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is an acute illness due to Epstein Barr virus infection, which occurs commonly
in young adults. Liver involvement in acute EBV infection occurs in up to 95%
of patients between the 6th and 15th day of illness and is usually mild .
Here we report on a 7-year-old girl treated by Gastroenterology, Hepatology,
and Nutrition Unit of Al-Adan Hospital pediatric Department, presented with
prolonged fever, lymphadenopathy, generalized edema, hyperbilurubi- nemia and
elevated liver enzymes secondary to EBV infection. This case represents a rare
presentation of common viral infection in pediatric population.
Mixed infection with hepatitis E virus
(HEV) in patients with chronic hepatitis B virus (HBV) infection is frequent.
HEV mixed infection often leads to activation of hepatic pathological changes
and worsens the inflammatory activity. However, it is not known clearly how
these two types of virus influence each other in human body. Intensive investigation
has revealed that HEV mixed infection inhibits HBV replication. We have just
encountered a relative rare case. The patient who was a HBV carrier and was
infected by HEV. Before he was infected by the HEV, the measurement of his HBV
DNA fixed quantity examination on fluorescence was <103 copies/ml; his
routine biochemistry was normal; and his anti HEV-IgM and anti-HEV-IgG appeared
to be negative reaction. After he was infected by HEV, his routine biochemistry
increased, and the measurement of his HBV DNA fixed quantity examination on
fluorescence was 8.51 × 105 copies/ml. It indicated that the replication of HBV
was activated after the patient infected HEV. Finally, he was dead. This case
revealed that HEV mixed infection may activate the replication of HBV, not
inhibit HBV replication, and demonstrated the needs for further studies about
the mechanism of the interaction of the two viruses.