A single-center retrospective analysis of serological and molecular findings in patients infected with Epstein-Barr virus.

Abstract

This retrospective study analyzed serological and molecular diagnostic data from 7,170 EBV-infected patients treated at the Clinical Laboratory Center of Lanzhou University Second Hospital between 2018 and 2024. The aim was to evaluate the clinical utility of combining EBV DNA quantification via qPCR with antibody testing (VCA-IgM, VCA-IgG, EA-IgM, EBNA-IgG, and VCA-IgA) using ELISA. Significant age-related variations were observed across DNA replication groups, with the high viral load (1 × 10⁵ copies/mL) predominantly detected in adolescents (median age: 13 years). VCA-IgM demonstrated the strongest association with DNA replication levels (OR = 0.168, p < 0.001), yet 45.2% (14/31) of high viral load(1 × 10⁵ copies/mL) cases were VCA-IgM negative, underscoring the limitations of relying solely on serology in immunocompromised populations. Our findings emphasize the necessity of integrating molecular and serological testing for accurate EBV diagnosis, particularly in resource-limited settings.