Epstein-Barr virus (EBV) early-antigen serologic testing in conjunction with peripheral blood EBV DNA load as a marker for risk of posttransplantation lymphoproliferative disease.

Epstein-Barr virus (EBV) early-antigen (EA) serologic profile was examined in conjunction with peripheral blood EBV DNA load, to assess its value in evaluating the risk of developing posttransplantation lymphoproliferative disease (PTLD). The cohort included 26 pediatric recipients of solid-organ transplants, 6 of whom developed PTLD. All 6 patients had high peripheral blood EBV DNA loads. Of the remaining 20 patients who did not develop PTLD, 14 had high EBV DNA loads, and 6 had low EBV DNA loads. None of the patients who developed PTLD had significant EA immunoglobulin G (IgG) titers. However, all 14 patients with high EBV DNA loads and without PTLD had high EA IgG titers, either at the time of initial high EBV DNA load or during the ensuing weeks. Here, we report that EBV DNA load analysis, combined with EA serologic analysis, is a potentially useful prognostic marker for evaluating the risk of developing PTLD.