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EBV IgG antibody to Viral capsid antigen(VCA)

Bacterial/ Viral
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Report in 240Hrs

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Detects Epstein-Barr virus antibodies.

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EBV IgG Antibody to Viral Capsid Antigen (VCA) - Comprehensive Test Information Guide

  • Why is it done?
    • Test Purpose: This test detects IgG antibodies against Epstein-Barr virus (EBV) viral capsid antigen (VCA), which indicates past or current EBV infection and demonstrates immune response to the virus.
    • Primary Indications: Confirms past EBV infection and immunity; assists in diagnosing infectious mononucleosis; evaluates chronic EBV infection; screens for EBV reactivation; assesses immune status in immunocompromised patients; investigates unexplained lymphadenopathy and fever.
    • Clinical Circumstances: Ordered when patients present with symptoms suggestive of infectious mononucleosis; during follow-up of confirmed EBV infection; as part of immunological workup in immunocompromised individuals; when evaluating post-viral syndrome; prior to organ or bone marrow transplantation; in cases of suspected EBV-associated malignancies or complications.
    • Timing: IgG antibodies typically appear 1-2 weeks after symptom onset and persist for life; testing is performed weeks to months after initial infection when EBV IgM may have declined; can be performed at any time during or after infection.
  • Normal Range
    • Reference Values: Negative: <1.10 Index or <0.91 AU/mL (varies by laboratory method). Positive: ≥1.10 Index or ≥0.91 AU/mL. Some laboratories report results as negative, equivocal, or positive based on specific thresholds.
    • Units of Measurement: Index (dimensionless ratio); AU/mL (Arbitrary Units per milliliter); mIU/mL (milli-International Units per milliliter); may also be reported qualitatively as negative, equivocal, or positive.
    • Result Interpretation: Negative: No significant IgG antibodies detected; indicates no past infection or very early infection (before antibody development). Equivocal/Borderline: Results near the cutoff; repeat testing may be recommended after 1-2 weeks. Positive: IgG antibodies detected; indicates past or current EBV infection with immune response established.
    • Normal vs Abnormal Significance: Normal (Negative): Absence of EBV-specific IgG antibodies; person has either never been infected with EBV or infection occurred so recently that antibodies have not yet developed. Abnormal (Positive): Presence of EBV-specific IgG antibodies; indicates past EBV infection, established immunity, or potential ongoing/chronic infection depending on clinical context and concurrent IgM results.
  • Interpretation
    • EBV IgG Positive + EBV IgM Negative: Indicates past infection with established immunity; person is immune to reinfection; most common pattern in the general population; suggests infection occurred weeks to months or years ago.
    • EBV IgG Positive + EBV IgM Positive: Indicates acute or recent primary EBV infection; antibodies are being actively produced; consistent with current or recently active infectious mononucleosis; IgM typically becomes negative while IgG remains positive over time.
    • EBV IgG Negative + EBV IgM Negative: Indicates no evidence of EBV infection; person is seronegative (never infected); susceptible to EBV infection; or very early infection (within first 1-2 weeks before any antibodies develop).
    • EBV IgG Negative + EBV IgM Positive: Rare pattern; may indicate very early primary infection (within first 1-2 weeks); or potentially false-positive IgM result requiring confirmation; repeat testing may be warranted.
    • Equivocal/Borderline Results: Values near the cutoff threshold; recommended to repeat testing after 1-2 weeks; results may change as antibody levels increase or decrease; clinical context is important in interpretation.
    • Factors Affecting Results: Timing of test relative to infection onset; immunocompromised status (may have lower or absent antibodies); certain medications affecting immune response; laboratory testing methodology and cutoff values; previous vaccination against EBV (if available); concurrent infections or illnesses.
    • Clinical Significance of Result Patterns: VCA-IgG is the most reliable marker for confirming past EBV infection; persistence of IgG throughout life indicates lasting immunity; high IgG titers may suggest recent or active infection, especially when combined with IgM positivity; negative IgG in symptomatic patients suggests either very early infection or alternative diagnosis; useful in distinguishing EBV-caused infectious mononucleosis from other causes of similar symptoms.
  • Associated Organs
    • Primary Organ Systems Involved: Lymphoid system (lymph nodes); immune system (B and T lymphocytes); oropharynx and throat; spleen; liver; nasopharynx; blood and bone marrow.
    • Common Conditions Associated with Abnormal Results: Infectious mononucleosis (IM); chronic active EBV infection; EBV-associated lymphoproliferative disease; post-transplant lymphoproliferative disorder (PTLD); nasopharyngeal carcinoma; Burkitt lymphoma; hodgkin lymphoma; T-cell lymphomas; gastric cancer associated with EBV.
    • Diseases Helped by This Test: Infectious mononucleosis diagnosis and confirmation; determination of immune status in patients with immunosuppression (HIV, transplant recipients); evaluation of fever of unknown origin; investigation of persistent lymphadenopathy; assessment of EBV reactivation in immunocompromised patients; diagnosis of EBV-associated malignancies; chronic EBV infection assessment.
    • Potential Complications or Risks with Abnormal Results: Severe hepatitis with liver dysfunction; splenic rupture from significant splenomegaly; upper airway obstruction from severe pharyngitis; hematologic complications (thrombocytopenia, hemolytic anemia); myocarditis; meningitis or encephalitis; secondary bacterial infections; in immunocompromised patients: severe disseminated disease, lymphoproliferative disorders, malignancies.
    • EBV Latency and Reactivation: EBV establishes lifelong latency in B lymphocytes and memory B cells after primary infection; positive IgG indicates latent infection; reactivation can occur with immunosuppression, stress, or other triggers; reactivation may lead to serious complications in severely immunocompromised individuals.
  • Follow-up Tests
    • Initial Follow-up Tests Based on Results: EBV IgM antibody (to assess for acute infection); EBV Nuclear Antigen (EBNA) antibody (confirms past infection, indicates latency); EBV Early Antigen (EA) antibody (indicates active viral replication); Complete Blood Count with differential (assess for lymphocytosis, atypical lymphocytes); Liver function tests (AST, ALT, bilirubin).
    • Additional Tests if Acute Infection Suspected: Monospot test (heterophile antibody test); throat culture to rule out bacterial pharyngitis; Abdominal ultrasound if splenic rupture suspected; Throat imaging if severe pharyngitis present; EBV viral load (PCR) testing in severe or immunocompromised cases.
    • Tests for Immunocompromised Patients: EBV viral load (real-time PCR); CD4+ T cell count (in HIV patients); Imaging studies (CT or MRI) if malignancy suspected; Lymph node biopsy if lymphoproliferative disorder suspected; HIV testing (if status unknown); CMV and other herpesvirus serology.
    • Monitoring Frequency for Ongoing Conditions: For acute infectious mononucleosis: follow-up testing typically not needed; clinical recovery is the measure of success; repeat testing only if diagnosis remains unclear after 1-2 weeks. For chronic/reactivated EBV: periodic monitoring with EBV viral load testing as clinically indicated; frequency depends on clinical presentation and immunologic status; typically every 3-6 months for severely immunocompromised patients. For transplant patients: baseline EBV serology pre-transplant; monitoring post-transplant based on immunosuppression level and presence of symptoms.
    • Complementary Tests: Cytomegalovirus (CMV) serology; Human Immunodeficiency Virus (HIV) testing; Other herpesvirus serology (HSV-1, HSV-2, VZV); Toxoplasma serology; Hepatitis serology (if liver involvement); Streptococcal culture (to rule out bacterial co-infection).
    • If Results Are Equivocal: Repeat EBV IgG testing after 1-2 weeks; order EBV IgM testing concurrently; consider EBV viral load (PCR) if acute infection is suspected; evaluate for alternative diagnoses if clinical presentation suggests other conditions.
  • Fasting Required?
    • Fasting Requirement: NO - Fasting is not required for this test.
    • Special Preparation Instructions: No special preparation needed; patient can eat and drink normally before the test; routine activities may be continued; the test only requires a blood draw via venipuncture.
    • Medications to Avoid: No medications need to be avoided for this test; blood draw can be performed regardless of current medication use; immunosuppressive medications do not need to be stopped prior to testing.
    • Additional Patient Information: Wear comfortable, loose-fitting clothing to facilitate blood draw; inform healthcare provider of any bleeding disorders or anticoagulant use; hydration is not harmful and may help with venipuncture; test may be performed at any time of day.
    • Specimen Collection: Blood sample collected via venipuncture into appropriate serum separator tube or plasma tube; typically 5-7 mL of blood; sample processed and serum separated at laboratory; may be stored at room temperature, refrigerated, or frozen depending on laboratory protocol; testing can be performed immediately or stored for delayed processing.

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