乙型肝炎与爱泼斯坦-巴尔病毒双重感染伴严重黄疸、凝血功能障碍及乙型肝炎病毒慢性化结局
Dual Infection with Hepatitis B and Epstein-Barr Virus Presenting with Severe Jaundice, Coagulopathy, and Hepatitis B Virus Chronicity Outcome.
作者信息
Rao Sirish C, Ashraf Imran, Mir Fazia, Samiullah Sami, Ibdah Jamal A, Tahan Veysel
机构信息
Department of Internal Medicine, University of Missouri Hospital , Columbia, MO, USA.
Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA.
出版信息
Am J Case Rep. 2017 Feb 16;18:170-172. doi: 10.12659/ajcr.901688.
Abstract
BACKGROUND Hepatitis B virus (HBV) has been reported as a coinfection with hepatitis C virus (HCV), hepatitis D virus (HDV), cytomegalovirus (CMV), and human immunodeficiency virus (HIV). CASE REPORT A 34-year-old female presented to our clinic with epigastric pain and severe acute hepatitis manifested as jaundice associated with hyperbilirubinemia, elevated transaminases, and coagulopathy. The patient was diagnosed with acute HBV with Epstein-Barr virus (EBV) coinfection leading to subsequent chronic hepatitis B. CONCLUSIONS To our knowledge, this patient case is the first reported case of HBV and EBV coinfection reported in the literature. HBV and EBV coinfection may cause severe acute hepatitis with HBV chronicity.
摘要
背景 据报道，乙型肝炎病毒（HBV）可与丙型肝炎病毒（HCV）、丁型肝炎病毒（HDV）、巨细胞病毒（CMV）和人类免疫缺陷病毒（HIV）合并感染。病例报告 一名34岁女性因上腹部疼痛和严重急性肝炎前来我院就诊，表现为黄疸伴高胆红素血症、转氨酶升高和凝血功能障碍。该患者被诊断为急性HBV与爱泼斯坦-巴尔病毒（EBV）合并感染，随后发展为慢性乙型肝炎。结论 据我们所知，该病例是文献中首次报道的HBV与EBV合并感染病例。HBV与EBV合并感染可能导致严重的急性肝炎并发展为慢性HBV感染。
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本文引用的文献
1
A Treatment Algorithm for the Management of Chronic Hepatitis B Virus Infection in the United States: 2015 Update.美国慢性乙型肝炎病毒感染管理治疗算法：2015 年更新。
Clin Gastroenterol Hepatol. 2015 Nov;13(12):2071-87.e16. doi: 10.1016/j.cgh.2015.07.007. Epub 2015 Jul 15.
2
Hepatitis B and human immunodeficiency virus co-infection.乙型肝炎与人类免疫缺陷病毒合并感染。
World J Gastroenterol. 2014 Dec 14;20(46):17360-7. doi: 10.3748/wjg.v20.i46.17360.
3
Cytomegalovirus infection and disease after allogeneic hematopoietic stem cell transplantation: experience in a center with a high seroprevalence of both CMV and hepatitis B virus.异基因造血干细胞移植后巨细胞病毒感染和疾病：高 CMV 和乙型肝炎病毒血清阳性率中心的经验。
Ann Hematol. 2012 Apr;91(4):587-95. doi: 10.1007/s00277-011-1351-8. Epub 2011 Oct 15.
4
Prevalence of human cytomegalovirus co-infection in patients with chronic viral hepatitis B and C: a comparison of clinical and histological aspects.慢性乙型和丙型病毒性肝炎患者中人类巨细胞病毒合并感染的患病率：临床和组织学方面的比较
J Clin Virol. 2009 Jul;45(3):212-7. doi: 10.1016/j.jcv.2009.05.009. Epub 2009 Jun 3.
5
Optimal treatment for chronic active Epstein-Barr virus disease.慢性活动性EB病毒病的最佳治疗方法。
Pediatr Transplant. 2009 Jun;13(4):393-6. doi: 10.1111/j.1399-3046.2008.01095.x.
6
Chronic hepatitis C responds poorly to combination therapy in chronic hepatis B carriers.慢性丙型肝炎对慢性乙型肝炎携带者的联合治疗反应不佳。
Neth J Med. 2008 May;66(5):191-5.
7
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Int J Med Sci. 2006;3(2):57-62. doi: 10.7150/ijms.3.57. Epub 2006 Apr 1.
8
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Curr Gastroenterol Rep. 2006 Feb;8(1):67-74. doi: 10.1007/s11894-006-0066-9.
9
A prospective clinical study of Epstein-Barr virus and host interactions during acute infectious mononucleosis.一项关于急性传染性单核细胞增多症期间爱泼斯坦-巴尔病毒与宿主相互作用的前瞻性临床研究。
J Infect Dis. 2005 Nov 1;192(9):1505-12. doi: 10.1086/491740. Epub 2005 Sep 26.
10
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Microbiol Immunol. 2002;46(8):579-82. doi: 10.1111/j.1348-0421.2002.tb02737.x.
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