A clinical study of chronic hepatitis B patients with Epstein-Barr virus infection

Objective To investigate the influence of Epstein-Barr virus ( EBV) infection on liver function and hepatitis B virus ( HBV) replication in chronic hepatitis B ( CHB) patients. Methods A total of 119 CHB patients who were admitted to The Affiliated Hospital of Xuzhou Medical University from January 2015 to August 2017 were enrolled, and according to the criteria for clinical grading of CHB, they were divided into mild group with 60 patients, moderate group with 38 patients, and severe group with 21 patients. Of all patients, 60 had CHB and EBV superinfection ( superinfection group) and 59 had CHB alone ( CHB group) . The two groups were compared in terms of the clinical data including sex, age, length of hospital stay, liver function parameters, HBV DNA quantification, routine blood test results, and coagulation function. The t-test and the Mann-Whitney U test were used for comparison of continuous data between two groups, and the chi-square test and the Fisher's exact test were used for comparison of categorical data between groups. Results The severe group had a significantly higher EBV DNA detection rate than the mild and moderate groups [76. 19% ( 16/21) vs 43. 33% ( 26/60) and 47. 37% ( 18/38) , χ2= 6. 727 and 4. 601, both P < 0. 05]. Compared with the CHB group, the superinfection group had significant increases in the length of hospital stay and the levels of alanine aminotransferase, aspartate aminotransferase, total bilirubin, direct bilirubin, and gamma-glutamyl transpeptidase ( t = 3. 523, 4. 085, 3. 755, 10. 976, and 8. 380, Z =-3. 474, all P < 0. 05) and significant reductions in prothrombin time activity and HBV DNA quantification ( t =-2. 501 and-6. 140, both P < 0. 05) . The superinfection group had significantly lower positive rates of HBeAg and HBV DNA than the CHB group ( both P < 0. 05) , and there were no significant differences between these two groups in lymphocyte percentage, albumin, white blood cell count, hemoglobin, and platelet count ( all P > 0. 05) . Conclusion In CHB patients, the risk of EBV superinfection or reactivation of latent EBV in the body increases with the severity of disease condition. EBV infection can aggravate patients' conditions and prolong the course of the disease, but it can reduce the serum level of HBV DNA, possibly by inhibiting the replication of HBV.