687 Role of Intrauterine Cmv Infection in Formation of Biliary Atresia

Abstract

Aims To establish the role of congenital virus infection in formation of biliary atresia (BA). Methods 75 pts age from 1 to 9 months with the following diagnoses: BA - 44, PFIC2-9, Alagille syndrome-9, bile duct cyst -7, deficiency of a-1-antitrypsin (ZZ-phenotype)-4, perinatal sclerosing cholangitis-2, galactosemia-1 and one patient had hepatitis as a result of congenital general acute CMV infection. Among common examinations, laboratory tests and instrumental methods, following methods were used: DNA of CMV, HSV1.2, EBV, HBV and RNA of HCV was analyzed by PCR on biopsies of the liver, blood and urine, as well as histological examination of liver biopsy performed. Results Liver biopsy specimens were CMV DNA positive for the patient with congenital acute CMV infection, for 37 (84%) pts with BA, for 4 pts with Alagille syndrome, for 3 pts with bile duct cyst and for 1 child with PFIC2. EBV DNA test was positive only for 1 patient with BA and 1 with bile duct cyst. Presences of HSV1.2, HBV DNA and HCV RNA have not been found in all liver biopsy specimens. Blood samples were CMV DNA positive for the patient with congenital acute CMV infection, for 6 (14%) pts with BA. Urine samples were CMV DNA positive for the patient with congenital acute CMV infection, for 7 (16%) pts with BA and for 5 pts with Alagille syndrome. Conclusion We assume that intrauterine CMV infection may play an important role in pathogenesis of BA.