Test 6111 - Epstein-Barr Virus Quantitation by Real-Time PCR
Method Real-Time Polymerase Chain Reaction (PCR) – Viral Load Monitoring
Specimen Requirements

2.0 ml (1.0 ml) Amniotic fluid: Room Temperature;
1.0 ml (0.5 ml) Bone Marrow EDTA or ACD: Refrigerated; 
2.0 ml (1.0ml)  CSF: Refrigerated; 
3.0 ml (2.0 ml) PPT Plasma: Refrigerated;
3.0 ml (2.0ml)  Whole Blood Plasma EDTA: Refrigerated;
2.0 ml (1.0 ml) Whole Blood EDTA or ACD: Refrigerated;
2.0 ml (1.0 ml)  Serum: Refrigerated.

Collection & Transport

Amniotic fluid:  Discard first 2 ml, then collect 3-5 ml in a sterile plastic conical tube or one T-25 flask of confluent cells.
Whole Blood Plasma EDTA: separate plasma from red cells within 6 hours.

Causes for Rejection

Whole Blood: in heparin;
Whole Blood Plasma EDTA:  not separated w/in 6 hrs; 
All:  insufficient volume or shipped at incorrect temperature.

Specimen Stability Refrigerated and ambient specimens stable for 96 hours; frozen specimens stable indefinitely.
Reference Range Less than 50 EBV DNA copies/ml
TAT 24-72 hours
CPT Code 87799, Infectious agent detection by nucleic acid, not otherwise specified; quantification probe technique

Epstein-Barr virus (EBV) is a herpes virus that has been implicated in the development of lymphoid malignancies such as Burkitt’s lymphoma and Hodgkin’s disease.  Recent studies have demonstrated a direct relationship between EBV viral load and risk of developing post transplant lymphoproliferative disorder (PTLD).  EBV DNA has been detected in cell-free fractions (plasma or serum) of patients with PTLD, Hodgkin’s, and AIDS-related lymphomas.  Conventional PCR-based allow only semi-quantitative results of viral DNA.  Real-time PCR allows the highly sensitive, specific and quantitative determination of EBV DNA.  Quantitative PCR of EBV DNA can be an important tool for early diagnosis of disease as well as a method to monitor response to treatment.  Real-time PCR has a greater dynamic range in which samples can be analyzed quantitatively without subsequent dilution.

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