PMID- 28468603 OWN - NLM STAT- MEDLINE DCOM- 20170814 LR - 20181202 IS - 1471-2334 (Electronic) IS - 1471-2334 (Linking) VI - 17 IP - 1 DP - 2017 May 3 TI - Fluorescence in situ hybridization is superior for monitoring Epstein Barr viral load in infectious mononucleosis patients. PG - 323 LID - 10.1186/s12879-017-2412-y [doi] LID - 323 AB - BACKGROUND: Epstein Barr virus (EBV) plays a causal role in some diseases, including infectious mononucleosis, lymphoproliferative diseases and nasopharyngeal carcinoma. Detection of EBV infection has been shown to be a useful tool for diagnosing EBV-related diseases. In the present study, we compared the performance of molecular tests, including fluorescence in situ hybridization (FISH) and EBV real-time PCR, to those of serological assays for the detection of EBV infection. METHODS: Thirty-eight patients with infectious mononucleosis (IM) were enrolled, of whom 31 were diagnosed with a mild type, and seven were diagnosed with IM with haemophagocytic lymphohistiocytosis and chronic active EBV infection. Twenty healthy controls were involved in the study. The atypical lymphocytes in peripheral blood were detected under a microscope and the percentage of positive cells was calculated. EBV DNA load in peripheral blood was detected using real-time PCR. The FISH assay was developed to detect the EBV genome from peripheral blood mononuclear cells (PBMC). Other diagnosis methods including the heterophil agglutination (HA) test and EBV-VCA-IgM test, to detect EBV were also compared. SPSS17.0 was used for statistical analysis. RESULTS: In all, 5-41% atypical lymphocytes were found among the PBMC in mild IM patients, whereas 8-51% atypical lymphocytes were found in IM patients with haemophagocytic lymphohistiocytosis and chronic active EBV infection patients. There was no significant difference in the ratios of atypical lymphoma between patients of the different types. We observed that 71.2% of mild IM patients and 85.7% of IM patients with haemophagocytic lymphohistiocytosis and chronic active EBV infection patients were positive for EBV-VCA-IgM. EBV-VCA-IgM was negative in all healthy control subjects. In addition, 67.1% of mild IM patients tested heterophile antibody positive, whereas 71.4% of IM patients with haemophagocytic lymphohistiocytosis and chronic active EBV infection tested positive. EBV DNA detected using real-time PCR was observed in 89.5% of these IM patients. The EBV genome was detected by the FISH assay in 97.4% of the IM patients. The EB viral loads detected by FISH and real-time PCR increased with the severity of IM. The EBV genome was detected in almost all the PBMC of IM with haemophagocytic lymphohistiocytosis and chronic active EBV infection patients. CONCLUSION: Molecular tests, including FISH and EBV real-time PCR, are more sensitive than serological assays for the detection of EBV infection. The FISH assay detecting EBV copies in unfractionated whole blood is preferable and superior to plasma real-time PCR in its reflection of the absolute viral burden circulating in the patients. FAU - Cao, Pengfei AU - Cao P AD - The Key Laboratory of Carcinogenesis of the Chinese Ministry of Health, Xiangya Hospital, Central South University, Changsha, Hunan, China. AD - The Key Laboratory of Carcinogenesis and Cancer Invasion of the Chinese Ministry of Education, Cancer Research Institute, Central South University, Changsha, Hunan, China. AD - Department of hematology, Xiangya hospital, Central South University, Changsha, China. FAU - Zhang, Meili AU - Zhang M AD - The Key Laboratory of Carcinogenesis of the Chinese Ministry of Health, Xiangya Hospital, Central South University, Changsha, Hunan, China. AD - The Key Laboratory of Carcinogenesis and Cancer Invasion of the Chinese Ministry of Education, Cancer Research Institute, Central South University, Changsha, Hunan, China. AD - People's Hospital of Dezhou, Dezhou, Shandong, 253045, China. FAU - Wang, Wei AU - Wang W AD - The Key Laboratory of Carcinogenesis of the Chinese Ministry of Health, Xiangya Hospital, Central South University, Changsha, Hunan, China. AD - The Key Laboratory of Carcinogenesis and Cancer Invasion of the Chinese Ministry of Education, Cancer Research Institute, Central South University, Changsha, Hunan, China. AD - Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Disease Genome Research Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China. FAU - Dai, Yafei AU - Dai Y AD - The Key Laboratory of Carcinogenesis of the Chinese Ministry of Health, Xiangya Hospital, Central South University, Changsha, Hunan, China. AD - The Key Laboratory of Carcinogenesis and Cancer Invasion of the Chinese Ministry of Education, Cancer Research Institute, Central South University, Changsha, Hunan, China. AD - Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Disease Genome Research Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China. FAU - Sai, Buqing AU - Sai B AD - The Key Laboratory of Carcinogenesis of the Chinese Ministry of Health, Xiangya Hospital, Central South University, Changsha, Hunan, China. AD - The Key Laboratory of Carcinogenesis and Cancer Invasion of the Chinese Ministry of Education, Cancer Research Institute, Central South University, Changsha, Hunan, China. AD - Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Disease Genome Research Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China. FAU - Sun, Jun AU - Sun J AD - The Key Laboratory of Carcinogenesis of the Chinese Ministry of Health, Xiangya Hospital, Central South University, Changsha, Hunan, China. AD - The Key Laboratory of Carcinogenesis and Cancer Invasion of the Chinese Ministry of Education, Cancer Research Institute, Central South University, Changsha, Hunan, China. AD - Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Disease Genome Research Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China. FAU - Wang, Lujuan AU - Wang L AD - The Key Laboratory of Carcinogenesis of the Chinese Ministry of Health, Xiangya Hospital, Central South University, Changsha, Hunan, China. AD - The Key Laboratory of Carcinogenesis and Cancer Invasion of the Chinese Ministry of Education, Cancer Research Institute, Central South University, Changsha, Hunan, China. AD - Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Disease Genome Research Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China. FAU - Wang, Fan AU - Wang F AD - The Key Laboratory of Carcinogenesis of the Chinese Ministry of Health, Xiangya Hospital, Central South University, Changsha, Hunan, China. AD - The Key Laboratory of Carcinogenesis and Cancer Invasion of the Chinese Ministry of Education, Cancer Research Institute, Central South University, Changsha, Hunan, China. AD - Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Disease Genome Research Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China. FAU - Li, Guiyuan AU - Li G AD - The Key Laboratory of Carcinogenesis of the Chinese Ministry of Health, Xiangya Hospital, Central South University, Changsha, Hunan, China. ligy@csu.edu.cn. AD - The Key Laboratory of Carcinogenesis and Cancer Invasion of the Chinese Ministry of Education, Cancer Research Institute, Central South University, Changsha, Hunan, China. ligy@csu.edu.cn. AD - Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Disease Genome Research Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China. ligy@csu.edu.cn. FAU - Xiang, Juanjuan AU - Xiang J AD - The Key Laboratory of Carcinogenesis of the Chinese Ministry of Health, Xiangya Hospital, Central South University, Changsha, Hunan, China. xiangjj@csu.edu.cn. AD - The Key Laboratory of Carcinogenesis and Cancer Invasion of the Chinese Ministry of Education, Cancer Research Institute, Central South University, Changsha, Hunan, China. xiangjj@csu.edu.cn. AD - Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Disease Genome Research Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China. xiangjj@csu.edu.cn. LA - eng PT - Journal Article DEP - 20170503 PL - England TA - BMC Infect Dis JT - BMC infectious diseases JID - 100968551 RN - 0 (Antigens, Viral) RN - 0 (Capsid Proteins) RN - 0 (DNA, Viral) RN - 0 (Epstein-Barr viral capsid antigen) SB - IM MH - Adolescent MH - Antigens, Viral/blood MH - Capsid Proteins/blood MH - Case-Control Studies MH - Child MH - Child, Preschool MH - DNA, Viral/blood MH - Epstein-Barr Virus Infections/diagnosis/virology MH - Female MH - Herpesvirus 4, Human/*genetics/immunology/pathogenicity MH - Humans MH - In Situ Hybridization, Fluorescence/*methods MH - Infant MH - Infectious Mononucleosis/*virology MH - Leukocytes, Mononuclear/virology MH - Lymphohistiocytosis, Hemophagocytic/virology MH - Male MH - Plasma/virology MH - Real-Time Polymerase Chain Reaction MH - Sensitivity and Specificity MH - Viral Load/*methods PMC - PMC5415799 OTO - NOTNLM OT - EB viral load OT - FISH OT - Infectious mononucleosis OT - Real-time PCR EDAT- 2017/05/05 06:00 MHDA- 2017/08/15 06:00 PMCR- 2017/05/03 CRDT- 2017/05/05 06:00 PHST- 2016/10/01 00:00 [received] PHST- 2017/04/20 00:00 [accepted] PHST- 2017/05/05 06:00 [entrez] PHST- 2017/05/05 06:00 [pubmed] PHST- 2017/08/15 06:00 [medline] PHST- 2017/05/03 00:00 [pmc-release] AID - 10.1186/s12879-017-2412-y [pii] AID - 2412 [pii] AID - 10.1186/s12879-017-2412-y [doi] PST - epublish SO - BMC Infect Dis. 2017 May 3;17(1):323. doi: 10.1186/s12879-017-2412-y.