Abnormal liver function in children hospitalized with acute respiratory infection of adenoviruses: a retrospective study

Xingui Tian; Xiao Li; Shuyan Qiu; Rong Zhou; Wenkuan Liu

doi:10.1016/j.virs.2023.07.007

October 2023

Xingui Tian, Xiao Li, Shuyan Qiu, Rong Zhou and Wenkuan Liu. Abnormal liver function in children hospitalized with acute respiratory infection of adenoviruses: a retrospective study[J]. Virologica Sinica, 2023, 38(5): 735-740. doi: 10.1016/j.virs.2023.07.007

Citation: Xingui Tian, Xiao Li, Shuyan Qiu, Rong Zhou, Wenkuan Liu. Abnormal liver function in children hospitalized with acute respiratory infection of adenoviruses: a retrospective study .VIROLOGICA SINICA, 2023, 38(5) : 735-740. http://dx.doi.org/10.1016/j.virs.2023.07.007

急性呼吸道腺病毒感染住院患儿肝功能异常的回顾性研究

呼吸疾病全国重点实验室, 呼吸疾病国家临床研究中心, 广州呼吸健康研究院, 广州医科大学附属第一医院, 广州医科大学, 广州, 510182, 中国

通讯作者： 田新贵, xgtian@gzhmu.edu.cn; 周荣, zhourong@gird.cn; 刘文宽, ahlwk2000-2004@163.com
收稿日期： 2023-04-20
录用日期： 2023-07-27

摘要

人腺病毒(HAdVs)可引起免疫功能低下患者的急性肝炎，但是否是免疫功能正常儿童肝炎的致病因素尚不清楚。本研究回顾性分析了2016年1月至2019年10月因急性呼吸道腺病毒感染住院的儿童(小于14岁)的肝功能检查结果。分别有7.74%和46.89%的患者谷丙转氨酶(ALT)和谷草转氨酶(AST)水平升高，而ALT或AST水平超过上限 2倍的患者都是由HAdV-7或HAdV-55感染引起。HAdV-7感染患儿的ALT、AST、γ-谷氨酰转肽酶(γ-GT)水平显著高于HAdV-3感染患儿，而白蛋白水平显著更低。与其他型别腺病毒感染相比，HAdV-55感染导致患儿γ-GT、总胆红素和直接胆红素水平显著升高。对4例长期连续监测肝功能的患者进行了分析，发现这些患者在整个住院期间多项肝功指标异常。这些结果表明，感染腺病毒的免疫功能正常儿童通常伴有肝功能异常，HAdV-7和HAdV-55可能是儿童肝炎的未被充分认识的致病因素。
- 急性呼吸道疾病
- , 腺病毒
- , 肝炎
- , 肝功能检查
- , 肝酶

Abnormal liver function in children hospitalized with acute respiratory infection of adenoviruses: a retrospective study

State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, 510182, China

Corresponding author: Xingui Tian, xgtian@gzhmu.edu.cn Rong Zhou, zhourong@gird.cn Wenkuan Liu, ahlwk2000-2004@163.com
Received Date: 20 April 2023
Accepted Date: 27 July 2023

Abstract

Human adenoviruses (HAdVs) can cause acute hepatitis in immunocompromised patients. However, it is unclear whether HAdVs are contributors to hepatitis in immunocompetent children. In this study, the liver function test (LFT) results were retrospectively analyzed among children hospitalized (age <14 years) between January 2016 and October 2019 for acute respiratory infection caused by adenoviruses. Alanine transaminase (ALT) and aspartate aminotransferase (AST) levels were elevated in 7.74% and 46.89% of patients, respectively. All patients with >2 folds of the upper limit of ALT or AST levels were infected with HAdV-7 or HAdV-55. Significantly higher levels of ALT, AST, γ-glutamyl transpeptidase (γ-GT), and lower albumin levels were observed in the HAdV-7 infection group than in the HAdV-3 infection group. HAdV-55 infection led to significantly higher γ-GT, total bilirubin, and direct bilirubin levels than the other infection types. The records of four patients with serial monitoring of the LFT results were further analyzed. Multiple indicators remained abnormal during the entire hospitalization in these patients. These results indicate that HAdV infection is often accompanied by abnormal liver function, and HAdV-7 and HAdV-55 might be under-recognized contributors to hepatitis among children.
- Acute respiratory disease
- , Adenovirus
- , Hepatitis
- , Liver enzyme
- , Liver function test

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Electronic Supplementary Material

10.1016j.virs.2023.07.007-ESM.docx