Incidence of hepatotropic viruses in biliary atresia.
Biliary atresia (BA) is the most frequent indication for paediatric liver transplantation. We tested the hypothesis of a viral aetiology of this disease by screening liver samples of a large number of BA patients for the common human hepatotropic viruses. Moreover, we correlated our findings to the expression of Mx protein, which has been shown to be significantly up-regulated during viral infections. Seventy-four liver biopsies (taken during Kasai portoenterostomy) were tested by polymerase chain reaction (PCR) for DNA viruses (herpes simplex virus [HSV], Epstein-Barr virus [EBV], varicella zoster virus [VZV], cytomegalovirus [CMV], adenovirus, parvovirus B19 and polyoma BK) and RNA viruses (enteroviruses, rotavirus and reovirus 3). Mx protein expression was assessed by immunohistochemistry. Virus DNA/RNA was found in less than half of the biopsies (8/74 CMV, 1/74 adenovirus; 21/64 reovirus, 1/64 enterovirus). A limited number presented with double infection. Patients that had detectable viral RNA/DNA in their liver biopsies were significantly older than virus-free patients (P = 0.037). The majority (54/59) of the liver biopsies showed expression of Mx proteins in hepatocytes, bile ducts and epithelium. Our data suggest that the known hepatotropic viruses do not play a major role in the aetiology and progression of BA. Their incidence appears to be, rather, a secondary phenomenon. Nonetheless, the inflammatory response in the livers of BA patients mimics that observed during viral infections.
Rauschenfels
Stefan
S
Department of Pediatric Kidney and Liver Diseases and Metabolic Disorders, Hannover Medical School, Hannover, Germany.
Krassmann
Miriam
M
Al-Masri
Ahmed N
AN
Verhagen
Willem
W
Leonhardt
Johannes
J
Kuebler
Joachim F
JF
Petersen
Claus
C
D000256:Adenoviridae / Q000302:isolation & purification; D001656:Biliary Atresia / Q000453:epidemiology / Q000821:virology*; D015415:Biomarkers / Q000378:metabolism; D015897:Comorbidity; D003587:Cytomegalovirus / Q000302:isolation & purification; D004279:DNA, Viral / Q000302:isolation & purification; D004770:Enterovirus / Q000302:isolation & purification; D005260:Female; D019204:GTP-Binding Proteins / Q000378:metabolism; D006518:Hepatitis Viruses / Q000302:isolation & purification* / Q000378:metabolism; D006525:Hepatitis, Viral, Human / Q000453:epidemiology* / Q000378:metabolism / Q000821:virology*; D014645:Herpesvirus 3, Human / Q000302:isolation & purification; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008099:Liver / Q000473:pathology / Q000821:virology; D008297:Male; D012089:Mammalian orthoreovirus 3 / Q000302:isolation & purification; D064547:Myxovirus Resistance Proteins; D016732:Parvovirus B19, Human / Q000302:isolation & purification; D011120:Polyomavirus / Q000302:isolation & purification; D012367:RNA, Viral / Q000302:isolation & purification; D012189:Retrospective Studies; D012401:Rotavirus / Q000302:isolation & purification; D018139:Simplexvirus / Q000302:isolation & purification
D015415:Biomarkers; D004279:DNA, Viral; D064547:Myxovirus Resistance Proteins; D012367:RNA, Viral; D019204:GTP-Binding Proteins