{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T14:07:10Z","timestamp":1773497230545,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T00:00:00Z","timestamp":1637193600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Since azathioprine is associated with lymphoproliferative disorders in Epstein\u2013Barr virus (EBV)\u2010na\u00efve patients with inflammatory bowel disease, guidelines advise avoidance. No recommendations exist for autoimmune liver disease (AILD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To evaluate EBV status and EBV\u2010related complications in paediatric AILD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Single\u2010centre, retrospective, observational study of paediatric AILD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 245 paediatric patients with AILD, azathioprine was used in 168 (68.6%) and mycophenolate mofetil in 69 (28.2%). EBV status was assessed in 18 (10.7%) prior to azathioprine and 6 (8.7%) MMF. Acute EBV infection was diagnosed in five patients while on immunosuppression, resulting in one transient hepatitis and one persistent hepatitis. There were no cases of lymphoproliferative disorder in native livers. Liver transplantation (LT) was performed in 39 (15.9%) patients, with 8 EBV IgG\u2010negative at LT. Post\u2010LT EBV viraemia developed in 29 (74.4%), first detected at median 26\u00a0days (IQR, 13\u201086). EBV IgG\u2010negative recipients had higher peak viraemia (266\u00a0984\u00a0IU\/mL [IQR, 41108\u20102429050] v 5333 [IQR, 2036\u201038770], <jats:italic>P<\/jats:italic>\u00a0=\u00a0.004) and longer time to peak viraemia (375\u00a0days [IQR, 251\u2010884] v 70 [IQR, 21\u2010604], <jats:italic>P<\/jats:italic>\u00a0=\u00a0.04). Early EBV\u2010associated post\u2010transplant lymphoproliferative disorder (PTLD) was diagnosed in two patients, both EBV\u2010IgG negative with prior azathioprine.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Real\u2010world data demonstrate that EBV serostatus is not routinely checked before immunosuppression for paediatric AILD. Lymphoproliferative disorder was not diagnosed in those with native livers; however, EBV IgG\u2010negative LT recipients receiving EBV IgG\u2010positive donor organs are at risk of early PTLD. Large multicentre studies with longer follow\u2010up are required to further evaluate the risk.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.16708","type":"journal-article","created":{"date-parts":[[2021,11,19]],"date-time":"2021-11-19T04:36:55Z","timestamp":1637296615000},"page":"455-463","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Epstein\u2013Barr virus status and immunosuppression use in paediatric autoimmune liver disease"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0344-0218","authenticated-orcid":false,"given":"Jeremy S.","family":"Nayagam","sequence":"first","affiliation":[{"name":"Institute of Liver Studies King\u2019s College Hospital  London UK"},{"name":"Department of Inflammation Biology King\u2019s College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael 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