ArticleHepatology communications2023
Cytomegalovirus in biliary atresia is associated with increased pretransplant death, but not decreased native liver survival.
Article in Hepatology communications, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 11 citations in OpenAlex.
- Diagnostic and management guidelines for biliary atresia in 2025.Hepatobiliary surgery and nutrition · 2026Review
- Pediatric Cholestasis: A Practical Approach to Histological Diagnosis.Diagnostics (Basel, Switzerland) · 2026Review
- HCMV infection disrupts barrier functions and promotes epithelial-mesenchymal transition in a cholangiocyte organoid model.Nature communications · 2026Article
- Enhancing prognostic insights in biliary atresia: implications of the iBALF score.Hepatobiliary surgery and nutrition · 2025Article
- Organoids in biliary atresia.World journal of pediatric surgery · 2025Review
- Considerable differences in management of cytomegalovirus infection in patients with biliary atresia.JPGN reports · 2024Article
- Biliary atresia.Nature reviews. Disease primers · 2024Review
- Cytomegalovirus infection in patients with biliary atresia-further questions and possible solutions.Hepatology communications · 2024Article
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9 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundBiliary atresia (BA) is likely caused by a common phenotypic response to various triggers; one proposed trigger, cytomegalovirus (CMV), may lead to worse outcomes. The aim of this study was to determine the severity of disease and pretransplant outcomes of infants with BA, who have evidence of CMV (CMV+) at diagnosis compared with CMV-negative (CMV-) infants.
methodsThe study used data and biospecimens from the Childhood Liver Disease Research Network PROBE study of cholestatic infants. Plasma obtained at the time of hepatic portoenterostomy (HPE) of 249 infants with BA was tested for CMV by DNA-PCR and CMV-IgM. Comparisons between CMV+ and CMV- infants were made using Wilcoxon rank sum, Student t test, chi-square, or Fisher exact test. Native liver survival (NLS) outcomes were analyzed using Kaplan-Meier and Cox regression adjusting for age at HPE; pretransplant patient survival outcomes were analyzed using a competing risk model and adjusting for age at HPE.
resultsCMV+ infants (n = 29, 12%) underwent HPE later (67.8±13.6 d vs. 55.1±18.5 d, p = 0.0005) and had higher baseline alkaline phosphatase and aminotransferases. There was no difference between groups in jaundice clearance or NLS. The subdistribution HR of pretransplant death for CMV+ infants adjusted for age at HPE was 3.8 (p = 0.034).
conclusionsCMV infection at the time of HPE in infants with BA is not associated with worse NLS despite the association with worse liver injury, older age at HPE, and increased risk of pretransplant death adjusted for age at HPE. Continued evaluation of the consequences of CMV infection and the effects of antiviral treatment should be explored.
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