Abstract：Objective To study the clinical and laboratory characteristics of chronic active Epstein-Barr virus(EBV) infection (CAEBV) in children and to provide a basis for the diagnosis and treatment of CAEBV. Methods The clinical data of 13 children with CAEBV, as well as 15 cases of acute EBV infection (AEBV) as controls, wereanalyzed, including clinical manifestations, EBV antibodies, EBV DNA, and peripheral blood lymphocyte subsets.Results Both groups of patients had infectious mononucleosis-like symptoms such as fever, hepatomegaly,splenomegaly, and lymphadenectasis, but CAEBV patients had a longer course of disease and continuous and recurrentsymptoms. Compared with the AEBV group, the CAEBV group had a significantly higher EBV DNA load in peripheralblood (P<0.05), a significantly higher VCA-IgG titer (P<0.05), and significantly lower numbers of white blood cells,lymphocytes, B cells, total T cells, CD4+ T cells, and CD8+ T cells in peripheral blood (P<0.05). Among 13 CAEBVpatients followed up, 8 cases died, 2 cases showed an improvement, 2 cases had a recurrence, and 1 case was lost tofollow-up after being transferred to another hospital. All the AEBV patients were cured and had no recurrence during theone-year follow-up. Conclusions The clinical manifestations of CAEBV vary in children. It is difficult to distinguish CAEBV from AEBV early. More attention should be paid to CAEBV because of its severe complications, poorprognosis, and high mortality. Measurement of EBV DNA load, VCA-IgG titer, and lymphocyte subsets in peripheralblood may be helpful in the diagnosis and differential diagnosis of CAEBV.
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