Zhang Y H, Li F, Zhou Y Y, Shi P, Cao L F, Wang J S, Shen J
Department of Infectious Disease, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China.
Clinical Research Unit, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China.
Zhonghua Er Ke Za Zhi. 2023 Mar 2;61(3):245-249. doi: 10.3760/cma.j.cn112140-20220825-00752.
To explore the characteristics of plasma Epstein-Barr virus (EBV) DNA in primary infection in pediatric cases. The laboratory and clinical data of 571 children diagnosed with EBV primary infection in Children's Hospital of Fudan University during September 1, 2017 to September 30, 2018 were retrospectively analyzed. According to the results of plasma EBV DNA, they were divided into positive group and negative group. According to the EBV DNA, they were devided into high plasma virol load group and low plasma virol load group. The Chi-square test, Wilcoxon rank sum test were used to compare the differences between groups. Among the 571 children with EBV primary infection, 334 were males and 237 were females. The age of first diagnosis was 3.8 (2.2, 5.7) years. There were 255 cases in positive group and 316 cases in negative group. The percentage of cases with fever,hepatomegaly and (or) splenomegaly, elevated transaminase in the positive group were higher than those in the negative group (235 cases (92.2%) . 255 cases (80.7%), χ=15.22, <0.001; 169 cases (66.3%) 85 cases (26.9%), χ=96.80, <0.001; and 144 cases (56.5%) 120 cases (38.0%), χ=18.27, <0.001; respectively).In the positive group, 70 cases were followed up for 46 (27, 106) days, 68 cases (97.1%) turned negative within 28 days, with the exception of 2 cases (2.9%) developed chronic active EBV infection by follow-up revision.There were 218 cases in high plasma viral DNA copies group and 37 cases in low copies group. More cases presented with elevated transaminases in the high plasma viral DNA copies group than those in the low group (75.7% (28/37) 56.0%(116/207), χ=5.00, 0.025).Both the positive rate of EBV DNA in peripheral blood leukocytes (84.2% (266/316) . 44.7% (255/571), χ=76.26, <0.001) and the copies of EBV DNA (7.0×10 (1.3×10, 3.0×10) 3.1×10 (1.6×10, 6.1×10) copies /L, =15.23, <0.001) were higher than that of plasma. In immunocompetent pediatric cases diagnosed as EBV primary infection, cases with positive plasma EBV DNA were prone to have fever, hepatomegaly and (or) splenomegaly, and elevated transaminase than those with negative plasma viral DNA. The plasma EBV DNA usually turns negative within 28 days after initial diagnosis.Most cases with high viral load in plasma showed elevated aminotransferase.
探讨儿童原发性感染中血浆爱泼斯坦-巴尔病毒（EBV）DNA的特征。回顾性分析2017年9月1日至2018年9月30日在复旦大学附属儿科医院确诊为EBV原发性感染的571例儿童的实验室及临床资料。根据血浆EBV DNA检测结果，将其分为阳性组和阴性组。根据EBV DNA水平，分为血浆病毒载量高组和低组。采用卡方检验、Wilcoxon秩和检验比较组间差异。571例EBV原发性感染儿童中，男性334例，女性237例。首次诊断年龄为3.8（2.2，5.7）岁。阳性组255例，阴性组316例。阳性组发热、肝肿大和（或）脾肿大、转氨酶升高的病例百分比高于阴性组（分别为235例（92.2%）、255例（80.7%），χ=15.22，<0.001；169例（66.3%）、85例（26.9%），χ=96.80，<0.001；144例（56.5%）、120例（38.0%），χ=18.27，<0.001）。阳性组70例随访46（27，106）天，68例（97.1%）在28天内转阴，随访复查发现2例（2.9%）发生慢性活动性EBV感染。血浆病毒DNA拷贝数高组218例，低拷贝数组37例。血浆病毒DNA拷贝数高组转氨酶升高的病例多于低拷贝数组（75.7%（28/37）、56.0%（116/207），χ=5.00，0.025）。外周血白细胞EBV DNA阳性率（84.2%（266/316）、44.7%（255/571），χ=76.26，<0.001）及EBV DNA拷贝数（7.0×10（1.3×10，3.0×10）拷贝/L、3.1×10（1.6×10，6.1×10）拷贝/L，=15.23，<0.001）均高于血浆。在诊断为EBV原发性感染的免疫功能正常儿童中，血浆EBV DNA阳性的病例比血浆病毒DNA阴性的病例更容易出现发热、肝肿大和（或）脾肿大以及转氨酶升高。血浆EBV DNA通常在初次诊断后28天内转阴。大多数血浆病毒载量高的病例转氨酶升高。
