Epstein-Barr Virus

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

• 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 should be informed for serological/PCR status

2) VCA-IgM-pos AND VCA-IgG and/or EBNA positive Inform the TC and proceed donation without EBV-DNA PCR

3)VCA-IgM-pos 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