[A study on virus localization and microcirculation in the liver in patients with epidemic hemorrhagic fever]

The findings in our clinical study was consistent with those reported by others that a temporary elevation of serum alanine aminotransferase activity is associated with epidemic hemorrhagic fever (EHF). However, the pathogenesis of the concomitant changes in liver function tests is still not clear. To clarify whether EHF virus is cytopathic or not for the liver, percutaneous liver biopsy was done in 19 patients with EHF within 3-12 days after the onset of symptoms. These liver biopsy specimens were examined with immunofluorescence assay and cell cultural technique, showing the presence of active viral replication in liver cells. Electron microscopy observation of the infected liver cells showed that ultrastructural distortions was accompanied by the existence of inclusion bodies of EHF virus in vacuoles of rough endoplasmic reticulum, endotheliocyte and microvilli. These findings strongly suggest that EHF virus may play a causative role in liver injury in patients suffering from EHF and hepatic microcirculation disturbance may be involved in the pathogenesis of EHF-related liver dysfunction as well.