{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T04:33:28Z","timestamp":1787459608813,"version":"build-2736575974"},"reference-count":45,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Epstein\u2010Barr virus (EBV) is linked to a spectrum of diseases. To investigate the characteristics of various EBV\u2010associated diseases in China, we conducted a multi\u2010center retrospective cohort study examining molecular and serological features. EBV DNA copy numbers in plasma and peripheral blood mononuclear cells (PBMCs) were determined using quantitative polymerase chain reaction (qPCR), while four EBV\u2010specific antibodies were assessed via chemiluminescence immunoassay. Our study included 746 patients with EBV\u2010related diseases and 350 control adults without EBV\u2010associated diseases. Among the patient group, EBV DNA was detectable in 97.7% of PBMC samples and 92.6% of plasma samples, significantly surpassing the positivity rates observed in controls (46.7% in PBMCs and 4.6% in plasma). In terms of specific diseases, EBV DNA was positive in PBMCs in almost all the patients across most disease groups, except in nasopharyngeal carcinoma (87.4%), whereas the EBV DNA positivity rates in plasma varied considerably. Most disease groups exhibited low positivity rates for viral capsid antigen (VCA)\u2010IgM and high positivity rates for EBV nuclear antigen (EBNA)\u2010IgG. Contrary, infectious mononucleosis demonstrated a high seropositivity rate (94.2%) for VCA\u2010IgM but a low rate (0.8%) for EBNA\u2010IgG. EBV DNA in plasma effectively distinguishes patients with EBV\u2010associated diseases from control subjects, and incorporating PBMC EBV DNA further enhances diagnostic accuracy. In conclusion, our findings delineate distinct patterns of EBV DNA presence, levels, and antibody responses across various EBV\u2010associated diseases. We recommend that plasma EBV DNA testing be employed as the first\u2010line diagnostic approach for high\u2010risk individuals, with subsequent PBMC EBV testing conducted for those exhibiting negative plasma results. A comprehensive evaluation of both EBV DNA and serological markers is essential for accurate identification and differential diagnosis of EBV\u2010related disorders.<\/jats:p>","DOI":"10.1002\/jmv.70421","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T03:06:20Z","timestamp":1748401580000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Development of a Diagnostic Algorithm for Epstein\u2010Barr Virus\u2010Related Diseases: A Retrospective Observational Study"],"prefix":"10.1002","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1392-710X","authenticated-orcid":false,"given":"Jiaoyuan","family":"Li","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan 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