Alanine aminotransferase elevation in hospitalized children with infectious mononucleosis: independent…

Cross-sectionalFrontiers in pediatrics· 2026

Alanine aminotransferase elevation in hospitalized children with infectious mononucleosis: independent associations with Epstein-Barr virus DNA load, age, and sex.

Songlin Gan, Yuan Tang, Lianying Jiang, Huazhuo Mai

Pediatric Infection & VaccinationCross-sectionalQ1IF 2.2

Each 10-fold rise in Epstein-Barr virus DNA load linked to ~38% higher ALT in hospitalized children

Alanine aminotransferase elevation in hospitalized children with infectious mononucleosis: independent associations with Epstein-Barr virus DNA load, age, and sex.

Songlin Gan … Huazhuo Mai

Frontiers in pediatrics · 2026 · Q1 in Pediatrics

Background

Alanine aminotransferase (ALT) elevation is common in pediatric infectious mononucleosis, but its relationship with Epstein-Barr virus (Epstein-Barr virus) DNA load, age, and sex remains incompletely defined.

Methods

In this single-center retrospective cross-sectional study, we included 365 children hospitalized with Epstein-Barr virus-associated infectious mononucleosis who had admission Epstein-Barr virus DNA quantification.

n = 365 children

Results

each tenfold rise in Epstein-Barr virus DNA load raised ALT levels

aOR 0.29 (95% CI 0.17 to 0.51)

null 1

0.17

0.51

CI excludes the null - significant

More results

In the primary logistic model, Epstein-Barr virus DNA load, age, and sex were associated with ALT elevation.

Compared with children aged <3 years, the adjusted odds ratios were 2.08 (95% CI: 1.15-3.74) for those aged 3-6 years and 5.89 (95% CI: 3.04-11.42) for those aged ≥6 years.

More results

Male sex was associated with lower odds of ALT elevation (adjusted odds ratio: 0.29, 95% CI: 0.17-0.51).

The Epstein-Barr virus DNA load-ALT association was similar across age groups and remained stable in sensitivity analyses.

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Conclusion

Among hospitalized children with Epstein-Barr virus-associated IM, higher Epstein-Barr virus DNA load, older age, and female sex were independently associated with ALT elevation, findings that may help contextualize ALT elevation at initial evaluation.

Alanine aminotransferase elevation in hospitalized children with infectious mononucleosis: independent associations with Epstein-Barr virus DNA load, age, and sex.

Alanine aminotransferase elevation in hospitalized children with infectious mononucleosis: independent associations with Epstein-Barr virus DNA load, age, and sex.

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