Clinical follow-up study of jaundice type of human cytomegalovirus hepatitis in infants / 临床儿科杂志

ABSTRACT

Objective To explore the recovery time of hepatic function in infants with jaundice type of human cytomega-lovirus (HCMV) hepatitis and its influencing factors. Methods The clinical data of 73 infants with jaundice type of HCMV hepa-titis admitted to hospital from February 2005 to October 2012 were retrospectively analyzed. The effects on hepatic function of nine factors including age, sex, liver size, total bilirubin (TBil), direct bilirubin (DBil), alanine aminotransferase (ALT), aspar-tate aminotransferase (AST), total bile acid (TBA) and the loads of HCMV DNA were assessed by Kaplan Meier method, and further analyzed by Cox proportional hazards regression model. Results The results of Cox proportional hazards regression showed that age≤3 month (RR=0.27, 95%CI0.10-0.70), DBil≤90μmol/L (RR=0.16, 95%CI0.08-0.32), male (RR=0.49, 95%CI0.26-0.94) and enlarged liver size<3 cm (RR=0.50, 95%CI0.27-0.93) were independent factors that shorten the time for TBil back to be normal. Furthermore, AST≤120 U/L (RR=0.16, 95%CI0.08-0.33) and enlarged liver size<3 cm (RR=0.28, 95%CI0.15-0.49) were independent factors that shorten the time for AST back to be normal. The time for TBil back to be normal was (2.23 ± 1.54) months, which was significantly shorter than that [(3.63 ± 1.93) months] of AST (t=10.37, P<0.001). Conclusions Jaundice type HCMV hepatitis had good outcome and varied in disease course. The recovery of hepatic function was significantly adversely affected by the degree of cholestasis and hepatomegaly as well as AST level, and early treatment was conducive to the recovery.