Epstein-Barr Virus and Cytomegalovirus

Epstein-Barr virus (EBV) and cytomegalovirus (CMV) are major pathogens, especially for the immuno-compromised host. Both are capable of causing disease during primary infection, reactivation, or superinfection. This chapter emphasizes the recognition of EBV and CMV diseases and focuses on the clinical relevance of laboratory findings. EBV infection has been implicated as a cause or risk factor for a number of autoimmune diseases, including multiple sclerosis, systemic lupus erythematosus, and rheumatoid arthritis. Antibody against EBV early antigen can be detected in serum or plasma by use of an enzyme immunoassay, immunofluorescence assay, or immunoblotting. While histopathology remains the reference standard for the diagnosis of tissue-invasive CMV disease, it requires an invasive procedure/biopsy to obtain tissue samples. The CMV antigenemia assay uses monoclonal antibodies to detect CMV lower-matrix phosphoprotein pp65 antigen, a structural late protein expressed in CMV-infected leukocytes during early CMV replication.