Analysis Of Clinical Characteristics And Risk Factors Of Children With CAEBV Infection

Objective:To explore the clinical characteristics of chronic active Epstein-Barr virus infection(CAEBV)in children,and analyze its clinical related risk factors to provide a reference for the early diagnosis and treatment of the disease.Methods:In this study,a total of 620 children hospitalized with EBV infection in the Department of Pediatric Hematology of Jilin University First Hospital from January2006 to January 2020 were collected,including 12 cases of CAEBV(including 5cases with EB virus-related hemophagocytic lymphohistiocytosis).(Epstein-Barr Virus Infection hemophagocytic lymphohistiocytosis,EBV-HLH),608 cases of infectious mononucleosis(IM)(58 of them combined with EBV-HLH),statistics of general data and clinical information of all children Clinical data such as manifestations,relevant laboratory examinations,treatment and prognosis.The children in the CAEBV group were regarded as the clinical case study group,and the children in the IM group were regarded as the clinical case control group.The clinical data of the two groups were statistically analyzed to obtain the clinical characteristics and related factors of CAEBV.Results:1.CAEBV patients account for 1.9% of all children with EBV infection.The ratio of CAEBV combined with EBV-HLH was 41.7%,and the ratio of IM combined with EBV-HLH was 9.5%.The incidence of CAEBV combined with EBV-HLH was higher(P<0.05).2.The sex ratio in the CAEBV group was 1.4:1,and the median age was 7.5years;the sex ratio in the IM group was 1.2:1,and the median age was 3.75 years.The ages of children in the CAEBV group were mostly between 3 to 7 years and 7 to 12 years,while the children in the IM group were mostly concentrated in children under 3 and 3 to 7 years old.There was no statistical difference in the sex ratio and age of the two groups of children(P>0.05).3.Comparison of clinical characteristics There were statistical differences between the two groups of children in the onset of insidious onset,heat history,hepatomegaly,and splenomegaly(P<0.05).4.Laboratory examination showed that the two groups of children with white blood cells,hemoglobin,platelets,lymphocyte percentage,neutrophil percentage,lymphocyte count,neutrophil count,total bilirubin,direct bilirubin,indirect bilirubin The comparison of blood lipids and ferritin was statistically different(P<0.05).The quantitative comparison of aspartate aminotransferase,alanine aminotransferase,albumin,lactate dehydrogenase and EBV-DNA had no statistical difference(P>0.05).5.In the comparison of the treatment effect,the CAEBV group was not effective with antiviral treatment alone,and there was a statistical difference between the two groups(P<0.05).6.During the follow-up,the proportion of children in the CAEBV group with repeated fever,persistent hepatosplenomegaly,and repeated liver injury was higher than that in the IM group,and the comparison between the two groups was statistically significant(P<0.05).7.All children in the IM group recovered.The CAEBV group showed a chronic disease process,5 cases died,and the mortality rate was 41.7%.8.Multivariate logistic regression analysis showed that insidious onset,moderate to severe liver and spleen enlargement,repeated fever,and repeated liver injury were independent risk factors for the onset of CAEBV.Conclusion:1.Most children with CAEBV have an insidious onset and often have HLH.Most of the children with liver and spleen are obviously enlarged,the antiviral treatment is not effective,the disease is repeated,and the prognosis is poor.2.When children with EBV infection have insidious onset,repeated fever,repeated liver injury,and moderate to severe liver and spleen enlargement,CAEBV should be paid attention to.