EB-DNA and VCA-IgM in diagnosis of children with infectious mononucleosis

Abstract

Objective To explore the value of Epstein-Barr virus DNA (EB-DNA) and VCA-IgM in the diagnosis of children with infectious mononucleosis (IM). Methods From January, 2017 to December, 2018, the blood samples from 134 IM children (106 mild cases and 28 severe cases) and 143 healthy subjects in our hospital were collected. EB-DNA was detected by real-time PCR, and VCA-IgM by ELISA. Results The positive rates of EB-DNA and VCA-IgM in the IM cases were 76.9% (103/134) and 61.2% (82/134), and were 7.7% (11/143) and 11.9% (17/143) in the control cases, respectively (both P<0.05). The sensitivity and specificity of EB-DNA were 76.9% (103/134) and 92.3% (132/143), which were higher than those of VCA-IgM (both P<0.05). The sensitivity of the combined-detection of EB-DNA and VCA-IgM was 91.0% (122/134), which was higher than those of single detection (both P<0.05). The positive rate of EB-DNA was 100.0% (28/28) in the severe patients, and was 70.8% (75/106) in the normal cases. The median of EB-DNA load in the severe cases was significant higher than that in the normal group (1.3×105 copies/ml vs. 6.1×103 copies/ml, Z=-4.756, P<0.05). The ROC curve showed that the optimal cut-off value for EB-DNA in the severe IM was 8.1×103 copies/ml, and the area under curve (AUC) was 0.862. Conclusions EB-DNA detection is suitable for the diagnosis of IM, while the combined-detection of EB-DNA and VCA-IgM can increase the detection rate of IM. The load of EB is valuable for the diagnose of severe IM. Key words: Epstein-Barr virus; Infectious mononucleosis; DNA; VCA-IgM