Study of histology,serology,urine HCMV-DNA-QPCR and on diagnosis of infantile cytomegalovirus hepatitis with cholestasis

Objective:To evaluate the feasibility and utility of Pathologic changes of liver biopsy,HCMV-IgM,urine HCMV-DNA-QPCR and inclusion detected in morning urine exfoliative cytes on diagnosis of cytomegalovirus infection in infantile hepatitis syndrome.Methods:Immediately early antigen(IEA)and early antigen(EA)of HCMV were detected in liver tissues by immunohistochemistry stain assay.Pathologic changes were compared between HCMV antigen positive samples and negative samples,and analyzed statistically by fisher exact test.Serum HCMV-IgM was detected by ELISA,urine HCMV-DNA was detected by real-time quantitative PCR assay and inclusion was detected in morning urine samples with Wright's staining under microscope.Specificities and sensitivities were evaluated.Results:HCMV-IEA/EA was positive in liver tissues of 22/36 cases.There was no significant difference in pathologic changes between HCMV-IEA/EA positive group and negative group under light microscope analyzed by SPSS software.There were significant differences for serum HCMV-IgM detection and urine HCMV-DNA real-time quantitative PCR assay(P0.01)and there was no significant difference for morning urine HCMV inclusion detection(P0.05)in HCMV-IEA/EA positive group and negative group.In HCMV-IEA/EA positive group,the specificity of serum HCMV-IgM detection,urine HCMV-DNA real-time quantitative PCR assay detection or morning urine HCMV inclusion detection was 71.4%,100% or 78.6% respectively.And the sensitivity was 81.8%,50.0% or 31.8% respectively.Conclusion:There are no specific pathologic changes in HCMV hepatitis in infants.Morning urine HCMV inclusion detection is not a specific method for the HCMV infection.Serum HCMV-IgM detection is still an expedient and utility method clinically.