Plasma Real Time-Quantitative Polymerase Chain Reaction of Epstein-Barr Virus in Immunocompetent Patients with Hepatitis
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
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.
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.
참고문헌 (25)
- Odumade OA, "Progress and problems in understanding and managing primary Epstein-Barr virus infections", Clin Microbiol Rev, 24, pp.193~209 (2011)
- Kofteridis DP, "Epstein Barr virus hepatitis", Eur J Intern Med, 22, pp.73~76 (2011)
- Kimura H, "Severe hepatitis caused by Epstein-Barr virus without infection of hepatocytes", Hum Pathol, 32, pp.757~762 (2001)
- Palanduz A, "Fulminant hepatic failure and autoimmune hemolytic anemia associated with Epstein-Barr virus infection", J Infect, 45, pp.96~98 (2002)
- Cheng CC, "Clinical manifestations and quantitative analysis of virus load in Taiwanese children with Epstein-Barr virus-associated infectious mononucleosis", J Microbiol Immunol Infect, 40, pp.216~221 (2007)
- Teramura T, "Quantitative analysis of cell-free Epstein-Barr virus genome copy number in patients with EBV-associated hemophagocytic lymphohistiocytosis", Leuk Lymphoma, 43, pp.173~179 (2002)
- Kasztelewicz B, "Epstein-Barr virus DNA load in peripheral blood mononuclear cells and whole blood from pediatric transplant recipients", Transpl Infect Dis, 13, pp.471~479 (2011)
- 백승현, "중합효소연쇄반응으로 확인된 엡스타인-바바이러스 재활성화가 소아 급성 A형 간염에 미치는 영향", Pediatric Gastroenterology, Hepatology & Nutrition, 14(1), pp.59~66 (2011), 대한소아소화기영양학회
- Kimura H, "Quantitative analysis of Epstein-Barr virus load by using a real-time PCR assay", J Clin Microbiol, 37, pp.132~136 (1999)
- Markin RS, "Manifestations of Epstein-Barr virus-associated disorders in liver", Liver, 14, pp.1~13 (1994)
- Petrova M, "Epstein-Barr virus: silent companion or causative agent of chronic liver disease?", World J Gastroenterol, 16, pp.4130~4134 (2010)
- 조대선, "소아의 전염성 단핵구증에서 사이토카인과 세포자멸사 연관 유전자의 발현의 변화", Korean Journal of Pediatrics, 52(12), pp.1348~1357 (2009), 대한소아과학회
- Gulley ML, "Laboratory assays for Epstein- Barr virus-related disease", J Mol Diagn, 10, pp.279~292 (2008)
- Luderer R, "Real-time Epstein-Barr virus PCR for the diagnosis of primary EBV infections and EBV reactivation", J Mol Diagn, 9, pp.195~200 (2005)
- Pitetti RD, "Clinical evaluation of a quantitative real time polymerase chain reaction assay for diagnosis of primary Epstein-Barr virus infection in children", Pediatr Infect Dis J, 22, pp.736~739 (2003)
- Bauer CC, "Serum Epstein- Barr virus DNA load in primary Epstein-Barr virus infection", J Med Virol, 75, pp.54~58 (2005)
- Maurmann S, "Molecular parameters for precise diagnosis of asymptomatic Epstein-Barr virus reactivation in healthy carriers", J Clin Microbiol, 41, pp.5419~5428 (2003)
- Liu Y, "Detection of Epstein-Barr virus DNA in serum or plasma for nasopharyngeal cancer: a meta-analysis", Genet Test Mol Biomarkers, 15, pp.495~502 (2011)
- Hara S, "Association of virus infected-t cell in severe hepatitis caused by primary Epstein-Barr virus infection", J Clin Virol, 35, pp.250~256 (2006)
- Drebber U, "The role of Epstein-Barr virus in acute and chronic hepatitis", J Hepatol, 44, pp.879~885 (2006)
- Cameron B, "Prolonged illness after infectious mononucleosis is associated with altered immunity but not with increased viral load", J Infect Dis, 193, pp.664~671 (2006)
- Suh N, "Epstein-Barr virus hepatitis: diagnostic value of in situ hybridization, polymerase chain reaction, and immunohistochemistry on liver biopsy from immunocompetent patients", Am J Surg Pathol, 31, pp.1403~1409 (2007)
- Yuge A, "Persistent hepatitis associated with chronic active Epstein-Barr virus infection", Pediatr Infect Dis J, 23, pp.74~76 (2004)
- Ma C, "Cytokine responses in a severe case of glandular fever treated successfully with foscarnet combined with prednisolone and intravenous immunoglobulin", J Med Virol, 81, pp.99~105 (2009)
- Ghosal R, "Infectious mononucleosis complicated by acute hepatitis and myocarditis: a response to corticosteroids", BMJ Case Rep (2009)[DOI]