Dynamics of Epstein-Barr virus DNA levels in serum during EBV-associated disease

A real-time polymerase chain reaction assay for quantitation of Epstein-Bar r virus (EBV) DNA in serum was developed. This assay detected EBV DNA in 24 (89%) of 27 sera from patients with infectious mononucleosis, but only in 9 (18%) of 51 sera from EBV carriers (P < 0.001) and in none of the sera fr om 32 EBV-seronegative individuals. EBV DNA levels were higher in sera from infectious mononucleosis (median 8,000, range 1833-150,069 copies/ml) than from carriers (median < 2, range < 2-2980; P < 0.001). In sera of 36 child ren with infectious mononucleosis followed prospectively, EBV DNA levels co rrelated inversely with the duration of symptoms. Among 18 children with tu mors including Hodgkin's disease (n = 7), non-Hodgkin's lymphoma (n = 6), B urkitt's lymphoma (n = 1), lymphoproliferative disorder (n = 4), and osteos arcoma (n = 1), EBV DNA was detected in serum from those 9 (100%) expressin g EBV in the tumor (Hodgkin's disease, 3; non-Hodgkin's lymphoma, 2; lympho proliferative disorder, 4), the levels peaking at diagnosis and correlating with disease activity. Quantitation of EBV DNA in serum may off era simple means of monitoring patients at risk of EBV-associated lymphoproliferation . J. Med. Virol. 64:505-512, 2001. (C) 2001 Wiley-Liss, Inc.