{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T21:17:33Z","timestamp":1790371053468,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,3,21]],"date-time":"2017-03-21T00:00:00Z","timestamp":1490054400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The aim of the present study was to clarify the roles of cytomegalovirus (<jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content>), Epstein\u2013Barr virus (<jats:styled-content style=\"fixed-case\">EBV<\/jats:styled-content>), and human herpesvirus 6 (<jats:styled-content style=\"fixed-case\">HHV<\/jats:styled-content>\u20106) in immunocompetent children with acute liver dysfunction not resulting from hepatitis virus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Sixty\u2010eight children (median age, 3 years) hospitalized as a result of acute liver dysfunction were enrolled in this study. Hepatitis A, B, and C were excluded. The prevalence of <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> EBV<\/jats:styled-content>, and <jats:styled-content style=\"fixed-case\">HHV<\/jats:styled-content>\u20106 and viral <jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content> load in whole blood was prospectively evaluated on multiplex real\u2010time polymerase chain reaction (<jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 68 children with acute liver dysfunction, multiplex real\u2010time <jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content> was positive in 30 (44%). <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> EBV<\/jats:styled-content>, and <jats:styled-content style=\"fixed-case\">HHV<\/jats:styled-content>\u20106 <jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content> were detected in 13 (19%), 14 (21%), and seven (10%), respectively. Serum <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content> immunoglobulin (Ig)G\/IgM and <jats:styled-content style=\"fixed-case\">EBV<\/jats:styled-content> viral capsid antigen IgG\/IgM were measured in 40 (<jats:styled-content style=\"fixed-case\">CMV DNA<\/jats:styled-content> positive, <jats:italic>n<\/jats:italic> = 10; negative, <jats:italic>n<\/jats:italic> = 30) and 45 (<jats:styled-content style=\"fixed-case\">EBV DNA<\/jats:styled-content> positive, <jats:italic>n<\/jats:italic> = 14; negative, <jats:italic>n<\/jats:italic> = 31) of the 68 children, respectively. Eighteen percent (<jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content>, 7\/40) and 9% (<jats:styled-content style=\"fixed-case\">EBV<\/jats:styled-content>, 4\/45) were positive for both <jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content> and viral\u2010specific IgM. There was no significant difference in <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">EBV<\/jats:styled-content> viral load between IgM\u2010positive and \u2010negative children with viremia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> EBV<\/jats:styled-content>, and <jats:styled-content style=\"fixed-case\">HHV<\/jats:styled-content>\u20106 <jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content> were frequently detected in immunocompetent children with acute liver dysfunction, but primary <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">EBV<\/jats:styled-content> infection were confirmed in 10\u201320% of the children with acute liver dysfunction. The combination of <jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content> assay and serology is necessary to make a diagnosis of acute liver dysfunction due to primary <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> EBV<\/jats:styled-content> and\/or <jats:styled-content style=\"fixed-case\">HHV<\/jats:styled-content>\u20106 infection in immunocompetent children.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ped.13249","type":"journal-article","created":{"date-parts":[[2017,1,30]],"date-time":"2017-01-30T14:17:45Z","timestamp":1485785865000},"page":"551-556","source":"Crossref","is-referenced-by-count":17,"title":["Acute liver dysfunction not resulting from hepatitis virus in immunocompetent children"],"prefix":"10.1111","volume":"59","author":[{"given":"Tomoyuki","family":"Tsunoda","sequence":"first","affiliation":[{"name":"Department of Pediatric Hepatology and Gastroenterology Eastern Yokohama Hospital Kanagawa 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