{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T13:43:37Z","timestamp":1792417417897,"version":"4.4.0"},"reference-count":29,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    This study aimed To describe the 10\u2010year temporal trends of serum Epstein\u2010Barr virus (EBV) DNA positivity among pediatric patients tested at Hangzhou Children's Hospital, and to explore demographic and seasonal variations across pre\u2010pandemic, pandemic, and post\u2010pandemic periods. A total of 11,689 serum samples from children aged 0\u201315 years who underwent EBV nucleic acid testing at Hangzhou Children's Hospital from January 2016 to December 2025 were retrospectively analyzed, including 2,160 positive results. Demographic characteristics (sex, age), visit type (outpatient\/inpatient), and temporal distributions (year, month) were examined. Monthly detection rates were calculated using monthly testing denominators. Group comparisons were performed using chi\u2010square tests; the linear\u2010by\u2010linear association Chi\u2010square test was applied to annual rates. Multivariable negative\u2010binomial regression with offset for monthly test volumes and interrupted time\u2010series analysis (ITSA) were used to evaluate independent associations with secular trend, seasonality, and pandemic phase. The overall EBV\u2010DNA detection rate was 18.48% (2,160\/11,689) among tested samples. A deduplication sensitivity analysis yielded a corrected patient\u2010level rate of 18.26%, confirming robustness. Females (20.04%) had a higher rate than males (17.26%, \u03c7\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u200914.66,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01). Outpatients (28.24%) showed a higher rate than inpatients (16.62%, \u03c7\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u2009141.6,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01). Age distribution was concentrated in children aged 1\u20138 years (86.02% of positives), peaking at 5 years (25.14%) and lowest in infants &lt;\u20091 year (2.46%). Annual detection rates rose from 7.25% (2016) to 29.69% (2025) (linear\u2010by\u2010linear association Chi\u2010square test,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01). Monthly detection rates suggested a descriptive bimodal pattern, with an autumn peak (September\u2013November, 21.07%) and a spring peak (March\u2013May, 17.88%), although formal testing did not reach statistical significance (joint Wald \u03c7\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u200914.72, df\u2009=\u200911,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.195). Across pandemic phases, unadjusted rates were 12.03% (pre\u2010pandemic), 19.61% (pandemic), and 21.64% (post\u2010pandemic). Multivariable negative\u2010binomial regression revealed that the long\u2010term secular trend was the only significant predictor (adjusted rate ratio [aRR]\u2009=\u20091.029 per month, 95% CI: 1.000\u20131.059,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.047), while pandemic phase (aRR\u2009=\u20091.171,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.347) and post\u2010pandemic phase (aRR\u2009=\u20091.233,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.288) were not significant. ITSA showed no significant level or slope changes at either breakpoint (all\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&gt;\u20090.05). In this hospital\u2010based tested population, serum EBV\u2010DNA positivity showed a significant upward secular trend over 2016\u20132025. The post\u2010pandemic increase was primarily driven by a pre\u2010existing secular trend rather than a discrete \u201crebound\u201d attributable to immunity debt. Due to selection bias from non\u2010standardized testing indications, these findings should not be generalized to the general pediatric community. Future studies with population\u2010based sampling and serological differentiation of primary infection versus reactivation are needed.\n                  <\/jats:p>","DOI":"10.1002\/jmv.71176","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T13:45:23Z","timestamp":1791812723000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Temporal Trends of Serum Epstein\u2010Barr Virus DNA Positivity Among Clinically Tested Pediatric Patients in Hangzhou, China, 2016\u20132025: A 10\u2010Year Retrospective Study"],"prefix":"10.1002","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7227-8222","authenticated-orcid":false,"given":"Xudong","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory Hangzhou Children's Hospital Hangzhou P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4711-1544","authenticated-orcid":false,"given":"Cuiying","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Hangzhou Children's Hospital Hangzhou P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2716-6264","authenticated-orcid":false,"given":"Jun","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Hangzhou Children's Hospital Hangzhou P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6223-0685","authenticated-orcid":false,"given":"Xiangyang","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Hangzhou Hospital of Traditional Chinese Medicine Hangzhou P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0777-8547","authenticated-orcid":false,"given":"Xinfeng","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Hangzhou Children's Hospital Hangzhou P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2018.03.001"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.24989"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1360\/SSV-2024-0191"},{"issue":"1","key":"e_1_2_10_5_1","first-page":"71","article-title":"Clinical Characteristics and Prognostic Analysis of Patients with EBV\u2010Positive Diffuse Large B\u2010Cell Lymphoma","volume":"34","author":"Nan F. Y.","year":"2026","journal-title":"Journal of Experimental Hematology\/Chinese Association of Pathophysiology"},{"issue":"19","key":"e_1_2_10_6_1","first-page":"2415","article-title":"Research Progress in Detection Techniques for Epstein\u2010Barr Virus\u2010Associated Lymphomas","volume":"46","author":"Ou Z. J.","year":"2025","journal-title":"International Journal of Laboratory Medicine & Research"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-pathmechdis-012418-013023"},{"issue":"7","key":"e_1_2_10_8_1","first-page":"330","article-title":"Diversity of Epstein\u2010Barr Virus Infection and Its Significance","volume":"48","author":"Wu K.","year":"2021","journal-title":"Chinese Clinical Oncology"},{"issue":"12","key":"e_1_2_10_9_1","first-page":"1520","article-title":"Clinical Analysis of Six Pediatric Nasopharyngeal Carcinoma Cases and Literature Review","volume":"27","author":"Tang M. L.","year":"2025","journal-title":"Chinese Journal of Contemporary Pediatrics"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.virs.2022.07.007"},{"issue":"8","key":"e_1_2_10_11_1","first-page":"1519","article-title":"Clinical Characteristics of 141 Cases of Infectious Mononucleosis","volume":"17","author":"Yan Z. J.","year":"2025","journal-title":"Journal of Molecular Diagnostics Therapeutics"},{"issue":"7","key":"e_1_2_10_12_1","first-page":"793","article-title":"Progress in Treatment of Epstein\u2010Barr Virus\u2010Associated Hemophagocytic Lymphohistiocytosis in Children","volume":"45","author":"Wang Y. Y.","year":"2024","journal-title":"Sichuan Medical Journal"},{"issue":"4","key":"e_1_2_10_13_1","first-page":"148","article-title":"Changes in Lymphocyte Subsets in Infectious Mononucleosis and Chronic Active Epstein\u2010Barr Virus Infection","volume":"32","author":"Qian B.","year":"2025","journal-title":"Journal of Rare Uncommon Diseases"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph15122672"},{"issue":"5","key":"e_1_2_10_15_1","first-page":"681","article-title":"Research Progress on the Regulation of Host Immunity by EBV","volume":"13","author":"Zhang X.","year":"2023","journal-title":"Biotechnology Progress"},{"issue":"3","key":"e_1_2_10_16_1","first-page":"110","article-title":"Epidemiological Characteristics of Epstein\u2010Barr Virus Infection in Children","volume":"34","author":"Zhang Q.","year":"2023","journal-title":"Journal of Preventive Medicine & Public Health"},{"issue":"4","key":"e_1_2_10_17_1","first-page":"323","article-title":"Epidemiological Characteristics of Epstein\u2010Barr Virus Infection in Hospitalized Children in Hebei Children's Hospital","volume":"35","author":"Yan J. H.","year":"2020","journal-title":"Laboratory Medicine"},{"issue":"4","key":"e_1_2_10_18_1","first-page":"310","article-title":"Epstein\u2010Barr Virus Infection and Epidemiological Analysis in Children in Luohu District, Shenzhen","volume":"38","author":"Wang M.","year":"2020","journal-title":"Chinese Journal of Clinical Laboratory Science"},{"issue":"5","key":"e_1_2_10_19_1","first-page":"22","article-title":"Seroepidemiological Analysis of Epstein\u2010Barr Virus Infection in Pediatric Patients in Binzhou, Shandong","volume":"25","author":"Yang L.","year":"2014","journal-title":"Journal of Public Health and Preventive Medicine"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2023.1064330"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2023.01.002"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.28597"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.29561"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/189096"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-3062.2001.003002060.x"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/nri.2016.90"},{"issue":"10","key":"e_1_2_10_27_1","first-page":"865","article-title":"Seroepidemiological Analysis of Epstein\u2010Barr Virus Infection in Children in Shenyang from 2022 to 2023","volume":"53","author":"Sun J.","year":"2024","journal-title":"Journal of China Medical University"},{"issue":"20","key":"e_1_2_10_28_1","first-page":"3840","article-title":"Clinical Characteristics and Prognosis of Epstein\u2010Barr Virus\u2010Associated Hemophagocytic Syndrome","volume":"31","author":"Wang Y.","year":"2023","journal-title":"Modern Oncology"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.3390\/v17030375"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-025-11407-2"}],"container-title":["Journal of Medical Virology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmv.71176","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jmv.71176","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmv.71176","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T13:04:29Z","timestamp":1792415069000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jmv.71176"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":29,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/jmv.71176"],"URL":"https:\/\/doi.org\/10.1002\/jmv.71176","archive":["Portico"],"relation":{},"ISSN":["0146-6615","1096-9071"],"issn-type":[{"value":"0146-6615","type":"print"},{"value":"1096-9071","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-02-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71176"}}