Evaluation Of EBV Infection Status And Immune Function In Patients With Hemophagocytic Syndrome

Objective:To investigate the clinical characteristics of EBV positive hemophagocytic syndrome patients and evaluate the immune status of these patients.Methods:The clinical data and related immunological indexes of 298 adult hemophagocytic syndrome patients who met the criteria of inclusion and exclusion in our hospital from January 2012 to December 2016 were analyzed retrospectively.Blood EBV-DNA>500 copies are defined as positive for EBV infection.SPSS19.0 software was used to compare the clinical and immunological differences between EBV infected patients and non EBV infected patients.And the correlation between the EBV-DNA levels and the clinical parameters were also determined.Results:Compared to EBV negative hemophagocytic syndrome patients,EBV positive ones had significantly higher tumor incidence(p=0.019)and higher mortality rate(46.67%,vs,34.97%).At the same time,platelet decreased significantly(73.65 + 55.65 vs 113.41 + 108.57,p=0.041),APTT significantly prolonged significantly(49.28 + 15.50 vs 37.70 + 13.97,p=0.000),total cholesterol was significantly decreased(3.32 + 1.23 vs 4.14 + 1.68,p=0.013),low density lipoprotein decreased significantly(1.73 + 0.85 vs 2.18 + 1.09,p=0.040),ferritin levels was significantly lower(8536.23 + 10688 vs 15504.46 + 199446.73,p=0.048).In the immunology aspect,t,EBV positive hemophagocytic syndrome patients had significantly higher C4(0.26 + 0.09 vs 0.21 + 0.10,p=0.018),and CD3+T cell count was significantly decreased(525.48 + 445.69 vs 865.85 + 839.89,p=0.041),CD8+T cell count was significantly decreased(238.13 + 264.34 vs 539.51 +774.84,p=0.035),the ratio of CD4/CD8 significantly increased(1.70 + 1.79 vs 0.91 + 0.98,p=0.023).Correlation analysis showed that APTT was positively related with EBV-DNA levels,(R=0.476,p=0.000);and PT was positively correlated with EBV-DNA(R=0.218,p=0.007);total bilirubin was positively related with EBV-DNA levels,(R=0.223,p=0.033);direct bilirubin was positively related with EBV-DNA levels,(R=0.288,p=0.005);low density lipoprotein was negatively related with EBV-DNA levels(R=-0.219,p=0.046);In the immunology aspect,the level of CD8 was negatively related with EBV-DNA levels(R=-0.359,p=0.002);the level of CD4/CD8 was positively related with EBV-DNA levels(R=0.402,p=0.000);C4 was positively related with EBV-DNA levels(R=0.418,p=0.000).Conclusion:The clinical parameters of EBV positive hemophagocytic syndrome patients are characterized by distinct clinical feature,they have higher tumor incidence and higher mortality.At the same time,in the immunology aspect,EBV infected patients had lower CD3+T and CD8+T cell counts and higher C4.And the CD8+T cell count and C4 were significantly correlated with the EBV-DNA levels.On the other side,The EBV virus may play an important role in the impairment of liver function in patients with hemophagocytic syndrome.