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HelpEPIC ORDER CODE LAB5266 Epstein-Barr Virus (EBV), Molecular Detection, PCR, Varies
Additional Codes
Sunquest Order Code: LEBVM
MAYO: EBVPV
Necessary Information
Specimen source is required.
Specimen Required
Submit only 1 of the following specimens:
Specimen Type: Fluid
Sources: Spinal fluid, sterile body fluids (peritoneal fluid/ascites, pericardial fluid, pleural fluid/thoracentesis), amniotic, or ocular
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Preferred: Sterile screwcap 5-mL plastic vial
Acceptable: Sterile container
Specimen Volume: 0.5 mL
Collection Instructions: Do not centrifuge.
Specimen Type: Fluid
Sources: Respiratory; bronchial washing, bronchoalveolar lavage, nasopharyngeal aspirate or washing, sputum, or tracheal aspirate
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Container/Tube:
Preferred: Sterile screwcap 5-mL plastic vial
Acceptable: Sterile container
Specimen Volume: 1.5 mL
Specimen Type: Swab
Sources: Eye and upper respiratory (nasal, throat)
Supplies:
-Culturette (BBL Culture Swab) (T092)
-M4-RT (T605)
Container/Tube: Multimicrobe media (M4-RT) and Eswabs
Collection Instructions: Place swab back into multimicrobe media (M4-RT, M4 or M5)
Specimen Type: Bone marrow
Container/Tube: Lavender top (EDTA) only
Specimen Volume: 0.5 mL
Additional Information: Clotted specimens will be rejected.
Specimen Type: Tissue
Sources: Brain, colon, kidney, liver, lung, cornea, etc.
Supplies: M4-RT (T605)
Preferred: Multimicrobe medium (M4-RT)
Acceptable: Sterile container containing 1-2 mL of sterile saline or multimicrobe medium (M4-RT, M4 or M5)
Specimen Volume: Entire collection
Collection Instructions: Submit only fresh tissue.
Useful For
Rapid qualitative detection of Epstein-Barr virus (EBV) DNA in specimens
Diagnosis of disease due to EBV
This test should not be used to screen asymptomatic patients.
Method Name
Real-Time Polymerase Chain Reaction (PCR)/DNA Probe Hybridization
Reporting Name
Epstein-Barr Virus, PCR, VariesSpecimen Type
VariesSpecimen Minimum Volume
Ocular Fluid, Spinal Fluid: 0.3 mL
Sterile body fluids (peritoneal fluid/ascites, pericardial fluid, pleural fluid/thoracentesis): See Specimen Required
Respiratory Specimens: 1 mL
Tissue: 2 × 2-mm biopsy
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Varies | Refrigerated (preferred) | 7 days | |
| Frozen | 7 days |
Reject Due To
| Calcium alginate-tipped swab Wood swab Transport swab containing gel Formalin-fixed and paraffin-embedded tissues Heat-inactivated specimens |
Reject |
Clinical Information
Epstein-Barr virus (EBV) is the causative agent of infectious mononucleosis, Burkitt lymphoma, and in Southern China, nasopharyngeal carcinoma. EBV-associated central nervous system (CNS) disease is most frequently associated with primary CNS lymphoma in patients with AIDS. In addition, CNS infection associated with the detection of EBV DNA can be seen in immunocompetent patients.
Reference Values
Negative
Reference values apply to all ages.
Interpretation
Detection of Epstein-Barr virus (EBV) DNA in cerebrospinal fluid (CSF) supports the clinical diagnosis of central nervous system (CNS) disease due to the virus. EBV DNA is not detected in CSF from patients without CNS disease caused by this virus.
Clinical Reference
1. Tachikawa N, Goto M, Hoshino Y, et al. Detection of toxoplasma gondii, epstein-barr virus, and JC virus DNAs in the cerebrospinal fluid in acquired immunodeficiency syndrome patients with focal central nervous system complications. Intern Med. 1999;38(7):556-562. doi:10.2169/internalmedicine.38.556
2. Antinori A, Cingolani A, De Luca A, et al. Epstein-Barr virus in monitoring the response to therapy of acquired immunodeficiency syndrome-related primary central nervous system lymphoma. Ann Neurol. 1999;45(2):259-261
3. Cingolani A, De Luca A, Larocca LM, et al. Minimally invasive diagnosis of acquired immunodeficiency syndrome-related primary central nervous system lymphoma. J Natl Cancer Inst. 1998 ;90(5):364-369. doi:10.1093/jnci/90.5.364
4. Niller HH, Wolf H, Minarovits J: Regulation and dysregulation of epstein-barr virus latency: implications for the development of autoimmune disease. Autoimmunity. 2008:41(4):298-328. doi:10.1080/08916930802024772
5. Studahl M, Hagberg L, Rekvdar E, Bergstrom T. Herpesvirus DNA detection in cerebrospinal fluid: difference in clinical presentation between alph-, beta-, and gamma-herpes viruses. Scand J Infect Dis. 2000;32(3):237-248. doi:10.1080/00365540050165857
6. Lau AH, Soltys K, Sindhi RK, Bond G, Mazariegos GV, Green M. Chronic high epstein-barr viral load carriage in pediatric small bowel transplant recipients. Pediatr Transplant. 2010;14(4):549-553. doi:10.1111/j.1399-3046.2009.01283.x
7. Fugl A, Andersen CL Epstein-barr virus and its association with disease - a review of relevance to general practice. BMC Fam Pract. 2019;20(1):62. doi:10.1186/s12875-019-0954-3
Method Description
Viral nucleic acid is extracted by the MagNA Pure automated instrument (Roche Applied Science) from clinical specimens. Primers are directed to the target gene (latent membrane protein). The LightCycler instrument amplifies and monitors by fluorescence the development of target nucleic acid sequences after the annealing step during polymerase chain reaction (PCR) cycling. This is an automated PCR system that can rapidly detect (30-40 minutes) amplicon development through stringent air-controlled temperature cycling in capillary cuvettes. The detection of amplified products is based on the fluorescence resonance energy transfer (FRET) principle. For FRET product detection, a hybridization probe with a donor fluorophore, fluorescein, on the 3' end is excited by an external light source and emits light that is absorbed by a second hybridization probe with an acceptor fluorophore, LC-Red 640, at the 5' end. The acceptor fluorophore then emits a light of a different wavelength that can be measured with a signal that is proportional to the amount of specific PCR product. Melting curve analysis is performed following PCR amplification. Starting at 45° C, the temperature in the thermal chamber is slowly raised to 80° C and the fluorescence is measured at frequent intervals. Analysis of the PCR amplification and probe melting curves is accomplished through the use of LightCycler software.(Unpublished Mayo method)
Day(s) Performed
Monday through Friday
Report Available
Same day/1 to 4 daysSpecimen Retention Time
7 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
87798
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| EBVPV | Epstein-Barr Virus, PCR, Varies | 5005-4 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| EBVS | Specimen Source | 31208-2 |
| 618327 | Epstein-Barr Virus PCR | 5005-4 |
Forms
If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.