Clinical laboratory tests for chronic enteroviral infections

Immunohistochemistry (IHC) - This technique is the most useful in analyzing organ biopsies or autopsy sections. In this procedure, cells are stained with an EV monoclonal antibody to determine if the viral protein is expressed at the time of the biopsy.

Biopsies of the organs where patients have symptoms are very helpful in making a diagnosis of persistent enteroviral infection. Brain, heart, and muscles are often involved with persistent enteroviral infections, but biopsies of these organs are not likely to be done. The stomach is the one common place where enteroviruses usually go despite the routes of virus transmission. Enterovirus protein, or RNA, and defective viruses have been found in the stomach biopsies of patients from endoscopy procedures. Enterovirus protein has also been demonstrated in the nasal and sinus tissue, throat, thyroid, heart and brain of patients.

It is important to note that a biopsy is often taken during an endoscopy and that biopsies are typically preserved in paraffin for years in the pathology department where the procedure was performed. These can be requested in order to perform this test.

This test can be ordered from EV Med Research.

Micro-neutralization test - Persistently elevated antibody levels for one or more enteroviruses over years can suggest a chronic enteroviral infection. The Micro-neutralization test is a very sensitive, specific test and only 11 enteroviruses, coxsackie B1-6 and echoviruses 6, 7, 9, 11, and 30 can be tested using this method. Titers of 1:320 and higher are good indicators of current infection.

It is important to note that only one commercial laboratory in the United States is recommended for this test: Associate Regional University Pathologist Laboratory (ARUP), Salt Lake City, Utah. These tests can be ordered directly from ARUP or ordered through Labcorp. If ordered through Labcorp, write on the form to specifically state to send this test to ARUP.

For more information:

Polymerase Chain Reaction (PCR) - The PCR test is not considered sensitive for chronic enteroviral infections. Since viruses are cleared quickly from the blood stream, the chance of finding viral gene or RNA in the blood by the PCR technique is low. With special techniques and repeated testing, enterovirus RNA can be found in close to thirty percent of whole blood samples taken from chronically infected EV patients.

For Immunohistochemistry stain requests, please do not send samples to the foundation.

EV Med Research

25332 Narbonne Ave. #170
Lomita, CA, 90717
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