Advanced Biomedical Research
Comparison of serological and molecular test for diagnosis of infectious mononucleosis
Authors
- Hassan Salehi 1
- Marziyeh Salehi 2
- Rasoul Roghanian 3
- Majid Bozari 3
- Shirin Taleifard 3
- Mohamad Mahdi Salehi 4
- Maryam Salehi 4
1 Department of Infectious Diseases, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Student Research Center, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 Department of Biology, Faculty of Sciences, University of Isfahan, Isfahan, Iran
4 Student Research Center, Faculty of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: Epstein-Bar virus (EBV) is the main etiology of infectious mononucleosis (IM) syndrome that is characterized by fever, sore throat, and lymph adenopathy. Since, this virus could be associated with a number of malignancies, some hematologic disorders, and chronic fatigue syndrome, identification of IM is very important.
The aim of study was to evaluate the specificity, as well as sensitivity of the two different methods that is, serology versus molecular diagnosis that are currently used for diagnosis of IM.
Materials and Methods: In this study, during a period of 3.5 years, 100 suspected patients as case group and 100 healthy individuals as a control group were studied. Fifty samples in each group were tested by polymerase chain reaction (PCR) and all the samples including case group and control group were carried out by enzyme-linked immunosorbent assay (ELISA).
Results: In 76% of patients and in 20% of the healthy individuals, samples were detected EBV DNA by PCR. On the other hand, 68.5% of the samples belong to the case group and 46% in the control group showed positivity by ELISA.
Conclusion: By comparing the two methods, since PCR is very expensive and time consuming, and the percentages of difference ranges are narrow, ELISA could be applied as a first, easiest, and preliminary diagnostic test for IM. In addition, this test could be applied in various phases of the disease with a higher sensitivity comparing to PCR.
Although PCR is routinely used for diagnosis of various infectious agents, it is considered as an expensive test and merely could be used after 1-2 weeks from the onset of the illness.
Keywords
| 1. |
Cohen JI. Epstein-Barr virus infection. N Engl J Med 2000;343:481-92.  |
| 2. |
Bensouda Y, El Hassani K, Ismaili N, Lalya I, Boutayeb S, Benjaafar N, et al. Primary nasopharyngeal Hodgkin's disease: Case report and literature review. J Med Case Rep 2010;4:116. |
| 3. |
Berger C, Day P, Meier G, Zingg W, Bossart W, Nadal D. Dynamics of Epstein-Barr virus DNA levels in serum during EBV-associated disease. J Med Virol 2001;64:505-12. |
| 4. |
Bell AT, Fortune B, Sheeler R. Clinical inquiries. What test is the best for diagnosing infectious mononucleosis? J Fam Pract 2006;55:799-802. |
| 5. |
Rubsamen-Waigmann H, Degres K, Hewlett G, Welker R. Viral Infections and Treatment: Copyright by Marcel Dekker; 2003. p. 752. |
| 6. |
Hickie I, Davenport T, Wakefield D, Vollmer-Conna U, Cameron B, Vernon SD, et al. Post-infective and chronic fatigue syndromes precipitated by viral and non-viral pathogens: Prospective cohort study. BMJ 2006; 333:575. |
| 7. |
Gulley ML, Tang W. Laboratory assays for Epstein-Barr virus-related disease. J Mol Diagn 2008; 10:279-92. |
| 8. |
Fleisher GR, Collins M, Fager S. Limitations of available tests for diagnosis of infectious mononucleosis. J Clin Microbiol 1983; 17:619-24. |
| 9. |
Fauci A, Braunwald E, Kasper D, Hauser S, Jameson L, Loscalzo J. Harrison's Principles of Internal Medicine. 18th ed., Ch. 181. The McGraw Hill Companies, Inc.; 2012. p. 1469-70 |
| 10. |
Richman D, Whitley R, Hayden F. Clinical Virology. American Society for Microbiology; 2009. p. 1374. |
| 11. |
Telenti A, Marshall WF, Smith TF. Detection of Epstein-Barr virus by polymerase chain reaction. J Clin Microbiol 1990; 28:2187-90. |
| 12. |
Balfour HH Jr, Hokanson KM, Schacherer RM, Fietzer CM, Schmeling DO, Holman CJ, et al. A virologic pilot study of valacyclovir in infectious mononucleosis. J Clin Virol 2007; 39:16-21. |
| 13. |
Chan KH, Ng MH, Seto WH, Peiris JS. Epstein-Barr virus (EBV) DNA in sera of patients with primary EBV infection. J Clin Microbiol 2001; 39:4152-4. |
| 14. |
She RC, Stevenson J, Phansalkar AR, Hillyard DR, Litwin CM, Petti CA. Limitations of polymerase chain reaction testing for diagnosing acute Epstein-Barr virus infections. Diagn Microbiol Infect Dis 2007; 58:333-5. |
| 15. |
Okay TS, Del Negro GM, Yamamoto L, Raiz Júnior R. Detection of EBV-DNA in serum samples of an immunosuppressed child during a three years follow-up: Association of clinical and PCR data with active infection. Rev Inst Med Trop Sao Paulo 2005;47:99-102. |
| 16. |
Gärtner B, Preiksaitis JK. EBV viral load detection in clinical virology. J Clin Virol 2010; 48:82-90. |
| 17. |
Kim M, Wadke M. Comparative evaluation of two test methods (enzyme immunoassay and latex fixation) for the detection of heterophil antibodies in infectious mononucleosis. J Clin Microbiol 1990; 28:2511-3.
|
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