Investigation And Analysis On Clinical Features Of Patients With Various Liver Diseases Complicated With Cytomegalovirus Infection

Background and aims:Cytomegalovirus(CMV)is a type of virus that is ubiquitous in nature but has strict species specificity.In the normal population,CMV infection is very common and the CMV infection rate reach more than 90%.The diagnosis and early treatment of CMV infection is very difficult owing to its variety of clinical symptoms and signs.CMV-induced liver injury is very similar with various liver diseases,which can easily be misdiagnosed and missed diagnosed and lost therapy opportunity.However,the investigation and analysis on clinical features of patients with various liver diseases complicated with CMV infection have not been carried out in detail.The aims of this study were to clarify the clinical characteristics of various liver diseases complicated with CMV infection and to highlight the diagnosis and differential diagnosis by comprehensive analyzing the clinical features of patients with various liver diseases who were admitted in the First Hospital of Jilin University due to positive for CMV antibodies and elevated in serum aminotransferases.Methods:Six hundred and twenty four patients with various liver diseases who had elevation of serum aminotransferases and undergone CMV antibody testing were enrolled in this retrospective analysis in First Hospital of Jilin University from January 2012 to December 2016.The patient's age,gender,symptoms,physical signs,and percentage of blood lymphocytes at the time of presentation.Liver function,various markers of hepatic virus,CMV serum antibodies and CMV DNA were collected.CMV DNA were detected in some patients with either positive for anti-CMV Ig M or positive for anti-CMV IgG from Serum Specimen Bank.Results:1.Of 624 inpatients with various liver diaseases who had elevated serum aminotransferases and positive for anti-CMV antibodies,32 were positive for CMV-IgM antibodies(5.13%),and 593 were positive for CMV-Ig G antibodies(95.03%).The total positive rate of anti-CMV antibodies was 95.35%.25 were positive for CMV DNA.2.A total of 40 patients was diagnosed as current CMV infection accounted for 6.24% of all patients with liver disease who had elevation of serum aminotransferases.3.Liver injured by CMV alone were 18 cases(45%).Of various liver diseases complicated with CMV infection,HBV-induced liver cirrhosis were 5(13%).In these 40 patients,21 were female and 19 were male.The ratio of male to female was approximately 1:1.The youngest is 17 years old and the oldest is 85 years old.4.Of 40 patients with CMV current infection,23 cases had fever,1 had lymphadenopathy,4 had hepatic splenomegaly,2 had rash.3 patients felt pharynx Pain or swelling in the throat.7 cases had elevated lymphocyte percentage in peripheral blood tests.5.Of 40 patients with current CMV infection,8 patients suffered from failure.One patient was discharged from hospital and one patient died.Another 6 patients have a good prognosis.Conclusions:There is a higher incidence of CMV current infection in liver diseases.The CMV infection alone or in combination with other pathogenic factor should be always considered when a patient had an elevation of serum aminotransferases.The accurate detecting rate can be increased by using combined detection of CMV-IgM and CMV-DNA.While the detecting rate of CMV current infection can be increased through determining CMVDNA when there is negative for CMV-IgM,positive for CMV-IgG and in presence of CMV-related symptoms.