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Quantitative Epstein‐Barr virus (EBV) serology in lung transplant recipients with primary EBV infection and/or post‐transplant lymphoproliferative disease

The Epstein‐Barr virus (EBV)‐specific antibody response was studied in lung transplant patients to assess their value in the diagnosis and prognosis of post‐transplant lymphoproliferative disease. Recently developed synthetic peptides representing Epstein‐Barr nuclear antigen‐1 (EBNA‐1), diffuse early antigen (EA(D)), and virus capsid antigen (VCA) were studied in a semiquantitative enzyme‐linked immunosorbent assay (ELISA) to study antibody patterns in 12 seronegative lung transplant patients, of whom four developed a post‐transplant lymphoproliferative disease, and seven seropositive lung transplant patients, all of whom developed a post‐transplant lymphoproliferative disease. Immunoblot technique was used as a control. All 12 EBV‐seronegative patients had a very limited antibody response that was restricted mainly to VCA antibodies. EA(D) antibodies became detectable in only two patients. Antibody response never preceded clinical diagnosis of post‐transplant lymphoproliferative disease in the four EBV‐seronegative patients who developed post‐transplant lymphoproliferative disease. In the seven seropositive lung transplant patients with post‐transplant lymphoproliferative disease, we found a rise in antibody titer in only two patients. Immunoblot analysis confirmed the serological results. In conclusion, EBV‐specific antibody patterns after lung transplantation are highly restricted and variable and of limited value for the diagnosis or prognosis of post‐transplant lymphoproliferative disease. J. Med. Virol. 69:258–266, 2003. © 2003 Wiley‐Liss, Inc.