Clinical application of Epstein-Barr virus DNA loads in Epstein-Barr virus-associated diseases: A cohort study

• Published in: The Journal of infection 2021-01, Vol.82 (1), p.105-111
• Main Authors: Yu, Shenglei, Yang, Qingluan, Wu, Jing, Zhu, Mengqi, Ai, Jingwen, Zhang, Haocheng, Xu, Bin, Shao, Lingyun, Zhang, Wenhong
• Format: Article
• Language: English
• Subjects: Chronic active EBV infection; Cohort Studies; Cut-off value; DNA, Viral - genetics; EBV-associated diseases; EBV-positive T/NK cell lymphoproliferative diseases; Epstein-Barr Virus Infections - diagnosis; Herpesvirus 4, Human - genetics; Humans; Infectious mononucleosis; Leukocytes, Mononuclear; Real-time PCR; Viral Load
• ISSN: 0163-4453; 1532-2742
• DOI: 10.1016/j.jinf.2020.11.027

•Using derivation and validation study cohorts, the diagnostic cut-off value of Epstein-Barr virus (EBV) viral load in PBMCs for EBV-associated diseases was determined to be 1.6 × 104 copies/106 cells.•The combined EBV DNA load cut-off in PBMCs and positive EBV DNA qualitative detection in plasma (>500 copies/mL) allowed for the differentiation of EBV-associated and non-associated diseases, with the sensitivity and specificity were 80.6 and 96.8%, respectively.•The strategy of combining a cut-off EBV DNA loads in PBMCs and positive EBV DNA qualitative detection in plasma will potentially help identify EBV-associated diseases in the clinical practice. This study evaluated the diagnostic value of Epstein-Barr virus (EBV) DNA load in blood samples of patients with EBV-associated diseases, and proposed a strategy for the interpretation of positive EBV DNA results. Derivation and validation cohorts were established to evaluate the clinical significance of EBV DNA loads in the peripheral blood mononuclear cells (PBMCs) and plasma from EBV-infected patients. EBV DNA loads were compared and receiver operating characteristic curves were employed to assess the optimal cutoff values of EBV DNA for identification of EBV-associated diseases. The derivation and validation cohorts comprised 135 and 71 subjects, respectively. EBV DNA loads in the PBMCs of the EBV-associated diseases group was significantly higher than that of the EBV non-associated diseases group (5.8 × 104 vs 7.8 × 103 copies/106 cells, P500 copies/mL) allowed for the differentiation of EBV-associated and non-associated diseases; the sensitivity and specificity were 80.6 and 96.8%, respectively. The strategy of combining EBV DNA loads in PBMCs and plasma will potentially help identify EBV-associated diseases.