Difference between revisions of "Epstein-Barr Virus"
| (8 intermediate revisions by 4 users not shown) | |||
| Line 18: | Line 18: | ||
The following serological tests should be obtained | The following serological tests should be obtained | ||
| − | • VCA-IgM | + | • VCA-IgM - if this is positive or equivocal, an EBV PCR should be obtained. |
• VCA-IgG | • VCA-IgG | ||
| − | • (EBNA-IgG) | + | • (EBNA-IgG) |
| + | |||
| − | |||
===Outcomes and recommended actions based on EBV serology and PCR:=== | ===Outcomes and recommended actions based on EBV serology and PCR:=== | ||
| Line 32: | Line 32: | ||
| − | 1) VCA-IgM neg AND VCA-IgG pos or neg. | + | 1) '''VCA-IgM neg AND VCA-IgG pos or neg. |
| − | |||
| − | |||
| − | |||
| − | |||
| + | ''' | ||
| − | ''Donor can be cleared - transplant centre | + | ''''Donor can be cleared - transplant centre will be informed of serological status on clearance document'' |
| + | '' | ||
| − | 2) VCA-IgM-pos AND VCA-IgG and/or EBNA | + | 2) '''VCA-IgM-pos OR equivocal AND VCA-IgG and/or EBNA positive |
| + | ''' | ||
| − | + | Request EBV-DNA PCR | |
| + | a) If EBV-DNA PCR negative--> inform the TC and proceed donation | ||
| − | + | b) If EBV-DNA PCR positive --> inform the TC, donation will have to be postponed and EBV serology repeated after 1 month. | |
| + | 3)'''VCA-IgM-pos OR equivocal AND VCA-IgG and/or EBNA weak or negative | ||
| − | + | Request EBV-DNA PCR | |
| + | a) If EBV-DNA PCR negative--> inform the TC and proceed donation | ||
| − | + | b) If EBV-DNA PCR positive --> inform the TC, donation will have to be postponed and EBV serology repeated after 1 month. | |
==Justification for guidance== | ==Justification for guidance== | ||
Latest revision as of 13:48, 31 July 2025
Contents
Condition
Herpes virus causing glandular fever (infectious mononucleosis).
Individual at risk
Recipient (and ?donor)
Guidance at RECRUITMENT
ACCEPTABLE
Guidance at CT
ACCEPTABLE
Guidance at Work-up
The following serological tests should be obtained
• VCA-IgM - if this is positive or equivocal, an EBV PCR should be obtained.
• VCA-IgG
• (EBNA-IgG)
Outcomes and recommended actions based on EBV serology and PCR:
Potential serology/PCR combinations:
1) VCA-IgM neg AND VCA-IgG pos or neg.
''Donor can be cleared - transplant centre will be informed of serological status on clearance document
2) VCA-IgM-pos OR equivocal AND VCA-IgG and/or EBNA positive
Request EBV-DNA PCR
a) If EBV-DNA PCR negative--> inform the TC and proceed donation
b) If EBV-DNA PCR positive --> inform the TC, donation will have to be postponed and EBV serology repeated after 1 month.
3)VCA-IgM-pos OR equivocal AND VCA-IgG and/or EBNA weak or negative
Request EBV-DNA PCR
a) If EBV-DNA PCR negative--> inform the TC and proceed donation
b) If EBV-DNA PCR positive --> inform the TC, donation will have to be postponed and EBV serology repeated after 1 month.
Justification for guidance
Primary EBV infection or reactivation in a transplant recipient is associated with post-transplant lymphoproliferative disease, amongst other morbidity.
References
Buisson, M., Fleurent, B., Mak, M., Morand, P., Chan, L., Ng, A., … Seigneurin, J. M. (1999). Novel Immunoblot Assay Using Four Recombinant Antigens for Diagnosis of Epstein-Barr Virus Primary Infection and Reactivation. Journal of Clinical Microbiology, 37(8), 2709–2714. [1]
APA Recommendations of the Center for International Blood and Marrow Transplant Research (CIBMTR®), the National Marrow Donor Program (NMDP), the European Blood and Marrow Transplant Group (EBMT), the American Society of Blood and Marrow Transplantation (ASBMT), the Canadian Blood and Marrow Transplant Group (CBMTG), the Infectious Disease Society of America (IDSA), the Society for Healthcare Epidemiology of America (SHEA), the Association of Medical Microbiology and Infectious Diseases Canada (AMMI), and the Centers for Disease Control and Prevention (CDC), Tomblyn, M., Chiller, T., Einsele, H., Gress, R., Sepkowitz, K., … Boeckh, M. A. (2009). Guidelines for Preventing Infectious Complications among Hematopoietic Cell Transplant Recipients: A Global Perspective. Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, 15(10), 1143–1238. doi:10.1016/j.bbmt.2009.06.019 [2]
Version
Version 2, Edition 1
Date of Last Update
3 March 2016
