{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T14:56:03Z","timestamp":1789656963537,"version":"4.0.1"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,1]]},"abstract":"\n Background and Aim:<\/jats:title>\n Biliary atresia is known to have a multifactorial etiology and perinatal infection with hepatotropic viruses such as cytomegalovirus (CMV) is a probable trigger in a subset of patients. The aim of the current study is to evaluate the effects of CMV association of biliary atresia on the initial presentation of patients and their response to Kasai portoenterostomy.<\/jats:p>\n <\/jats:sec>\n \n Patients and Methods:<\/jats:title>\n \n We conducted a retrospective, single-center study on 20 patients of biliary atresia and classified them into two groups based on their CMV immunoglobulin M (IgM) positivity. We compared the age of initial presentation, the liver biochemistry at presentation, immediate and delayed follow-up, rate of jaundice clearance following Kasai portoenterostomy, and histopathology of liver between the two groups. Data were reported in terms of means, and\n P<\/jats:italic>\n < 0.05 was considered significant.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Out of 20 cases of biliary atresia, 60% (\n n<\/jats:italic>\n = 12) were CMV IgM positive. Infants with CMV-positive status were noted to be older at presentation (88.5 days [65\u2013150 days] vs. 83 days [45\u2013160 days]\n P<\/jats:italic>\n < 0.05) were more jaundiced at presentation (total bilirubin \u2013 13.51 mg\/dl [9.09\u201315.99 mg\/dl] vs. 11.83 mg\/dl [6.5\u201313.5 mg\/dl]\n P<\/jats:italic>\n < 0.05), had higher alkaline phosphatase (751.2 IU\/L [387\u20131951 IU\/L] vs. 621.75 IU\/L [172\u2013857 IU\/L]\n P<\/jats:italic>\n < 0.05), higher gamma-glutamyl transferase levels (505.58 IU\/L [376\u20131127 IU\/L] vs. 376.75 IU\/L [186\u2013624 IU\/L]\n P<\/jats:italic>\n < 0.05), and had higher incidence of splenomegaly. The rate of resolution of jaundice postKasai portoenterostomy was also evidently less in CMV-positive patients. Four out of 12 patients have bilirubin >2 mg\/dl at a 6-month follow-up.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n CMV-associated biliary atresia patients have delayed initial presentation and impaired jaundice clearance postKasai portoenterostomy. The role of antiviral therapy should be studied in this subset of patients.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jiaps.jiaps_92_22","type":"journal-article","created":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T10:55:00Z","timestamp":1716548100000},"page":"5-8","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":9,"title":["Effect of Cytomegalovirus Infection on Initial Presentation and Overall Prognosis of Biliary Atresia Patients"],"prefix":"10.4103","volume":"28","author":[{"given":"Ayushi","family":"Vig","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Poonam","family":"Elhence","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirtikumar J.","family":"Rathod","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shubhalaxmi","family":"Nayak","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avinash Sukdev","family":"Jadhav","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manish","family":"Pathak","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Saxena","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arvind","family":"Sinha","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,1,10]]},"reference":[{"key":"R1-20250528","doi-asserted-by":"crossref","first-page":"710450","DOI":"10.3389\/fped.2021.710450","article-title":"Prognosis of biliary atresia associated with cytomegalovirus: A meta-analysis","volume":"9","author":"Zhao","year":"2021","journal-title":"Front 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valganciclovir","volume":"49","author":"Shah","year":"2012","journal-title":"Indian Pediatr"},{"key":"R6-20250528","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1007\/s12519-008-0024-8","article-title":"Relationship between prognosis of biliary atresia and infection of cytomegalovirus","volume":"4","author":"Shen","year":"2008","journal-title":"World J Pediatr"},{"key":"R7-20250528","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1007\/s12098-022-04093-4","article-title":"Antiviral therapy in cytomegalovirus-associated biliary atresia","volume":"89","author":"Mathur","year":"2022","journal-title":"Indian J Pediatr"},{"key":"R8-20250528","doi-asserted-by":"crossref","first-page":"56","DOI":"10.7869\/tg.169","article-title":"Biliary atresia with cytomegalovirus infection and its response to ganciclovir","volume":"35","author":"Shah","year":"2014","journal-title":"Trop Gastroenterol"},{"key":"R9-20250528","doi-asserted-by":"crossref","first-page":"1941","DOI":"10.1016\/j.jpedsurg.2018.12.014","article-title":"Adjuvant therapy of cytomegalovirus IgM + ve associated biliary atresia: Prima facie evidence of effect","volume":"54","author":"Parolini","year":"2019","journal-title":"J Pediatr Surg"}],"container-title":["Journal of Indian Association of Pediatric Surgeons"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jiaps.jiaps_92_22","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:07:59Z","timestamp":1787774879000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jiaps.jiaps_92_22"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1]]},"references-count":9,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/jiaps.jiaps_92_22","relation":{},"ISSN":["0971-9261","1998-3891"],"issn-type":[{"value":"0971-9261","type":"print"},{"value":"1998-3891","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1]]},"assertion":[{"value":"2022-07-08","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-12","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}