sera with known EBV infection and 47 sera with no EBV infection
by IgG and IgM antibodies to EBV VCA were tested on 6 rapid test
kits for heterophile antigens. Sensitivities of the latex
agglutination kits ranged from 85-91%, specificities ranged from
in the study ranged from 2-83yo. Half of the non-EBV infected
sera were infected with other viral diseases often confused with
EBV (CMV, Adeno, HIV, VZV).
authors found a sensitivity of 89% in children under age of 13
years. This is contrary to previous evidence of poor heterophile
response in small children.
study used a gold standard of IgG and IgM antibodies to EBV VCA.
However, in the face of discordant results, they retested serum
using a second gold standard of EB virus nuclear antigen 1 (EBNA-1).
No detection of EBNA-1 along with an IgM antibody titer > 1:20
were defined as primary EBV infection. This is a form of
verification or work-up bias.