{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T19:23:54Z","timestamp":1793215434666,"version":"4.5.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"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. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Infectious mononucleosis is often complicated by hepatic injury, in which Epstein\u2013Barr virus load and immune response may play important roles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the correlation between EBV-DNA viral load and lymphocyte subsets in patients with IM with hepatic injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted on children diagnosed with IM from January 2022 to August 2025. Patients were divided into hepatic injury group and non-hepatic injury group. EBV-DNA load, lymphocyte subsets (CD3+, CD4+, CD8+, CD19+, CD16+ CD56+) and liver function indicators were measured and analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 202 children, the hepatic injury group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009143) showed significantly higher EBV-DNA load (\n                      <jats:italic>t<\/jats:italic>\n                      \u2009=\u20094.844,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), increased CD8+ T cell percentage (\n                      <jats:italic>t<\/jats:italic>\n                      \u2009=\u20097.235,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), decreased CD4+\/CD8+ ratio (\n                      <jats:italic>t<\/jats:italic>\n                      \u2009=\u20099.876,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) and reduced NK cell percentage (\n                      <jats:italic>t<\/jats:italic>\n                      \u2009=\u20094.325,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). Liver function tests revealed significantly elevated ALT, AST, GGT and TBil (\n                      <jats:italic>t<\/jats:italic>\n                      \u2009=\u200915.678, 13.456, 8.923, 7.234,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), and decreased ALB (\n                      <jats:italic>t<\/jats:italic>\n                      \u2009=\u20095.678,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) in the hepatic injury group. Correlation analysis showed positive correlation between EBV-DNA load and CD8+ T cell percentage (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), and negative correlation with CD4+\/CD8+ ratio (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). Multivariate analysis identified high EBV-DNA load and elevated CD8+ T cell percentage as independent risk factors for hepatic injury (OR\u2009=\u20095.678, 1.456,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Elevated EBV-DNA load and an increased CD8+ T cell percentage are independently associated with hepatic injury in pediatric IM. Monitoring these parameters may help in identifying children at higher risk for hepatic involvement, although prospective validation is required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1735179","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T06:56:18Z","timestamp":1774421778000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["EBV-DNA viral load and lymphocyte subsets correlation in pediatric infectious mononucleosis with hepatic injury a retrospective cohort study"],"prefix":"10.3389","volume":"14","author":[{"given":"Zhi","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Pediatric Infectious Disease, Anhui Provincial Children\u2019s Hospital","place":["Hefei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zong-Tao","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Pediatric, Lixin Hospital of Chinese Medicine","place":["Bozhou, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing-Feng","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Disease, Anhui Provincial Children\u2019s Hospital","place":["Hefei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bi-Quan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Disease, Anhui Provincial Children\u2019s Hospital","place":["Hefei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Nephrology, Anhui Provincial Children's Hospital","place":["Hefei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"B1","first-page":"71","article-title":"Infectious 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