Clinical features of chronic liver disease complicated with Epstein-Barr virus infection
Objective To analyze the clinical characteristics of Epstein-Barr virus(EBV)infection in patients with chronic liver disease,and explore the possible mechanism of the effect of EBV infection on the disease progression in patients with chronic liver disease.Methods A total of 221 patients with chronic liver disease who were hospitalized in the Infectious Diseases Department of the First Affiliated Hospital of Chongqing Medical University,from January 2019 to June 2023 were divided into EBV positive(EBV+)group and EBV negative(EBV-)group according to the inclusion and exclusion criteria,and the clinical characteristics of patients with chronic liver disease in the two groups were analyzed.The differential expression genes of lymphocytes in peripheral blood of EBV+group and EBV-group were screened through biogenic analysis on the GeneCards website,and four significantly differentially expressed genes were selected as target genes,namely TNF,TGF-β1,STAT3 and NPM1.qRT-PCR was used to further verify the differential expression of target genes in peripheral blood lymphocytes of patients with chronic liver disease in EBV+group and EBV-group.Results There were 92 patients(41.6％)with EBV+chronic liver disease,including 20 patients(21.7％)with chronic hepatitis B,42 cases(45.7％)of hepatitis B cirrhosis and 30 cases(32.6％)of non-hepatitis B cirrhosis.There were statistically significant differences in age and distribution(≥60 years old),red blood cell count,hemoglobin,albumin,alanine aminotransferase,aspartate aminotransferase,cholinesterase,alpha-fetoprotein,urea,Na+,D-dimer and fibrinogen degradation product(FDP)between the two groups(t/x2/Z=3.416,4.203,-2.567,-2.214,-2.876,-2.632,-2.586,-3.534,-2.221,-3.529,-3.453,-3.632,-4.346;all P＜0.05).Among 72 patients with liver cirrhosis in EBV+group,the absolute value of peripheral blood monocytes,percentage of monocytes,alanine aminotransferase,γ-glutamyl transpeptide,alpha-fetoprotein,prothrombin activity,fibrinogen and MELD model were compared between hepatitis B cirrhosis group and non-hepatitis B cirrhosis group,and there were statistically significant differences(Z/x2=-2.103,-2.004,-2.011,-3.248,-2.930,-1.985,-2.063,4.101;all P＜0.05).At the same time,peripheral blood of 11 patients with EBV+and 13 patients with EBV-were collected.According to the four target differential genes screened by the GeneCards website,the experimental verification showed that there were statistically significant differences in TNF gene expression in peripheral blood lymphocytes of the two groups of patients(Z=-2.206,P＜0.05).Conclusions The EBV infection rate was higher in patients with chronic liver disease,and age was a risk factor for infection.EBV infection mainly aggravated the damage of liver synthesis function;it might affect the immune state of the body by up-regulating the expression of TNF gene in peripheral blood lymphocytes,promoting the progression of chronic liver disease and affecting the prognosis of patients.
Chronic liver diseaseEpstein-Barr virusDifferential expression genesLiver function
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NSTL
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