Pediatr Gastroenterol Hepatol Nutr.  2012 Mar;15(1):38-43.

Plasma Real Time-Quantitative Polymerase Chain Reaction of Epstein-Barr Virus in Immunocompetent Patients with Hepatitis

• Hong JH
• Bae YJ
• Sohn JH
• Ye BI
• Chun JK
• Kim HM

Abstract

PURPOSE
Epstein-Barr virus (EBV) hepatitis is a usually asymptomatic and self-limiting disease in immunocompetent patients. However, the range of severity is wide, and the serological diagnosis is typically difficult until the convalescent phase. Thus, we examined the value of plasma EBV DNA real-time quantitative polymerase chain reaction (RT-qPCR) in EBV hepatitis for the timely diagnosis and the relationship between EBV viral load and clinical severity.
METHODS
Sixty samples were confirmed as having EBV infection by RT-qPCR with the EBV BALF5 gene sequence. We examined the clinical characteristics of EBV hepatitis by reviewing medical records.
RESULTS
The median total duration of fever was 8 days (range: 0-13 days). The mean peak value of aspartate aminotransferase (AST) was 241+/-214 U/L, and the mean peak value of alanine aminotransferase (ALT) was 298+/-312 U/L. There was no correlation between the serum levels of liver enzyme and plasma EBV DNA titer (p=0.1) or between median total duration of fever and EBV DNA titer (p=0.056). The median age of the EBV VCA IgM-negative group was lower compared with the EBV VCA IgM-positive group in EBV hepatitis (2 years vs. 6 years, p=0.0009).
CONCLUSION
The severity of EBV hepatitis does not correlate with circulating EBV DNA load according to our data. Furthermore, we suggest that plasma EBV PCR may be valuable in young infants in whom the results of serology test for EBV infection commonly are negative.

Keyword

Epstein-Barr virus; Polymerase chain reaction; Hepatitis

MeSH Terms

Alanine Transaminase
Aspartate Aminotransferases
DNA
Epstein-Barr Virus Infections
Fever
Hepatitis
Herpesvirus 4, Human
Humans
Infant
Liver
Plasma
Polymerase Chain Reaction
Viral Load
Alanine Transaminase
Aspartate Aminotransferases
DNA

Figure

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  Fig. 1 The age difference between Epstein-Barr virus (EBV) IgM positive group and EBV IgM negative group. The median age of EBV IgM negative group was significantly younger than that of EBV IgM positive group (2 years of age vs. 6 years of age, p=0.0009). *p<0.001.

• 

  Fig. 2 The association between total fever duration and Epstein-Barr virus (EBV) DNA concentration. The correlation was not statistically significant (p=0.056).

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