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A prospective evaluation of the diagnostic potential of EBV-DNA in plasma and whole blood.
Ludvigsen, Lene Ugilt Pagter; Andersen, Annemette Sloth; Hamilton-Dutoit, Stephen; Jensen-Fangel, Søren; Bøttger, Pernille; Handberg, Kurt Jensen; Ivarsen, Per; d'Amore, Francesco; Bibby, Bo Martin; Albertsen, Birgitte Klug; Jespersen, Bente; Thomsen, Marianne Kragh.
Afiliação
  • Ludvigsen LUP; Department of Renal Medicine, Aarhus University Hospital, Denmark; Department of Infectious Diseases, Odense University Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Denmark. Electronic address: Lene.ugilt@auh.rm.dk.
  • Andersen AS; Department of Clinical Microbiology, Aarhus University Hospital, Denmark.
  • Hamilton-Dutoit S; Department of Clinical Medicine, Aarhus University, Denmark; Department of Pathology, Aarhus University Hospital, Denmark.
  • Jensen-Fangel S; Department of Infectious Diseases, Aarhus University Hospital, Denmark.
  • Bøttger P; Department of Clinical Microbiology, Aarhus University Hospital, Denmark.
  • Handberg KJ; Department of Clinical Microbiology, Aarhus University Hospital, Denmark.
  • Ivarsen P; Department of Renal Medicine, Aarhus University Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Denmark.
  • d'Amore F; Department of Clinical Medicine, Aarhus University, Denmark; Department of Haematology, Aarhus University Hospital, Denmark.
  • Bibby BM; Department of Biostatistics, Aarhus University, Denmark.
  • Albertsen BK; Department of Clinical Medicine, Aarhus University, Denmark; Department of Paediatrics, Aarhus University Hospital, Denmark.
  • Jespersen B; Department of Renal Medicine, Aarhus University Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Denmark.
  • Thomsen MK; Department of Clinical Medicine, Aarhus University, Denmark; Department of Clinical Microbiology, Aarhus University Hospital, Denmark.
J Clin Virol ; 167: 105579, 2023 10.
Article em En | MEDLINE | ID: mdl-37683299
BACKGROUND: Quantitative polymerase chain reaction (qPCR) for Epstein-Barr virus (EBV)-DNA is an important diagnostic tool for EBV-associated disease, but interpretation of its clinical significance is challenging. OBJECTIVES: We assessed the diagnostic and clinical performance of WHO-standardised qPCR for EBV-DNA (WHO EBV-qPCR) in plasma and whole blood (WB) for proven EBV disease in a prospectively accrued patient cohort. STUDY DESIGN: Central Denmark Region patients, tested with WHO EBV-qPCR from November 2017 to March 2019, were screened for EBV disease. Incidence (IR) was estimated by Poisson regression. Sensitivity, specificity, positive and negative predictive values (PPV, NPV) were calculated for EBV-qPCR in plasma and WB. Risk of diagnostic latency was compared between patients with EBV-positive and EBV-negative lymphomas. RESULTS: EBV disease was diagnosed in 95 of 1484 participants (IR: 16.3 per 1000 patientyears 95%CI; 13.3-19.9). Sensitivity and specificity of WHO EBV-qPCR in plasma was 82.4% (95% CI; 74.2-90.7%) and 87.8% (95% CI; 85.6-90%), yielding a PPV of 32.2% (95% CI; 24.9-39.5%) and NPV of 98.6% (95% CI; 97.7-99.5%) for proven EBV disease. Sensitivity and NPV were comparable in WB, while specificity and PPV decreased to 66.9% (95% CI; 60.6-73.1%) and 18.1% (95% CI; 7.5-28.7%). Risk of diagnostic latency was 2.3-fold (95% CI 1.4-4.1) higher for patients with EBV-positive compared with EBV-negative lymphomas. CONCLUSIONS: WHO EBV-qPCR in plasma and WB have a low PPV but a high NPV for proven EBV disease. Implementation of WHO EBV-qPCR could improve interpretation and facilitate EBV-positive lymphoma diagnosis.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Herpesvirus Humano 4 / Infecções por Vírus Epstein-Barr Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Herpesvirus Humano 4 / Infecções por Vírus Epstein-Barr Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article