{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T05:48:44Z","timestamp":1782366524330,"version":"3.54.5"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The clinical characteristics and contributing factors of cholestasis in infants with cytomegalovirus (CMV) infection remain incompletely understood. This study aimed to investigate the clinical features and associated factors of cholestasis in infants with CMV infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective case\u2013control study enrolled infants aged \u22643\u202fmonths with confirmed CMV infection. Infants with cholestasis were classified as cases, and age-matched infants without cholestasis were randomly selected as controls in a 1:1 ratio. Clinical and laboratory characteristics were compared between groups. Factors independently associated with cholestasis were identified using multivariable logistic regression analysis, and a predictive nomogram was constructed accordingly. Furthermore, an exploratory phenotype axis framework was applied to delineate the multidimensional clinical characteristics of CMV-infected infants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 64 infants with CMV infection and cholestasis were included. Compared with controls, infants with cholestasis had a later onset and longer duration of jaundice, a lower rate of passing hearing screening, and longer hospital stays (all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). Multivariable logistic regression revealed that delayed onset of jaundice was independently associated with cholestasis (aOR 1.247, 95% CI 1.101\u20131.412), whereas breastfeeding (aOR 0.408, 95% CI 0.159\u20130.840), higher total protein levels (aOR 0.882, 95% CI 0.797\u20130.976), and higher CD4\n                      <jats:sup>+<\/jats:sup>\n                      \/CD8\n                      <jats:sup>+<\/jats:sup>\n                      ratios (aOR 0.589, 95% CI 0.365\u20130.951) were inversely associated with the occurrence of cholestasis. Exploratory analysis indicated that infants with cholestasis exhibited a higher overall burden across multidimensional clinical phenotypes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      In infants with CMV infection, delayed onset of jaundice was independently associated with cholestasis, whereas higher total protein levels, higher CD4\n                      <jats:sup>+<\/jats:sup>\n                      \/CD8\n                      <jats:sup>+<\/jats:sup>\n                      ratios, and breastfeeding were associated with a lower risk.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmicb.2026.1860504","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T05:30:02Z","timestamp":1782365402000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical characteristics and associated factors of cholestasis in infant\u2019s \u22643\u202fmonths with cytomegalovirus infection"],"prefix":"10.3389","volume":"17","author":[{"given":"Wenmei","family":"Li","sequence":"first","affiliation":[{"name":"Department of Neonatology, Children\u2019s Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Children\u2019s Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haifeng","family":"Geng","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Children\u2019s Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinjing","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Children\u2019s Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caimei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Children\u2019s Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinghui","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Children\u2019s Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangfang","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Children\u2019s Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weifang","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Children\u2019s Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianmei","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Children\u2019s Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huawei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Children\u2019s Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Che","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Children\u2019s Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1111\/jvh.12374","article-title":"Hepatic involvement in congenital cytomegalovirus infection\u2014infrequent yet significant","volume":"22","author":"Bilavsky","year":"2015","journal-title":"J. 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Virol."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"149","DOI":"10.3389\/fmed.2020.00149","article-title":"Pediatric cholestatic liver disease: review of bile acid metabolism and discussion of current and emerging therapies","volume":"7","author":"Kriegermeier","year":"2020","journal-title":"Front. Med. (Lausanne)"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"100892","DOI":"10.1016\/j.lanepe.2024.100892","article-title":"Consensus recommendation for prenatal, neonatal and postnatal management of congenital cytomegalovirus infection from the European congenital infection initiative (ECCI)","volume":"40","author":"Leruez-Ville","year":"2024","journal-title":"Lancet Reg. Health Eur."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1007\/s00018-024-05369-y","article-title":"The battle between host antiviral innate immunity and immune evasion by cytomegalovirus","volume":"81","author":"Li","year":"2024","journal-title":"Cell. 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Hepatol."}],"container-title":["Frontiers in Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2026.1860504\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T05:30:03Z","timestamp":1782365403000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2026.1860504\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,25]]},"references-count":29,"alternative-id":["10.3389\/fmicb.2026.1860504"],"URL":"https:\/\/doi.org\/10.3389\/fmicb.2026.1860504","relation":{},"ISSN":["1664-302X"],"issn-type":[{"value":"1664-302X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,25]]},"article-number":"1860504"}}