Epstein-Barr Virus and Cytomegalovirus Infections of the Liver

Gastroenterol Clin North Am. 2020 Jun;49(2):331-346. doi: 10.1016/j.gtc.2020.01.008.

Abstract

Epstein-Barr virus (EBV) and cytomegalovirus (CMV) infections are common and are associated with a variety of liver manifestations. EBV and CMV infections, in immunocompetent hosts, commonly manifest as acute hepatitis, with severity varying from asymptomatic, self-limited icteric hepatitis to acute liver failure. Atypical manifestations, such as cholestasis, chronic hepatitis, precipitation of acute-on-chronic liver failure, and autoimmune hepatitis, are reported with EBV infection, whereas cholestasis, portal vein thrombosis, and Budd-Chiari syndrome are reported with CMV infection. In the setting of liver transplantation, CMV is the most common infectious complication and carries significant morbidity; EBV is the major cause of post-transplant lymphoproliferative disorders.

Keywords: Cytomegalovirus; Epstein-Barr virus; Hepatitis; Infectious mononucleosis; Liver; Transplantation.

Publication types

  • Review

MeSH terms

  • Cytomegalovirus Infections*
  • Epstein-Barr Virus Infections*
  • Hepatitis, Viral, Human / diagnosis
  • Hepatitis, Viral, Human / therapy
  • Hepatitis, Viral, Human / transmission
  • Hepatitis, Viral, Human / virology*
  • Humans
  • Immunocompromised Host
  • Liver Transplantation
  • Lymphoproliferative Disorders / virology
  • Postoperative Complications