Concurrent reactivation of latent EBV with hepatitis A can affect clinical feature of childhood hepatitis.
OBJECTIVE
Some children with acute hepatitis A virus (HAV) infection have concurrent Epstein-Barr virus (EBV) reactivation serologically. We studied the frequency of EBV reactivation during HAV infection and determined whether simultaneous occurrence of EBV reactivation and HAV infection affected the clinical features of HAV infection.


METHODS
The medical records of patients under 19 years of age diagnosed with acute hepatitis A between January 1996 and June 2009 were reviewed.


RESULTS
Among 72 patients with acute hepatitis A, 22 patients (30.6%) had EBV reactivation. A markedly prolonged duration of full recovery from hepatitis was observed in reactivated group. The peak levels of AST and ALT in reactivated group were higher than non-reactivated group (p = 0.012 and p < 0.001, respectively). Higher peak levels of AST and ALT in reactivated subgroups over 10 years old were observed compared to non-reactivated subgroup (p = 0.027 and p = 0.001, respectively). Duration of recovery showed significant differences between two subgroups.


CONCLUSIONS
Concurrent reactivation of latent EBV and HAV infections is common. EBV reactivation with HAV infection adversely affects the clinical feature of hepatitis. Therefore, we should keep in mind that the concurrence especially in older children may cause worse injury to the liver.
Kim
S Y
SY
Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
Ryu
I S
IS
Baek
S H
SH
Chung
K S
KS
Koh
H
H
D000208:Acute Disease; D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D002648:Child; D020031:Epstein-Barr Virus Infections / Q000150:complications*; D005260:Female; D006506:Hepatitis A / Q000175:diagnosis / Q000276:immunology*; D017957:Hepatitis A Virus, Human / Q000276:immunology; D004854:Herpesvirus 4, Human / Q000276:immunology / Q000502:physiology*; D006801:Humans; D008297:Male; D014775:Virus Activation
D000914:Antibodies, Viral; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase