{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T21:17:57Z","timestamp":1790371077992,"version":"4.1.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T00:00:00Z","timestamp":1740614400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100018684","name":"National Health Commission Scientific Research Fund","doi-asserted-by":"publisher","award":["WKJ-ZJ-2432"],"award-info":[{"award-number":["WKJ-ZJ-2432"]}],"id":[{"id":"10.13039\/501100018684","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018684","name":"National Health Commission Scientific Research Fund","doi-asserted-by":"publisher","award":["2024C03178"],"award-info":[{"award-number":["2024C03178"]}],"id":[{"id":"10.13039\/501100018684","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To evaluate the risk of hemophagocytic lymphohistiocytosis (HLH) linked to Epstein-Barr virus (EBV) infection in different lymphocyte subtypes during infectious mononucleosis (IM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with IM and patients with EBV-HLH were included within the Children's Critical EBV Infection cohort for a nested case-control study. Lymphocytes were isolated into T, B, and natural killer cells using magnetic bead sorting, followed by individual polymerase chain reaction testing. Receiver operating characteristic curve analysis identified subtype-specific cutoffs for EBV-HLH prediction. Kaplan-Meier and Cox regression analyses assessed viral load-HLH risk associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients with EBV-HLH exhibited significantly higher T-cell viral loads than patients with IM (median, 5.1 \u00d7 104 vs 6.0 \u00d7 102 copies\/106 cells). A T-cell viral load &amp;gt;1.5 \u00d7 104 copies\/106 cells was linked with higher incidences of viral sepsis, renal dysfunction, hepatic dysfunction, coagulation dysfunction, and cardiovascular dysfunction (odds ratios, 10.0, 4.7, 6.5, 15.7, and 6.5). This elevated T-cell viral load was a strong predictor for distinguishing EBV-HLH (AUC 0.815) and increased the risk of developing EBV-HLH (hazard ratio 4.7).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>High EBV DNA load in T cells can serve as a potential predictor for the development of EBV-HLH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiaf065","type":"journal-article","created":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T08:40:58Z","timestamp":1740472858000},"page":"212-219","source":"Crossref","is-referenced-by-count":7,"title":["High Epstein-Barr Virus DNA Load in T Cells Predicts Hemophagocytic Lymphohistiocytosis"],"prefix":"10.1093","volume":"232","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5477-1738","authenticated-orcid":false,"given":"Xiaohui","family":"Fang","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health , Hangzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanshan","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Xinhua Children's Hospital, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kang","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Xinhua Children's Hospital, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Cong","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health , Hangzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5543-6457","authenticated-orcid":false,"given":"Yujia","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health , Hangzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0561-308X","authenticated-orcid":false,"given":"Yan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health , Hangzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongqiang","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The Children's Hospital, Zhejiang 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