European Journal of Pediatrics

, Volume 168, Issue 4, pp 469–476

Incidence of hepatotropic viruses in biliary atresia

  • Stefan Rauschenfels
  • Miriam Krassmann
  • Ahmed N. Al-Masri
  • Willem Verhagen
  • Johannes Leonhardt
  • Joachim F. Kuebler
  • Claus Petersen
Original Paper

DOI: 10.1007/s00431-008-0774-2

Cite this article as:
Rauschenfels, S., Krassmann, M., Al-Masri, A.N. et al. Eur J Pediatr (2009) 168: 469. doi:10.1007/s00431-008-0774-2

Abstract

Biliary atresia (BA) is the most frequent indication for paediatric liver transplantation. We tested the hypothesis of a viral aetiology of this disease by screening liver samples of a large number of BA patients for the common human hepatotropic viruses. Moreover, we correlated our findings to the expression of Mx protein, which has been shown to be significantly up-regulated during viral infections. Seventy-four liver biopsies (taken during Kasai portoenterostomy) were tested by polymerase chain reaction (PCR) for DNA viruses (herpes simplex virus [HSV], Epstein-Barr virus [EBV], varicella zoster virus [VZV], cytomegalovirus [CMV], adenovirus, parvovirus B19 and polyoma BK) and RNA viruses (enteroviruses, rotavirus and reovirus 3). Mx protein expression was assessed by immunohistochemistry. Virus DNA/RNA was found in less than half of the biopsies (8/74 CMV, 1/74 adenovirus; 21/64 reovirus, 1/64 enterovirus). A limited number presented with double infection. Patients that had detectable viral RNA/DNA in their liver biopsies were significantly older than virus-free patients (P = 0.037). The majority (54/59) of the liver biopsies showed expression of Mx proteins in hepatocytes, bile ducts and epithelium. Our data suggest that the known hepatotropic viruses do not play a major role in the aetiology and progression of BA. Their incidence appears to be, rather, a secondary phenomenon. Nonetheless, the inflammatory response in the livers of BA patients mimics that observed during viral infections.

Keywords

Biliary atresia Herpes viridae Adenovirus Enterovirus Reovirus 3 RNA DNA Mx protein 

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Stefan Rauschenfels
    • 1
  • Miriam Krassmann
    • 2
  • Ahmed N. Al-Masri
    • 2
  • Willem Verhagen
    • 3
  • Johannes Leonhardt
    • 2
  • Joachim F. Kuebler
    • 2
  • Claus Petersen
    • 2
  1. 1.Department of Pediatric Kidney and Liver Diseases and Metabolic DisordersHannover Medical SchoolHannoverGermany
  2. 2.Department of Pediatric SurgeryHannover Medical SchoolHannoverGermany
  3. 3.Department of VirologyHannover Medical SchoolHannoverGermany

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