Positivity Rate of Epstein–Barr Virus Antiviral Capsid Antigen Immunoglobulin M among Children with Infectious Mononucleosis in Diyala


Background: Epstein–Barr virus(EBV) is a small double‑stranded linear DNA human herpes virus that is transmitted primarily through saliva. Majority of primary EBV infections in infants and young children are clinically silent. Clinically, primary infections by EBV are presented as infectious mononucleosis (IMN) syndrome, which is characterized by pharyngitis, cervical lymphadenopathy, fever, and lymphocytosis. Objectives: This study was designed to explore the rate of EBV anti‑viral capsid antigen (VCA) immunoglobulin M (IgM) among children who were clinically suspected as having IMN in Diyala province. Subjects and Methods: A total of 248 subjects were included; 190 were clinically suspected as having IMN and 58 apparently healthy subjects were included as a control group. The age range of the patients was 9–168 months; 88 of them were males, while 102 were females. Similarly, the age range of the apparently healthy subjects was 9–168 months; 29 of them were males while 29 were females. The anti‑VCA IgM antibodies were detected in the serum samples using the VCA IgM enzyme‑linked immunosorbent assay technique (DiaPro Diagnostic Bioprobes Srl, Italy). Human privacy was respected by taking the parents’ verbal consent. Statistical analysis of the data was carried out using Statistical Packages for the Social Sciences (SPSS), Version 25. Statistical significance was considered whenever the P ≤ 0.05. Results: The results showed that the anti‑VCA IgM positivity rate among clinically suspected children with IMN was 24/190 (12.6%), while only 2/58 (3.4%) of the apparently healthy subjects were positive, with a statistically significant difference (P = 0.046). Age and gender distribution had no statistically significant effect on the IgM positivity rate (P = 0.432 andP = 0.960, respectively). Furthermore, most IgM‑positive patients had at least three of the main clinical features; however, no statistically significant association was found between the IgM positivity rate and the main clinical features (P = 0.157 for headache and P = 0.692 for malaise). Conclusion: The rate of IMN among clinically suspected patients in Diyala province was 12.6%, the peak age of primary infection was 1–4 years, the male‑to‑female ratio was 1:1.2, and the main presenting complaints were fever and sore throat.Keywords: Anti‑viral capsid antigen immunoglobulin M, Epstein–Barr virus, infectious mononucleosis