Problems related to cytomegalovirus infection and biliary atresia
Date
2012-11
Authors
Zabiegaj-Zwick, C.
Nel, E. D.
Moore, S. W.
Journal Title
Journal ISSN
Volume Title
Publisher
Health and Medical Publishing Group (HMPG)
Abstract
Background. Human cytomegalovirus (CMV) infection is related
to biliary disease, being cholestatic in its own right. It has also been
associated with intrahepatic bile duct destruction and duct paucity,
indicating a possible role in the pathogenesis and progression
of extrahepatic biliary atresia (BA). BA patients who are CMV-IgM-positive appear to have greater liver damage than uninfected
patients, consequently affecting outcome.
Methods. We reviewed the medical records of 74 patients
diagnosed with hepatobiliary disease between 2000 and 2011,
assessing clinical outcome and potential risk factors. Patients,
categorised into those with and those without BA, were compared
in terms of CMV infection.
Results. The 74 patients included 39 (52%) BA and 35 non-BA
patients; following the exclusion of patients due to insufficient data,
27 (69%) BA and 31 non-BA patients were reviewed. Twenty-one
(78%) BA patients were CMV-positive (IgM/IgG), including 20
IgM-positive patients versus 8 in the non-BA group (p<0.01). Two
(7.5%) CMV-IgM-positive BA infants were HIV-exposed versus 7
(35%) in the non-BA group (p<0.01). Long-term outcomes included
3 deaths in the non-HIV CMV-positive group and a higher rate of
severe early liver damage, suggesting a poorer outcome in CMV affected
patients.
Conclusions. Our results suggest a correlation between CMV
exposure/infection and BA which affects clinical outcome. HIV positivity
does not preclude BA and should be investigated further.
Description
The original publication is available at http://www.samj.org.za
Keywords
Cytomegalovirus infections, Biliary atresia
Citation
Zabiegag-Zwick, C., Nel, E. D. & Moore, S. W. 2012. Problems related to cytomegalovirus infection and biliary atresia. South African Medical Journal, 102(11):890-892, doi:10.7196/SAMJ.6163.