population. When infection occurs in childhood, it is usually asymptomatic; in adolescents and young adults, however, it is the main cause of infectious mononucleosis, an acute disease that typically presents with fever, sore throat and non-specific lymph node involvement.
Although its course is generally benign, rapid and reliable diagnosis remains important, as other conditions such as acute toxoplasmosis, some acute viral hepatitis or primary HIV infection may present in a similar way.
From a serological perspective, diagnosis relies on different markers, including heterophile antibodies and virus-specific antibodies, mainly VCA IgM, VCA IgG and EBNA IgG, together with other complementary markers such as EA in selected contexts.
Product features
- High-performance ELISA kits with guaranteed stability and lyophilized conjugates when necessary.
- Complete panel: EA IgG, EBNA IgG, VCA IgG, VCA IgM
- Simple workflow with no sample pre-dilution required for most assays.
- Colour-coded, ready-to-use liquid reagents and individual break-apart wells for flexible use.
- Samples and controls are processed under equivalent conditions to help compensate pipetting variability.
- Suitable for manual processing and compatible with automated ELISA systems.
Diagnostic recommendations
- Isolated or discordant EBV antibody results should be interpreted with caution, as they may reflect early infection, past infection with an incomplete antibody profile, atypical immune response or non-specific reactivity.
- Isolated VCA IgG may indicate past infection, early seroconversion before EBNA IgG appearance or an incomplete serological profile.
- Isolated VCA IgM may suggest very early infection, but non-specific IgM reactivity should be considered.
- Isolated EBNA IgG or isolated EA IgG are atypical profiles and are not sufficient to diagnose acute EBV infection on their own.
- When results are discordant, clinically incompatible or suggest recent infection, repeat testing with a new sample after 10–14 days may help clarify seroconversion. Complementary methods may be considered in selected cases, especially in immunocompromised patients or when clinical suspicion remains high.
EBV serological interpretation table
| Heterophile IgM | VCA IgM | VCA IgG | EBNA IgG | Possible condition | Diagnostic recommendation |
|---|---|---|---|---|---|
| – | – | – | – | No serological evidence of EBV infection | If symptoms are recent or clinical suspicion remains high, repeat testing in 10–14 days. Consider impaired antibody response in immunocompromised patients. |
| + | +/– | +/– | – | Infectious mononucleosis / recent EBV infection | Supports recent EBV infection in a compatible clinical context, especially in adolescents and adults. If heterophile IgM is negative but suspicion remains high, interpret with EBV-specific antibodies. |
| –/+ | + | + | – | Primary or recent EBV infection | Compatible with acute or recent primary infection. Follow-up testing may be considered if the sample was collected very early or results do not match the clinical presentation. |
| –/+ | + | + | + | Late primary infection, reactivation or non-specific IgM | Interpret with caution. If clinically relevant, repeat testing in 10–14 days and consider complementary methods. |
| – | – | + | + | Past EBV infection | Usually no further serological testing is required, unless symptoms suggest another diagnosis or reactivation needs to be assessed in a specific clinical context. |
Sources
- Centers for Disease Control and Prevention. Laboratory testing for Epstein-Barr virus (EBV). Atlanta: CDC; 2024 Apr 10. Available from: https://www.cdc.gov/epstein-barr/php/laboratories/index.html
- Public Health England. UK Standards for Microbiology Investigations. V 26: Epstein-Barr virus serology [Internet]. Issue 6. London: Public Health England; 2019 Jan 18. Available from: https://rcpath.org/static/8aae5792-485b-4051-a4563b7763136d15/uk-smi-v-26i6-epstein-barr-virus-serology-january-2019-pdf.pdf
- Royal College of Pathologists of Australasia. Epstein-Barr virus serology. Surry Hills: RCPA Manual; 2024 Jan 2. Available from: https://www.rcpa.edu.au/Manuals/RCPA-Manual/Pathology-Tests/E/Epstein-Barr-virus-serology
PRODUCTS
EPSTEIN-BARR EA ELISA IgG
Analytes: Epstein-Barr
EPSTEIN-BARR EBNA ELISA IgG
Analytes: Epstein-Barr
EPSTEIN-BARR VCA ELISA IgG
Analytes: Epstein-Barr
EPSTEIN-BARR VCA ELISA IgM
Analytes: Epstein-Barr
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