Hepatic manifestations of Epstein-Barr viral infection

Little information exists in the international scientific or medical literature about the hepatic manifestations and complications of Epstein-Barr virus (EBV). The aim of this study was to describe a series of patients with hepatic manifestations of EBV infection. Our sample population was a series of patients whose hepatic dysfunction was correlated with a documented EBV infection. Serum concentrations of IgG and IgM antibodies against the EBV viral capsid antigen (anti-EBV VCA IgG), EBV early antigen, and EBV nuclear antigen (EBV-EBNA), and heterophilic antibodies were determined. The expression of latent membrane protein (LMP 1) was also evaluated in each patient.

The study included nine patients (six men, three women) with a mean age of 43.5 years. Five patients presented with recent clinical pictures suggestive of acute EBV infection. Five patients began with a cholestatic pattern. Two patients required liver biopsies. Those liver biopsies showed positive immunohistochemical staining for LPM 1. No fatalities were attributed to EBV infection. In conclusion, the bilirubin levels of patients with acute EBV infection differed from those reported in the medical literature. EBV infection should be considered in the differential diagnosis of patients with liver abnormalities or diverse hepatic manifestations, increased levels of aminotransferases, or a transitory cholestatic pattern with a favorable outcome.