Division of Gastroenterology and Hepatology, Department of Medicine, Rajavithi Hospital, College of Medicine, Rangsit University, 2 Phayathai Road, Ratchathewi, Bangkok 10400, Thailand.
Division of Gastroenterology and Hepatology, Department of Medicine, University of Pennsylvania, 2 Dulles, 3400 Spruce Street, Philadelphia, PA 19104, USA.
Gastroenterol Clin North Am. 2020 Jun;49(2):331-346. doi: 10.1016/j.gtc.2020.01.008.
Epstein-Barr virus (EBV) and cytomegalovirus (CMV) infections are common and are associated with a variety of liver manifestations. EBV and CMV infections, in immunocompetent hosts, commonly manifest as acute hepatitis, with severity varying from asymptomatic, self-limited icteric hepatitis to acute liver failure. Atypical manifestations, such as cholestasis, chronic hepatitis, precipitation of acute-on-chronic liver failure, and autoimmune hepatitis, are reported with EBV infection, whereas cholestasis, portal vein thrombosis, and Budd-Chiari syndrome are reported with CMV infection. In the setting of liver transplantation, CMV is the most common infectious complication and carries significant morbidity; EBV is the major cause of post-transplant lymphoproliferative disorders.
EBV 和 CMV 感染很常见，与多种肝脏表现相关。在免疫功能正常的宿主中，EBV 和 CMV 感染通常表现为急性肝炎，严重程度从无症状、自限性黄疸性肝炎到急性肝衰竭不等。EBV 感染可表现为非典型表现，如胆汁淤积、慢性肝炎、急性加重慢性肝衰竭和自身免疫性肝炎，而 CMV 感染可表现为胆汁淤积、门静脉血栓形成和 Budd-Chiari 综合征。在肝移植中，CMV 是最常见的感染性并发症，具有显著的发病率；EBV 是移植后淋巴组织增生性疾病的主要原因。
