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Published on: March 30, 2018
[Risk factors and regularity of transaminase elevation associated with primary Epstein-Barr virus infection in
1Department of Infectious Diseases, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China.
Insights
Pediatric primary Epstein-Barr virus (EBV) infection can cause elevated transaminases, with age being a significant risk factor. Most children recover within eight weeks, but monitoring is essential for managing liver enzyme levels.
Area of Science:
- Pediatrics
- Infectious Diseases
- Hepatology
Background:
- Pediatric primary Epstein-Barr virus (EBV) infection is common.
- Elevated transaminases (ALT, AST) can accompany EBV infection.
- Understanding risk factors and recovery patterns is crucial for clinical management.
Purpose of the Study:
- To identify risk factors for elevated transaminases in children with primary EBV infection.
- To analyze the recovery patterns of alanine transaminase (ALT) and aspartate transaminase (AST) levels.
- To determine the correlation between elevated transaminases and factors like age, gender, fever duration, and EBV-DNA load.
Main Methods:
- Retrospective analysis of clinical data from 399 children with primary EBV infection.
- Logistic regression used to assess correlations between elevated ALT/AST and clinical factors.
- Calculation of cumulative recovery rates for transaminase levels over time.
Main Results:
- Over half (51.9%) of the children experienced elevated transaminases.
- Age was identified as a significant risk factor for transaminase elevation (OR=1.13, P<0.05).
- Transaminases normalized within approximately 3 weeks for half of the patients and within 8 weeks for most.
Conclusions:
- Age is a key risk factor for transaminase elevation in pediatric primary EBV infection.
- Most children achieve normal transaminase levels within two months.
- The study provides insights into the clinical course and recovery of liver enzymes in EBV-infected children.
Abstract:
Objective: To explore the risk factors and regularity of pediatric primary Epstein-Barr virus (EBV) infection accompanied with elevated transaminase. Methods: Clinical data of 399 children diagnosed as primary EBV infection in the outpatient department, Children's Hospital of Fudan University from September 2016 to October 2017 were analyzed retrospectively. Logistic regression analysis was performed to determine the potential correlations between elevated alanine transaminase (ALT) or aspartate transaminase (AST) and age, gender, course of fever and plasma EBV-DNA load. The cumulative rates of elevated transaminase recovery to nomal at different times were caculated. Results: Among 399 children diagnosed with primary EBV infection, there were 219 males and 180 females. The age was (4.2±2.7) years. Among all cases, 51.9% (207/399) had elevated transaminase. In patients who had elevated ALT, 74.5% (149/200), 21.0% (42/200) and 4.5% (9/200) had mild (40-160 U/L), moderate (160-400 U/L) and severe (>400 U/L) elevation of ALT, respectively. In patients who had elevated AST, 83.8% (155/185), 11.9% (22/185) and 4.3% (8/185) had mild (40-160 U/L), moderate (160-400 U/L) and severe (>400 U/L) elevation of AST, respectively. Only age was correlated with the occurrence of elevated transaminase (OR=1.13, 1.10, both P<0.05). A total of 167 repeated tests were ordered in patients with elevated ALT and/or AST, including 113 cases with elevated ALT and 104 cases with elevated AST. The time of ALT and AST returned to normal were (24±13) days and (25±18) days respectively. The cumulative rates for ALT returned to normal within 1, 1-<4, 4-<8 weeks and more than 8 weeks were 2.7% (3/113), 54.0% (61/113), 79.6% (90/113) and 81.4% (92/113) respectively, and were 1.9% (2/104), 48.1% (50/104), 71.2% (74/104) and 74.0% (77/104) for AST. Conclusions: Age is a risk factor for transaminase elevation associated with primary EBV infection in children. The transaminases returned to normal within 3 weeks in half of the cases, and within 8 weeks in most cases.
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