Abstract：Objective: To investigate the relationship between Epstein-Barr virus (EBV)-deoxyribonucleic acid (DNA) load and liver function damage in children with infectious mononucleosis (IM). Methods: Totally 126 IM children who were diagnosed in department of pediatrics of our hospital from February 2016 to March 2023 were included as the IM group, and 50 healthy children during the same period as the control group. The liver function indexes such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TBIL) were compared between the control group and the IM group. Children in the IM group were divided into liver damage subgroup (76 cases) and non-liver damage subgroup (50 cases) according to the presence or absence of liver function damage, and the levels of liver function indexes were compared. The correlation between EBV-DNA load and liver function damage was assessed by Spearman rank correlation analysis, and receiver operating characteristic (ROC) curve was drawn to analyze the predictive ability of EBV-DNA load and liver function damage. Results: The levels of ALT, AST, and TBIL in the IM group were significantly increased, and which were significantly higher than those in the control group (P<0.05). The levels of ALT, AST and TBIL and EBV-DNA load were significantly higher in the liver damage subgroup compared to the non-liver damage subgroup (P<0.05). Spearman rank correlation analysis showed that EBV-DNA load was positively correlated with ALT, AST, and TBIL (r=0.652, 0.628, 0.634, respectively; all P<0.05). Logistic regression analysis demonstrated that increased ALT, AST, TBIL and EBV-DNA load were influencing factors for liver function damage. ROC curve analysis results revealed that the area under the curve (AUC) of EBV-DNA load, ALT, AST, and TBIL alone in predicting liver function damage was 0.868, 0.830, 0.821 and 0.681, respectively, and while the AUC of combined prediction was 0.962, with the sensitivity of 0.908 and the specificity of 0.920. Conclusion: EBV-DNA load is closely related to the degree of liver function damage in IM children, and the risk of liver function damage is higher in the high load group, suggesting that the liver function indexes should be closely monitored in clinical management to relieve the risk of liver damage.
路璐, 姜丽娜, 王颖慧, 丁瑛雪, 杨兵宾. 传染性单核细胞增多症患儿EB病毒DNA载量与肝功能损害关系研究[J]. 河北医学, 2024, 30(12): 2033-2038.
LU Lu, JIANG Lina, WANG Yinghui, et al. Correlation between Epstein-Barr Virus DNA Load and Liver Function Damage in Children with Infectious Mononucleosis. HeBei Med, 2024, 30(12): 2033-2038.
[1] Rutkowska M,Pokorska-spiewak M.The influence of steroid therapy of complications of infectious mononucleosis on the course of Epstein-Barr virus hepatitis[J].Clin Exp Hepatol,2023,9(4):375-385. [2] Tan ET,Wilkinson D,Edafe O.The utility of liver function tests and abdominal ultrasound in infectious mononucleosis-A systematic review[J].Clin Otolaryngol,2022,47(6):611-619. [3] 李利,刘梅,毛国顺.传染性单核细胞增多症患儿合并肝功能损伤的临床特征和预后研究[J].中国感染与化疗杂志,2024,24(2):171-175. [4] 中华医学会儿科学分会感染学组,全国儿童EB病毒感染协作组.儿童主要非肿瘤性EB病毒感染相关疾病的诊断和治疗原则建议[J].中华儿科杂志,2016,54(8):563-568. [5] Qiu MZ,He CY,Lu SX,et al.Prospective observation:clinical utility of plasma epstein-barr virus DNA load in EBV-associated gastric carcinoma patients[J].Int Cancer,2020,146(1):272-280. [6] Sako K,Kenzaka T,Kumabe A.Epstein-Barr virus-associated infectious mononucleosis with acute epididymitis:a case report [J].BMC Infect Dis,2022,22(1):147. [7] Trunfio M,Sacchi A,Vai D,et al.Intrathecal production of anti-Epstein–Barr virus viral capsid antigen IgG is associated with neurocognition and tau proteins in people with HIV[J].AIDS,2023,38(4):477-486. [8] Yang X,Cui X,Yang X,et al.Liver involvement is associated with higher risk of rapidly progressive interstitial lung disease and mortality in anti-melanoma differentiation-associated gene 5 antibody- positive dermatomyositis[J].Inflamm Res.2024,17(17):3101-3113. [9] 金雪锋,贾晓怡,张颖,等.儿童传染性单核细胞增多症并发肝损害的因素分析及列线图的建立[J].中国妇幼健康研究,2022,33(6):112-116. [10] 杨幸幸,单鸣凤,孟慧.儿童传染性单核细胞增多症并发肺炎的影响因素分析及列线图模型的建立[J].中华全科医学,2023,21(12):2077-2080. [11] 李萍,安莉莉,韩冰.血清ADA、IL-10及TLR9与EBV相关传染性单核细胞增多症患儿EBV-DNA载量的相关性[J].国际检验医学杂志,2023,44(23):2924-2928.
2024, Vol. 30 
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