Serum IgA antibodies to Epstein-Barr virus (EBV) early lytic antigens are present in primary EBV infection

Primary Epstein-Barr virus (EBV) infection is characterized by the presence of IgM antibodies to viral capsid antigen and the absence of antibodies to EB nuclear antigen. Here, using a flow cytometry-based assay, we investigated whether IgA antibodies are a marker for primary infection. Serum IgA antibodies in 15 individuals with primary EBV infection reacted with 15%-55.6% of HH514-16 Burkitt lymphoma cells expressing early lytic antigens (EAs), whereas IgA antibodies in serum samples from 15 healthy EBV-seropositive individuals reacted with 0.02%-2% of cells with EAs (P < .0001). IgA antibodies in primary infection were directed against the Bam Z Epstein-Barr replication activator (ZEBRA) (BZLF1) and diffuse EA (BMRF1) EAs. Thus, IgA antibodies to EBV EAs are produced during primary EBV infection and are likely to be stimulated as a result of lytic EBV replication in mucosal sites. Detection of IgA antibodies to EA may be developed into a diagnostic tool for primary EBV infection.