Evaluation of 4 methods for the serological diagnosis of Epstein–Barr virus infection using an immunofluorescence assay as the reference method

Background/aim: Tests specific for VCA IgM, VCA IgG, and EBNA IgG are used to diagnose Epstein–Barr virus (EBV) infections and interpret disease status. The immunofluorescence assay (IFA) is accepted as the “gold standard” test. The purpose of this study was to evaluate the performance of 4 methods in comparison with IFA. Materials and methods: In total, 101 serum samples were obtained from clinically suspected cases of EBV infection between May 2010 and May 2012 and evaluated by IFA. All serum samples were analyzed by an immunoblot assay, enzyme-linked fluorescent assay (ELFA), enzyme immunoassay (EIA), and immunochromatographic assay (ICA). Results: ELFA and ICA results were in good agreement with IFA for the detection of VCA IgM, VCA IgG, and EBNA IgG. The results of the immunoblot assay agreed less well with IFA for EBNA IgG, while EIA results were not in agreement with IFA for EBNA IgG or VCA IgM. Conclusion: Among the tests studied, ELFA and ICA appear to be suitable methods for the diagnosis and staging of EBV when considering cost-effectiveness, turnaround times, need for a specialist, and IFA concordance.