Clinical features of liver injury associated with acute Epstein-Barr virus infection in adults: an analysis of 115 cases

Objective To investigate the clinical manifestations and features of laboratory examinations including liver function and peripheral blood lymphocyte subsets of adult patients with acute Epstein-Barr virus (EBV) infection, and to provide a basis for the diagnosis and treatment of liver injury associated with acute EBV infection in adults. Methods A retrospective analysis was performed for the clinical data of 115 adult patients with acute EBV infection and abnormal liver function who were treated from June 2009 to March 2016, and these patients were divided into two groups according to the presence or absence of jaundice. The influencing factors for jaundice were analyzed. The t-test was used for comparison of normally distributed continuous data between groups, the Wilcoxon test was used for comparison of non-normally distributed continuous data between groups, and the logistic regression analysis was used for univariate analysis. Results Of all patients, 106 (92. 2%) had pyrexia, 97 (84. 3%) had angina, 73 (63. 5%) had swelling of the tonsil, 73 (63. 5%) had superficial lymph node enlargement, and 74 (64. 4%) had splenomegaly. There were significant differences between the jaundice group and the non-jaundice group in terms of the percentage of peripheral blood lymphocytes (t =-2. 51, P = 0. 014) and the levels of alanine aminotransferase (ALT) (Z = 4. 93, P < 0. 001) , aspartate aminotransferase (AST) (Z = 5. 34, P < 0. 001) , gamma-glutamyl transpeptidase (Z =5. 26, P < 0. 001) , and alkaline phosphatase (ALP) (Z = 5. 29, P < 0. 001) . The logistic regression analysis showed that AST (OR =1. 008, 95% CI: 1. 003-1. 012, P < 0. 001) and ALP (OR = 1. 008, 95% CI: 1. 003-1. 013, P = 0. 001) were independent risk factors for the increase in total bilirubin (TBil) . Conclusion Liver injury associated with acute EBV infection mainly manifests as increases in ALT and AST, and common clinical manifestations include pyrexia, angina, swelling of the tonsil, cervical lymph node enlargement, and splenomegaly. AST and ALP are independent risk factors for the increase in TBil and provide a basis for clinical diagnosis.