Journal List > Korean J Pediatr Gastroenterol Nutr > v.14(1) > 1043530

Korean J Pediatr Gastroenterol Nutr. 2011 Mar;14(1):59-66. Korean.
Published online March 31, 2011.  https://doi.org/10.5223/kjpgn.2011.14.1.59
Copyright © 2011 The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition
Effects of Reactivation of Latent Epstein-Barr Virus Using Polymerase Chain Reaction on Acute Hepatitis A in Children
Seung Hyon Baek, M.D., Sang Yong Kim, M.D.,* and Hong Koh, M.D.*
Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
*Severance Pediatric Liver Disease Research Group, Severance Children's Hospital, Seoul, Korea.

Corresponding author (Email: khong@yuhs.ac )
Received August 09, 2010; Revised August 28, 2010; Accepted August 28, 2010.

Abstract

Purpose

We previously reported that concurrent reactivation of latent Epstein-Barr virus (EBV) in children with hepatitis A virus (HAV) infection is common and EBV reactivation with HAV infection adversely affects the clinical features of hepatitis. However, the incidence of concurrent reactivation was not accurate because the detection of EBV reactivation was based on serologic methods. Therefore, we studied the effects of polymerase chain reaction (PCR)-proven EBV reactivation, thus a more precise concurrence, on acute HAV infection in children.

Methods

PCR were conducted in 34 patients, who had enrolled previous study and diagnosed with acute HAV infection between January 2008 and June 2010. Their medical records were reviewed.

Results

Among 34 patients with acute HAV infection, 12 patients (35.3%) had EBV reactivation which was proven using serologic and molecular biologic techniques. There were significant differences in the peak levels of AST and ALT between the reactivated and non-reactivated groups (p=0.001 and p<0.001, respectively). The duration of full recovery from hepatitis was more prolonged in the reactivated group (p<0.001). Clinical parameters, such as serum protein (p<0.001) and albumin concentrations (p<0.001), atypical lymphocyte count (p=0.001), prothrombin time-international normalized ratio (PT-INR, p<0.001), and splenomegaly (p<0.001), showed significant differences. The clinical features in the reactivated sub-group >10 years of age revealed more liver dysfunction compared to the non-reactivated sub-group. A comparison with a previous study was performed.

Conclusion

PCR-proven reactivation of latent EBV in children with HAV infection is common and EBV reactivation with HAV infection adversely affects the clinical features of hepatitis, especially in older children.

Keywords: Epstein-Barr virus; Acute hepatitis A; Polymerase chain reaction

Tables


Table 1
Clinical Characteristics of the Patients and Correlation between Non-reactivated and Reactivated EBV Infection Groups
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Table 2
Clinical Characteristics and Correlation of Patients according to Status of EBV Infection in the Two Age Groups
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Table 3
Comparison between the Serologic and PCR Method Study Results
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Table 4
Comparison between Serologic and PCR Method Study according to Age Groups
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