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Age-Dependent Hepatic Involvement in Pediatric Epstein-Barr Virus Infection: Clinical Associations and Biochemical
Tuğba Gürsoy Koca1, Dicle Şener Okur2, Abdülkerim Elmas3
1Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition, Pamukkale University Faculty of Medicine, Denizli 20070, Türkiye.
Journal of Clinical Medicine
|March 28, 2026
Summary
Epstein-Barr virus (EBV) infection commonly causes hepatitis in children, particularly older ones. Most cases resolve with supportive care, with typical recovery within 20 days.
Area of Science:
- Pediatric Infectious Diseases
- Hepatology
- Virology
Background:
- Epstein-Barr virus (EBV) is a common childhood infection often associated with liver enzyme abnormalities.
- Hepatic involvement in pediatric EBV infection is typically self-limited, but data on predictors and recovery are limited.
Purpose of the Study:
- To determine the frequency and severity of liver involvement in children with primary EBV infection.
- To identify clinical and laboratory predictors of hepatitis in pediatric EBV infection.
- To analyze biochemical recovery patterns in pediatric EBV hepatitis.
Main Methods:
- Retrospective cohort study of children (0-18 years) with confirmed primary EBV infection.
- Exclusion of co-infections, chronic liver disease, and hepatotoxic drug exposure.
- Definition of hepatic involvement as elevated ALT; logistic regression used to identify predictors.
Main Results:
- Hepatitis occurred in 59.2% of 294 pediatric EBV cases.
- Older age was an independent predictor of hepatitis (OR 1.010 per year increase, p < 0.001).
- Median time to ALT normalization was 20 days; no acute liver failure observed.
Conclusions:
- Hepatic involvement is frequent in pediatric EBV infection, with higher incidence in older children.
- Biochemical recovery is typical, and all patients experienced full recovery with supportive care.
- Understanding age-related risks and recovery patterns can optimize management and reduce unnecessary investigations.
Keywords:
Epstein–Barr virusbiochemical recoveryhepatic involvementlogistic regressionpediatric cohortMore Related Videos
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