巨细胞病毒感染和抗病毒治疗是否影响胆道闭锁的预后？一项真实世界的回顾性队列研究。
Does cytomegalovirus infection and antiviral therapy affect prognosis of biliary atresia? A real-world retrospective cohort study.
机构信息
Pediatric Research Institute of Hunan Province, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children's Hospital), Changsha, China.
Department of Fetal and Neonatal Surgery, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children's Hospital), Changsha, China.
出版信息
J Med Virol. 2024 Aug;96(8):e29842. doi: 10.1002/jmv.29842.
To explore the impacts of cytomegalovirus (CMV) infection and antiviral treatment (AVT) on native liver survival (NLS) in biliary atresia (BA) infants. This retrospective cohort study included infants diagnosed as BA between January 2015 and December 2021 at Hunan Children's Hospital. CMV infection was defined by DNA polymerase chain reaction alone (DNA data set) and combination of DNA and immunoglobulin M (CMV data set). In the DNA data set of 330 patients, 234 patients (70.9%) survived with their native liver in 2 years, with 113 (73.9%) in the DNA- cohort, 70 (65.4%) in the DNA+ and AVT- cohort and 51 (72.9%) in the DNA+ and AVT+ cohort, without significant differences by log-rank tests. In patients administrated between 2015 and March 2019, there were 206 evaluable patients in the DNA data set, with rates of 5-year NLS of 68.3% in the DNA- cohort, similar to that in the DNA+ and AVT+ cohort (62.2%, p = 0.546), but significantly higher than that in the DNA+ and AVT- cohort (51.4%, p = 0.031). Similar trends were also observed in the CMV data set, although statistically insignificant. CMV infection before or on the day of HPE can reduce the rate of 5-year NLS and AVT was recommended for CMV-infected BA infants.
探讨巨细胞病毒（CMV）感染和抗病毒治疗（AVT）对胆道闭锁（BA）婴儿固有肝脏存活率（NLS）的影响。本回顾性队列研究纳入了 2015 年 1 月至 2021 年 12 月在湖南省儿童医院诊断为 BA 的婴儿。CMV 感染仅通过 DNA 聚合酶链反应（DNA 数据集）和 DNA 与免疫球蛋白 M 的组合（CMV 数据集）来定义。在 330 例患者的 DNA 数据集中，234 例（70.9%）在 2 年内存活并保留其固有肝脏，其中 DNA 队列 113 例（73.9%），DNA+和 AVT-队列 70 例（65.4%），DNA+和 AVT+队列 51 例（72.9%），log-rank 检验无显著差异。在 2015 年至 2019 年 3 月期间接受治疗的患者中，DNA 数据集中有 206 例可评估患者，DNA-队列的 5 年 NLS 率为 68.3%，与 DNA+和 AVT+队列相似（62.2%，p=0.546），但显著高于 DNA+和 AVT-队列（51.4%，p=0.031）。CMV 数据集也观察到了类似的趋势，尽管统计学上无显著性。HPE 前或当天存在 CMV 感染可降低 5 年 NLS 率，建议对 CMV 感染的 BA 婴儿进行 AVT。
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