Characteristics of Epstein–Barr virus hepatitis among patients with jaundice or acute hepatitis
Article first published online: 3 MAY 2012
© 2012 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 36, Issue 1, pages 16–21, July 2012
How to Cite
Vine, L. J., Shepherd, K., Hunter, J. G., Madden, R., Thornton, C., Ellis, V., Bendall, R. P. and Dalton, H. R. (2012), Characteristics of Epstein–Barr virus hepatitis among patients with jaundice or acute hepatitis. Alimentary Pharmacology & Therapeutics, 36: 16–21. doi: 10.1111/j.1365-2036.2012.05122.x
- Issue published online: 1 JUN 2012
- Article first published online: 3 MAY 2012
- Manuscript Accepted: 16 APR 2012
- Manuscript Revised: 13 APR 2012
- Manuscript Revised: 23 JAN 2012
- Manuscript Received: 19 DEC 2011
Abnormal liver blood tests are common in Epstein–Barr virus (EBV) infection, but symptomatic hepatitis is rare. The demographics, clinical features and outcome of EBV hepatitis are incompletely understood, particularly in the elderly people.
To identify the demographics, presenting features and natural history of EBV hepatitis.
Retrospective review of 1995 consecutive patients attending the jaundice hotline clinic over a 13-year period. Data collected included demographic information, presenting features, clinical and laboratory parameters, radiology imaging and clinical outcome.
Seventeen of 1995 (0.85%) had EBV hepatitis. The median age was 40 years (range 18–68 years). Ten of 17 (59%) patients were aged >30 years, and seven of 17 (41%) patients were aged ≥60 years. Fifteen of 17 (88%) patients presented with clinical/biochemical evidence of jaundice. Seventeen of 17 (100%) patients had a serum lymphocytosis at presentation. 2/17 (12%) patients with EBV hepatitis presented with the classical features of infectious mononucleosis (fever, sore throat and lymphadenopathy). Splenomegaly was present in 15/17 (88%) of patients. Symptoms lasted for a median 8 weeks (range 1–12 weeks). Three of 17 (18%) patients required a brief hospital admission.
In patients presenting with jaundice/hepatitis, EBV hepatitis is an uncommon diagnosis and causes a self-limiting hepatitis. The diagnosis is suggested by the presence of a lymphocytosis and/or splenomegaly. The majority of patients do not have infectious mononucleosis. Compared with infectious mononucleosis, EBV hepatitis affects an older age group, with nearly half of patients being aged more than 60 years. The diagnosis should be considered in all patients with unexplained hepatitis irrespective of their age.