To compare the performance of four diagnostic commercial systems for Epstein-Barr virus (EBV) serology (for
IgM and
IgG virus capsid
antigen [VCA] and
EBV nuclear antigen [EBNA]
antibodies), a collection of 125 samples from clinically suspected
infectious mononucleosis cases was studied. Indirect immunofluorescence (IIF) for VCA
IgM and
IgG antibodies and
anticomplement immunofluorescence for EBNA
antibodies (Meridian Bioscience Inc.) were used as reference methods. By these methods, the cases were classified EBV primary
infection (presence of
IgM to VCA or
IgG to VCA in the absence of EBNA
antibodies; n = 82), EBV past
infection (presence of VCA
IgG and EBNA
antibodies in the absence of VCA
IgM; n = 26), or no
infection (negative for the three markers; n = 17). The following systems were tested: two chemiluminescent immunoassays (CLIAs; the Liason [CLIA-L; DiaSorin] and the Immulite 2000 [CLIA-I; Siemens]), immunofiltration (IF; All.Diag), and an
enzyme-linked
immunosorbent assay (ELISA; DiaSorin). In the
IgM assays, sensitivities ranged from 67.1% (ELISA) to 92.2% (CLIA-L) and specificities ranged from 93.8% (CLIA-L) to 100% (IF). In the VCA
IgG assays, sensitivities varied from 79.4% (IF) to 94.4% (CLIA-I) and specificities varied from 94.4% (IF and CLIA-L) to 100% (CLIA-I and ELISA). In EBNA assays, sensitivities ranged from 78.1% (IF) to 93.8% (CLIA-I) and specificities ranged from 32.3% (CLIA-L) to 91.4% (IF). In relation to EBV profiles, the corresponding figures for sensitivity (in detecting primary
infection) for IF, CLIA-L, CLIA-I, and ELISA were 92.7%, 93.8%, 89%, and 89.6%, respectively, and those for specificity (to exclude primary recent
infection) were 90.7%, 94.6%, 97.7%, and 95.2%, respectively. Although there were limitations in some individual markers, especially CLIA-L for EBNA
IgG, the systems evaluated appear to be useful for diagnosis of
EBV infection.