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Proportion Positive for Epstein-Barr Virus, Cytomegalovirus, Human Herpesvirus 6,Toxoplasma,and Human Immunodeficiency Virus Types 1 and 2 in Heterophile-Negative Patients With an...
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| Zeitschriftentitel: | Archives of Pathology & Laboratory Medicine |
|---|---|
| Personen und Körperschaften: | , , , , , |
| In: | Archives of Pathology & Laboratory Medicine, 124, 2000, 9, S. 1324-1330 |
| Format: | E-Article |
| Sprache: | Englisch |
| veröffentlicht: |
Archives of Pathology and Laboratory Medicine
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| Schlagwörter: |
| author_facet |
Tsaparas, Yotis F. Brigden, Malcolm L. Mathias, Richard Thomas, Eva Raboud, Janet Doyle, Patrick W. Tsaparas, Yotis F. Brigden, Malcolm L. Mathias, Richard Thomas, Eva Raboud, Janet Doyle, Patrick W. |
|---|---|
| author |
Tsaparas, Yotis F. Brigden, Malcolm L. Mathias, Richard Thomas, Eva Raboud, Janet Doyle, Patrick W. |
| spellingShingle |
Tsaparas, Yotis F. Brigden, Malcolm L. Mathias, Richard Thomas, Eva Raboud, Janet Doyle, Patrick W. Archives of Pathology & Laboratory Medicine Proportion Positive for Epstein-Barr Virus, Cytomegalovirus, Human Herpesvirus 6,Toxoplasma,and Human Immunodeficiency Virus Types 1 and 2 in Heterophile-Negative Patients With an Absolute Lymphocytosis or an Instrument-Generated Atypical Lymphocyte Flag Medical Laboratory Technology General Medicine Pathology and Forensic Medicine |
| author_sort |
tsaparas, yotis f. |
| spelling |
Tsaparas, Yotis F. Brigden, Malcolm L. Mathias, Richard Thomas, Eva Raboud, Janet Doyle, Patrick W. 1543-2165 0003-9985 Archives of Pathology and Laboratory Medicine Medical Laboratory Technology General Medicine Pathology and Forensic Medicine http://dx.doi.org/10.5858/2000-124-1324-ppfebv <jats:title>Abstract</jats:title><jats:p>Objectives.—To determine the proportion of patients with evidence of an acute infection due to Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpesvirus 6 (HHV-6), Toxoplasma, or human immunodeficiency virus types 1 and 2 (HIV-1 and HIV-2) in heterophile-negative patients with an absolute lymphocytosis or an instrument-generated atypical lymphocyte flag, and to develop a cost-effective testing algorithm for managing such heterophile-negative patients.</jats:p><jats:p>Design.—We conducted a prospective investigation of 70 selected outpatients who tested negative for heterophile antibody in association with an absolute lymphocytosis or instrument-generated atypical lymphocyte flag. The control population consisted of 50 patients who were heterophile negative and had a normal absolute lymphocyte count and no instrument-generated atypical lymphocyte flag.</jats:p><jats:p>Setting.—A large outpatient laboratory system.</jats:p><jats:p>Intervention.—Viral serology for HHV-6 was performed by immunofluorescence, and all other serologies were performed by enzyme-linked immunoassay. All testing was for immunoglobulin (Ig) M antibodies, except in the case of HIV.</jats:p><jats:p>Results.—The proportion of study patients positive for EBV was 40% (28/70); for CMV, 39% (27/70); for HHV-6, 25% (16/65); for Toxoplasma, 3% (2/70); and for HIV, 0% (0/70). All 50 control patients were negative for EBV IgM antibodies. When patients with more than 1 positive viral test were excluded from analysis, positivity was 20% (9/45) for EBV, 22% (10/45) for CMV, 9% (4/45) for HHV-6, and 2% (1/45) for Toxoplasma. Utilizing hypothesis-generating logistic regression models, Downey type II atypical lymphocytes were significantly associated with EBV positivity (P = .006), while Downey type III lymphocytes were significantly associated with HHV-6 positivity (P = .016), and there was a trend for the association of Downey type I lymphocytes with CMV positivity (P = .097).</jats:p><jats:p>Conclusions.—A positive viral serology was identified in 70% of study patients. Multiple positive serologies complicate establishing a definitive diagnosis. Potential cost savings may be associated with the use of an appropriate testing algorithm.</jats:p> Proportion Positive for Epstein-Barr Virus, Cytomegalovirus, Human Herpesvirus 6,<i>Toxoplasma,</i>and Human Immunodeficiency Virus Types 1 and 2 in Heterophile-Negative Patients With an Absolute Lymphocytosis or an Instrument-Generated Atypical Lymphocyte Flag Archives of Pathology & Laboratory Medicine |
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Archives of Pathology and Laboratory Medicine, 2000 |
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Archives of Pathology and Laboratory Medicine, 2000 |
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| title |
Proportion Positive for Epstein-Barr Virus, Cytomegalovirus, Human Herpesvirus 6,Toxoplasma,and Human Immunodeficiency Virus Types 1 and 2 in Heterophile-Negative Patients With an Absolute Lymphocytosis or an Instrument-Generated Atypical Lymphocyte Flag |
| title_unstemmed |
Proportion Positive for Epstein-Barr Virus, Cytomegalovirus, Human Herpesvirus 6,Toxoplasma,and Human Immunodeficiency Virus Types 1 and 2 in Heterophile-Negative Patients With an Absolute Lymphocytosis or an Instrument-Generated Atypical Lymphocyte Flag |
| title_full |
Proportion Positive for Epstein-Barr Virus, Cytomegalovirus, Human Herpesvirus 6,Toxoplasma,and Human Immunodeficiency Virus Types 1 and 2 in Heterophile-Negative Patients With an Absolute Lymphocytosis or an Instrument-Generated Atypical Lymphocyte Flag |
| title_fullStr |
Proportion Positive for Epstein-Barr Virus, Cytomegalovirus, Human Herpesvirus 6,Toxoplasma,and Human Immunodeficiency Virus Types 1 and 2 in Heterophile-Negative Patients With an Absolute Lymphocytosis or an Instrument-Generated Atypical Lymphocyte Flag |
| title_full_unstemmed |
Proportion Positive for Epstein-Barr Virus, Cytomegalovirus, Human Herpesvirus 6,Toxoplasma,and Human Immunodeficiency Virus Types 1 and 2 in Heterophile-Negative Patients With an Absolute Lymphocytosis or an Instrument-Generated Atypical Lymphocyte Flag |
| title_short |
Proportion Positive for Epstein-Barr Virus, Cytomegalovirus, Human Herpesvirus 6,Toxoplasma,and Human Immunodeficiency Virus Types 1 and 2 in Heterophile-Negative Patients With an Absolute Lymphocytosis or an Instrument-Generated Atypical Lymphocyte Flag |
| title_sort |
proportion positive for epstein-barr virus, cytomegalovirus, human herpesvirus 6,<i>toxoplasma,</i>and human immunodeficiency virus types 1 and 2 in heterophile-negative patients with an absolute lymphocytosis or an instrument-generated atypical lymphocyte flag |
| topic |
Medical Laboratory Technology General Medicine Pathology and Forensic Medicine |
| url |
http://dx.doi.org/10.5858/2000-124-1324-ppfebv |
| publishDate |
2000 |
| physical |
1324-1330 |
| description |
<jats:title>Abstract</jats:title><jats:p>Objectives.—To determine the proportion of patients with evidence of an acute infection due to Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpesvirus 6 (HHV-6), Toxoplasma, or human immunodeficiency virus types 1 and 2 (HIV-1 and HIV-2) in heterophile-negative patients with an absolute lymphocytosis or an instrument-generated atypical lymphocyte flag, and to develop a cost-effective testing algorithm for managing such heterophile-negative patients.</jats:p><jats:p>Design.—We conducted a prospective investigation of 70 selected outpatients who tested negative for heterophile antibody in association with an absolute lymphocytosis or instrument-generated atypical lymphocyte flag. The control population consisted of 50 patients who were heterophile negative and had a normal absolute lymphocyte count and no instrument-generated atypical lymphocyte flag.</jats:p><jats:p>Setting.—A large outpatient laboratory system.</jats:p><jats:p>Intervention.—Viral serology for HHV-6 was performed by immunofluorescence, and all other serologies were performed by enzyme-linked immunoassay. All testing was for immunoglobulin (Ig) M antibodies, except in the case of HIV.</jats:p><jats:p>Results.—The proportion of study patients positive for EBV was 40% (28/70); for CMV, 39% (27/70); for HHV-6, 25% (16/65); for Toxoplasma, 3% (2/70); and for HIV, 0% (0/70). All 50 control patients were negative for EBV IgM antibodies. When patients with more than 1 positive viral test were excluded from analysis, positivity was 20% (9/45) for EBV, 22% (10/45) for CMV, 9% (4/45) for HHV-6, and 2% (1/45) for Toxoplasma. Utilizing hypothesis-generating logistic regression models, Downey type II atypical lymphocytes were significantly associated with EBV positivity (P = .006), while Downey type III lymphocytes were significantly associated with HHV-6 positivity (P = .016), and there was a trend for the association of Downey type I lymphocytes with CMV positivity (P = .097).</jats:p><jats:p>Conclusions.—A positive viral serology was identified in 70% of study patients. Multiple positive serologies complicate establishing a definitive diagnosis. Potential cost savings may be associated with the use of an appropriate testing algorithm.</jats:p> |
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| author | Tsaparas, Yotis F., Brigden, Malcolm L., Mathias, Richard, Thomas, Eva, Raboud, Janet, Doyle, Patrick W. |
| author_facet | Tsaparas, Yotis F., Brigden, Malcolm L., Mathias, Richard, Thomas, Eva, Raboud, Janet, Doyle, Patrick W., Tsaparas, Yotis F., Brigden, Malcolm L., Mathias, Richard, Thomas, Eva, Raboud, Janet, Doyle, Patrick W. |
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| description | <jats:title>Abstract</jats:title><jats:p>Objectives.—To determine the proportion of patients with evidence of an acute infection due to Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpesvirus 6 (HHV-6), Toxoplasma, or human immunodeficiency virus types 1 and 2 (HIV-1 and HIV-2) in heterophile-negative patients with an absolute lymphocytosis or an instrument-generated atypical lymphocyte flag, and to develop a cost-effective testing algorithm for managing such heterophile-negative patients.</jats:p><jats:p>Design.—We conducted a prospective investigation of 70 selected outpatients who tested negative for heterophile antibody in association with an absolute lymphocytosis or instrument-generated atypical lymphocyte flag. The control population consisted of 50 patients who were heterophile negative and had a normal absolute lymphocyte count and no instrument-generated atypical lymphocyte flag.</jats:p><jats:p>Setting.—A large outpatient laboratory system.</jats:p><jats:p>Intervention.—Viral serology for HHV-6 was performed by immunofluorescence, and all other serologies were performed by enzyme-linked immunoassay. All testing was for immunoglobulin (Ig) M antibodies, except in the case of HIV.</jats:p><jats:p>Results.—The proportion of study patients positive for EBV was 40% (28/70); for CMV, 39% (27/70); for HHV-6, 25% (16/65); for Toxoplasma, 3% (2/70); and for HIV, 0% (0/70). All 50 control patients were negative for EBV IgM antibodies. When patients with more than 1 positive viral test were excluded from analysis, positivity was 20% (9/45) for EBV, 22% (10/45) for CMV, 9% (4/45) for HHV-6, and 2% (1/45) for Toxoplasma. Utilizing hypothesis-generating logistic regression models, Downey type II atypical lymphocytes were significantly associated with EBV positivity (P = .006), while Downey type III lymphocytes were significantly associated with HHV-6 positivity (P = .016), and there was a trend for the association of Downey type I lymphocytes with CMV positivity (P = .097).</jats:p><jats:p>Conclusions.—A positive viral serology was identified in 70% of study patients. Multiple positive serologies complicate establishing a definitive diagnosis. Potential cost savings may be associated with the use of an appropriate testing algorithm.</jats:p> |
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| spelling | Tsaparas, Yotis F. Brigden, Malcolm L. Mathias, Richard Thomas, Eva Raboud, Janet Doyle, Patrick W. 1543-2165 0003-9985 Archives of Pathology and Laboratory Medicine Medical Laboratory Technology General Medicine Pathology and Forensic Medicine http://dx.doi.org/10.5858/2000-124-1324-ppfebv <jats:title>Abstract</jats:title><jats:p>Objectives.—To determine the proportion of patients with evidence of an acute infection due to Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpesvirus 6 (HHV-6), Toxoplasma, or human immunodeficiency virus types 1 and 2 (HIV-1 and HIV-2) in heterophile-negative patients with an absolute lymphocytosis or an instrument-generated atypical lymphocyte flag, and to develop a cost-effective testing algorithm for managing such heterophile-negative patients.</jats:p><jats:p>Design.—We conducted a prospective investigation of 70 selected outpatients who tested negative for heterophile antibody in association with an absolute lymphocytosis or instrument-generated atypical lymphocyte flag. The control population consisted of 50 patients who were heterophile negative and had a normal absolute lymphocyte count and no instrument-generated atypical lymphocyte flag.</jats:p><jats:p>Setting.—A large outpatient laboratory system.</jats:p><jats:p>Intervention.—Viral serology for HHV-6 was performed by immunofluorescence, and all other serologies were performed by enzyme-linked immunoassay. All testing was for immunoglobulin (Ig) M antibodies, except in the case of HIV.</jats:p><jats:p>Results.—The proportion of study patients positive for EBV was 40% (28/70); for CMV, 39% (27/70); for HHV-6, 25% (16/65); for Toxoplasma, 3% (2/70); and for HIV, 0% (0/70). All 50 control patients were negative for EBV IgM antibodies. When patients with more than 1 positive viral test were excluded from analysis, positivity was 20% (9/45) for EBV, 22% (10/45) for CMV, 9% (4/45) for HHV-6, and 2% (1/45) for Toxoplasma. Utilizing hypothesis-generating logistic regression models, Downey type II atypical lymphocytes were significantly associated with EBV positivity (P = .006), while Downey type III lymphocytes were significantly associated with HHV-6 positivity (P = .016), and there was a trend for the association of Downey type I lymphocytes with CMV positivity (P = .097).</jats:p><jats:p>Conclusions.—A positive viral serology was identified in 70% of study patients. Multiple positive serologies complicate establishing a definitive diagnosis. Potential cost savings may be associated with the use of an appropriate testing algorithm.</jats:p> Proportion Positive for Epstein-Barr Virus, Cytomegalovirus, Human Herpesvirus 6,<i>Toxoplasma,</i>and Human Immunodeficiency Virus Types 1 and 2 in Heterophile-Negative Patients With an Absolute Lymphocytosis or an Instrument-Generated Atypical Lymphocyte Flag Archives of Pathology & Laboratory Medicine |
| spellingShingle | Tsaparas, Yotis F., Brigden, Malcolm L., Mathias, Richard, Thomas, Eva, Raboud, Janet, Doyle, Patrick W., Archives of Pathology & Laboratory Medicine, Proportion Positive for Epstein-Barr Virus, Cytomegalovirus, Human Herpesvirus 6,Toxoplasma,and Human Immunodeficiency Virus Types 1 and 2 in Heterophile-Negative Patients With an Absolute Lymphocytosis or an Instrument-Generated Atypical Lymphocyte Flag, Medical Laboratory Technology, General Medicine, Pathology and Forensic Medicine |
| title | Proportion Positive for Epstein-Barr Virus, Cytomegalovirus, Human Herpesvirus 6,Toxoplasma,and Human Immunodeficiency Virus Types 1 and 2 in Heterophile-Negative Patients With an Absolute Lymphocytosis or an Instrument-Generated Atypical Lymphocyte Flag |
| title_full | Proportion Positive for Epstein-Barr Virus, Cytomegalovirus, Human Herpesvirus 6,Toxoplasma,and Human Immunodeficiency Virus Types 1 and 2 in Heterophile-Negative Patients With an Absolute Lymphocytosis or an Instrument-Generated Atypical Lymphocyte Flag |
| title_fullStr | Proportion Positive for Epstein-Barr Virus, Cytomegalovirus, Human Herpesvirus 6,Toxoplasma,and Human Immunodeficiency Virus Types 1 and 2 in Heterophile-Negative Patients With an Absolute Lymphocytosis or an Instrument-Generated Atypical Lymphocyte Flag |
| title_full_unstemmed | Proportion Positive for Epstein-Barr Virus, Cytomegalovirus, Human Herpesvirus 6,Toxoplasma,and Human Immunodeficiency Virus Types 1 and 2 in Heterophile-Negative Patients With an Absolute Lymphocytosis or an Instrument-Generated Atypical Lymphocyte Flag |
| title_short | Proportion Positive for Epstein-Barr Virus, Cytomegalovirus, Human Herpesvirus 6,Toxoplasma,and Human Immunodeficiency Virus Types 1 and 2 in Heterophile-Negative Patients With an Absolute Lymphocytosis or an Instrument-Generated Atypical Lymphocyte Flag |
| title_sort | proportion positive for epstein-barr virus, cytomegalovirus, human herpesvirus 6,<i>toxoplasma,</i>and human immunodeficiency virus types 1 and 2 in heterophile-negative patients with an absolute lymphocytosis or an instrument-generated atypical lymphocyte flag |
| title_unstemmed | Proportion Positive for Epstein-Barr Virus, Cytomegalovirus, Human Herpesvirus 6,Toxoplasma,and Human Immunodeficiency Virus Types 1 and 2 in Heterophile-Negative Patients With an Absolute Lymphocytosis or an Instrument-Generated Atypical Lymphocyte Flag |
| topic | Medical Laboratory Technology, General Medicine, Pathology and Forensic Medicine |
| url | http://dx.doi.org/10.5858/2000-124-1324-ppfebv |