Dynamic relationship between infantile hepatitis syndrome and cytomegalovirus infection

Abstract

We investigated the correlation between cytomegalovirus (CMV) infection and infantile hepatitis syndrome and the correlation between blood ammonia levels in children with CMV-induced hepatitis syndrome and liver function indicators. To analyze the relationship between the positive-negative attributes of CMV infection and the recurrence rate of infantile hepatitis syndrome, a total of 86 cases of children with hepatitis syndrome admitted to Xuzhou Children's Hospital from January 2014 to March 2015 were selected for the study group. Furthermore, 86 cases of healthy children who visited our hospital for a physical examination during the same period were selected as the control group. From the two groups, serum CMV-immunoglobulin M (IgM) levels were determined via enzyme-linked immunosorbent assay, and urinary CMV-deoxyribonucleic acid (DNA) was ascertained by fluorescent ratio polymerase chain reaction. These levels were then compared between the two groups and analyzed. A fully automatic biochemical analyzer was utilized to evaluate the blood ammonia and liver function indicators of the children with infantile hepatitis syndrome induced by CMV infection and to analyze the correlation of these factors. A mean follow-up of 12 months after the children's discharge was adopted to observe the relationship between the negative-positive attributes of CMV infection and the recurrence rate in the children upon cure. The positive detection rate for the serum CMV-IgM was 24.4%, and that for the urinary CMV-DNA was 34.9%; both values were significantly higher than that for the control group (P<0.05). The blood ammonia levels of the children with infantile hepatitis syndrome induced by CMV infection were not correlated with the liver function indicators, such as total bilirubin, direct bilirubin, alanine aminotransferase, aspartate aminotransferase, γ-glutamyltransferase, total bile acid, and cholinesterase (P>0.05), but they were negatively correlated with blood albumin (ALB) (P<0.05). The recurrence rate of hepatitis syndrome among the children with negative CMV infection was 3.8%, which was significantly lower than that among the children with positive CMV infection (62.5%, P<0.05). A significant correlation was found between CMV infection and infantile hepatitis syndrome, with the former being a risk factor for the latter. Changes in the conditions of infantile hepatitis syndrome may be reflected by blood ammonia and ALB indicators. Through improved monitoring, these indicators facilitate the early diagnosis and treatment of children with hepatitis syndrome induced by CMV infection. Sufficient attention should be paid to preventive measures to reduce the incidence rate of infantile hepatitis syndrome.

Clinical characteristics of Chinese children with liver function test abnormalities: A single-center retrospective study

“…Liver damage caused by CMV infection tends to occur in infancy [11], and most infants infected with EBV have a recessive infection [12]. The liver function damage caused by EBV is not due to the damage to the liver cells caused by the virus itself, but rather by the indirect immune damage to the liver cells caused by EBV as a promoter [13]. Kofteridis et al reported that liver injury caused by EBV infection is very common, and most cases have no obvious symptoms; however, in some cases, although there are no symptoms, EBV infection can still lead to fulminant hepatitis [13].…”

“…The liver function damage caused by EBV is not due to the damage to the liver cells caused by the virus itself, but rather by the indirect immune damage to the liver cells caused by EBV as a promoter [13]. Kofteridis et al reported that liver injury caused by EBV infection is very common, and most cases have no obvious symptoms; however, in some cases, although there are no symptoms, EBV infection can still lead to fulminant hepatitis [13]. Bacterial and mycoplasma infections were also common causes of abnormal liver function in our study.…”

Acute murine cytomegalovirus infection boosts cell-type specific response and lipid metabolism changes in the liver of infant mice

“…Acquired CMV infection is asymptomatic in a majority of immunocompetent hosts; however, its effects in infants and immunocompromised patients are severe ( 4 ). Due to an immature and developing immune system, newborns have an increased vulnerability to infectious disease, including hepatitis, a common complication of CMV infection, especially neonatal hepatitis ( 5 ).…”