Wang Anrui, Dai Xiaoke, Yang Chenyu, Tan Bingqian, Zhang Mingman
Department of Hepatobiliary Surgery Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.
J Med Virol. 2025 Aug;97(8):e70562. doi: 10.1002/jmv.70562.
Chronic high Epstein-Barr virus (EBV) load (CHL) carriage has been closely associated with EBV infection after pediatric liver transplantation. Elevated tacrolimus (Tac) blood concentrations increased the risk of EBV-associated diseases. Tacrolimus intra-patient variability (Tac-IPV) help predict poor outcomes. This study examines whether Tac-IPV correlate with CHL carriage in living-donor-dominant pediatric liver transplantation. We analyzed the clinical data of 153 pediatric liver transplant recipients receiving Tac treatment with a 2-year follow-up period. Tac-IPV quantification as coefficient of variation (CV). CHL was defined as EBV DNA > 16,000 copies/mL in whole blood or > 200 copies/10 peripheral blood mononuclear cells in ≥ 50% of samples over 6 months. The results showed that 81 cases (52.94%) of recipients developed CHL after liver transplantation. CV-IPV (OR = 1.034, 95% CI: 1.006-1.063, p = 0.019) was an independent risk factor for CHL carriage. Additional risk factors included younger age, absence of mycophenolate mofetil use, and earlier timing of first EBV viremia. In conclusion, CHL carriage development in pediatric liver transplant recipients is positively correlated with Tac-IPV.
慢性高EB病毒（EBV）载量（CHL）携带与小儿肝移植后的EBV感染密切相关。他克莫司（Tac）血药浓度升高会增加EBV相关疾病的风险。他克莫司患者内变异性（Tac-IPV）有助于预测不良预后。本研究探讨在以活体供体为主的小儿肝移植中，Tac-IPV是否与CHL携带相关。我们分析了153例接受Tac治疗且随访2年的小儿肝移植受者的临床资料。Tac-IPV以变异系数（CV）进行量化。CHL定义为在6个月内，≥50%的样本中全血EBV DNA>16,000拷贝/mL或每10个外周血单个核细胞中>200拷贝。结果显示，81例（52.94%）受者在肝移植后出现CHL。CV-IPV（OR = 1.034，95%CI：1.006 - 1.063，p = 0.019）是CHL携带的独立危险因素。其他危险因素包括年龄较小、未使用霉酚酸酯以及首次EBV病毒血症出现时间较早。总之，小儿肝移植受者中CHL携带的发生与Tac-IPV呈正相关。
