Liver injury during Ebola virus infections: Characteristics and molecular mechanisms

Ebola virus (EBOV) causes severe and often fatal Ebola virus disease (EVD) in humans, posing a major threat to global public health. Since EVD was first identified in the Democratic Republic of Congo (DRC) in 1976, the World Health Organization (WHO) has declared it a Public Health Emergency of International Concern (PHEIC) on three occasions. EBOV infection is characterized by rapid progression from non-specific febrile illness to severe gastrointestinal symptoms, followed by hemorrhagic fever and multi-organ dysfunction, with case fatality rates reaching as high as 90%. The liver is a primary target of EBOV, and virus-induced liver injury is characterized by elevated aspartate aminotransferase (AST) levels, mild hyperbilirubinemia, impaired coagulation factor synthesis, hepatocyte necrosis, and robust inflammatory responses, all of which are closely correlated with disease severity and mortality risk. In this review, we summarize the characteristics and mechanisms of EBOV-induced liver injury, which may help to further elucidate the pathogenesis of EVD and provide novel strategies for combating EBOV infection.