Viral Diagnostic Tests
Viral Diagnostic Tests
Viral Diagnostic Tests
1. HEPATITIS
HBV DNA assay should be performed in any patient with a positive HBsAg to determine whether active replication is occurring.
HBcAb is only relevant when dealing with acute HBV infection because HBcAb may be positive during serologic gap/window
between seroconversion from HBsAg positivity to HBsAb positivity. With chronic HBV infection, HBsAg remains positive; thus, no
serologic gap/window occurs.
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*Enzyme immunoassay (EIA) or enhanced chemiluminescence immunoassay (CIA)
5. CYTOMEGALOVIRUS (CMV)
Test Result Interpretation Recommendation/Notes
Shell-vial culture (Gold Positive Active CMV replication Presence of true CMV infection is determined by active
Standard) replication PLUS clinical correlation.
CMV IgM Positive Indicates exposure Usually detected in primary infection except in
immunocompromised patients. However, false positives are not
uncommon. Should be confirmed by culture. Can also see false
negatives in immunocompromised patients.
CMV IgG Positive Indicates exposure Produced early in infection and persists life-long.
Intranuclear Inclusions Positive Active CMV replication Inclusions in epithelial cells in urine sediment and liver biopsy
are diagnostic. More useful in infants than adults. Presence of
true CMV infection is determined by active replication PLUS
clinical correlation.
PCR for CMV DNA in urine, Positive Active CMV replication Presence of true CMV infection is determined by active
CSF or serum replication PLUS clinical correlation. The higher the number of
viral copies in serum, the higher the probability of true
infection.
DNA & RNA hybridization Positive Active CMV replication Presence of true CMV infection is determined by active
replication PLUS clinical correlation.
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6. EPSTEIN-BARR VIRUS (EBV)
+ + - + Consistent with
convalescence of primary
infection
- - + - Unknown Repeat 2-4 wks.
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Abbreviations and Notes:
Abbreviation/Symbol Definition
EBNA Epstein-Barr nuclear antigen
ELISA Enzyme-linked immunosorbent assay
HBsAg Hepatitis B surface antigen
HBsAb Hepatitis B surface antibody
HBcAb Hepatitis B core antibody
HBeAg Hepatitis e antigen; if present indicates high infectivity
HBeAb Hepatitis e antibody; if present indicates low/no infectivity
IgD (EA) Anti-D antibody; Early antigen antibody
IM Infectious mononucleosis
NA Not applicable
PCR Polymerase chain reaction
VCA Viral capsid antigen
References:
1. http://www.rapid-diagnostics.org/rti-hepb-diag.htm
2. http://www.hepb.org/pdf/understanding_blood_tests.pdf
3. http://www.cdc.gov/hepatitis/HBV/PDFs/SerologicChartv8.pdf
4. http://www.acphd.org/AXBYCZ/ADMIN/PUBLICATIONS/interprethepatitislabresults.pdf
5. Wallach, Jacques. Interpretation of Diagnostic Tests. Philadelphia: Lippincott Williams & Wilkins, 2007.
6. http://www.cdc.gov/Hepatitis/HCV/PDFs/hcv_graph.pdf
7. http://virology-online.com/viruses/CMV4.htm