{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T18:17:07Z","timestamp":1769537827081,"version":"3.49.0"},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T00:00:00Z","timestamp":1766534400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T00:00:00Z","timestamp":1766534400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Epstein\u2010Barr virus (EBV) is well established as the cause of nasopharyngeal carcinoma (NPC), which is prevalent in China and Southeast Asia. Immunofluorescent assays (IFA) for detecting IgA have played an important role in surveillance for early detection of NPC in high\u2010risk groups. However, enzyme\u2010linked immunosorbent assays (ELISA) are increasingly favoured for the higher throughput and interpretation ease. In this study, we compare the performance of both methods comprising 9 EBV IgA kits, using 100 samples from NPC patients and 100 samples from patients who remained NPC\u2010free at follow\u2010up of at least 2 years. Using manufacturer cutoffs, IFA were more sensitive (96%\u201398%) than ELISA (56%\u201363%) in the detection of EBV\u2010early antigen (EA) IgA. Both methods had similar specificity (range 95%\u2013100%). Similarly, IFA were also more sensitive (99%\u2013100%), but had lower specificity (48%\u201381%), in the detection of viral capsid antigen (VCA) IgA than ELISA (sensitivity: 19%\u201372%; specificity: 73%\u201394%). However, optimisation of assay cutoff based on receiver operating characteristic (ROC) curves improved the diagnostic accuracy of IFA\u2010VCA IgA kits and ELISA\u2010EA &amp; VCA IgA kits. Overall, IFA demonstrated superior performance to ELISA regardless of the IgA target detected: IFA\u2010EA kits had area under curve (AUC) values of 0.975\u20130.985 vs. ELISA\u2010EA AUC\u2009=\u20090.873\u20130.989, and IFA\u2010VCA AUC\u2009=\u20090.961\u20130.978 vs. ELISA\u2010VCA AUC\u2009=\u20090.748\u20130.777. Contrary to other publications, IFA was more sensitive than ELISA in the detection of EA and VCA\u2010IgA in our local context. Despite being more laborious with lower throughput, IFA plays a crucial role in NPC screening.<\/jats:p>","DOI":"10.1002\/jmv.70767","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T13:34:56Z","timestamp":1766583296000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Value of Epstein\u2010Barr Virus Immunofluorescence and Enzyme\u2010Immunoassay Platforms for Detecting IgA Antibodies in Nasopharyngeal Carcinoma in the Singaporean Cohort"],"prefix":"10.1002","volume":"98","author":[{"given":"Soon Hwee","family":"Ng","sequence":"first","affiliation":[{"name":"Department of Microbiology Singapore General Hospital  Singapore"},{"name":"SingHealth Duke\u2010NUS Pathology Academic Clinical Programme  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenjie","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Microbiology Singapore General Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eng Hong","family":"Seng","sequence":"additional","affiliation":[{"name":"Department of Microbiology Singapore General Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qimei","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Microbiology Singapore General Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qirong","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Microbiology Singapore General Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Su Ming","family":"Thean","sequence":"additional","affiliation":[{"name":"Department of Microbiology Singapore General Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wee Ching","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Microbiology Singapore General Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kwok Seng","family":"Loh","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery National University of Singapore  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua K.","family":"Tay","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery National University of Singapore  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chwee Ming","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery Singapore General Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei Yee","family":"Wan","sequence":"additional","affiliation":[{"name":"Department of Microbiology Singapore General Hospital  Singapore"},{"name":"SingHealth Duke\u2010NUS Pathology Academic Clinical Programme  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,24]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1128\/microbiolspec.dmih2-0011-2015"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1750-9378-9-38"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djad012"},{"key":"e_1_2_10_5_1","unstructured":"O.NRoD \u201cSingapore Cancer Registry 50th Anniversary Monograph (1968\u20132017) \u201dhttps:\/\/www.nrdo.gov.sg\/publications\/cancer."},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.5732\/cjc.010.10547"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6603609"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0019100"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.7150\/jca.23755"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.26380"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers10040109"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.2910170102"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(83)90341-3"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.32774"},{"key":"e_1_2_10_15_1","first-page":"263","article-title":"Epstein Barr Virus (EBV) Antibodies in the Diagnosis of NPC\u2014Comparison Between IFA and Two Commercial ELISA Kits","volume":"39","author":"Chan S. 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