Chapter 11.7 : Virology Introduction

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Virology Introduction, Page 1 of 1

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Serology has long played a role in diagnosing viral infections, although previous editions of the did not address viral serology testing. As seen elsewhere in this manual, molecular techniques have supplanted viral culture in many instances. However, serology retains a role for diagnosing infection with or exposure to many viruses. Classically, IgM assays have been used to diagnose current infections, while IgG and total antibody assays have been used for both documenting a current infection and immune status testing. IgM is not always produced during an acute infection, particularly in cases of latent virus reactivation. Positive IgG and total antibody assays not only indicate past infection or exposure but also may be positive early during infection. Acute- and convalescent-phase specimens are helpful for differentiating those possibilities. Unfortunately, paired specimens are rarely submitted. The viral serology assays use standard and often simple or automated methods. Interpreting the results of these procedures is not always a straightforward process. The next few procedures in this section highlight the role of antibody detection in diagnosing 4 viral infections where interpreting the results plays a major role in the clinical laboratory. Linda E. Miller reviews Epstein-Barr virus (EBV) testing. While a classic heterophile antibody assay is still used as a screen for EBV infections, many laboratories offer “EBV panels” consisting of 4 or 5 different antibody assays. Miller reviews the technology and interpretation of these panels. Marc R. Couturier and Bijaya K. Dhakal discuss serology testing for three other herpesvirus family members, cytomegalovirus (CMV) and herpes simplex virus (HSV) 1 and 2. Recent advances in testing for these viruses include CMV avidity testing and type-specific antibody testing for HSV. Again, interpreting the results in light of the clinical presentation is important for these viruses. Human immunodeficiency virus (HIV) serology testing is undergoing a revolution with the advent of fourth- and fifth-generation assays which can detect both HIV antibody and antigen. Western blots are no longer appropriate for use following these assays; thus, the CDC developed a new algorithm for HIV testing. Thomas S. Alexander describes these assays and the recently developed algorithm.

Citation: Leber A. 2016. Virology Introduction, p 11.7.1-11.7.1. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch11.7
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