Epidemiologic features of children with Epstein‐Barr virus associated diseases in Hangzhou, China

Abstract Epstein‐Barr virus (EBV) infection is the causative agent of multiple diseases. EBV DNA in blood is a useful diagnostic marker of primary EBV infection and reactivation. This study aimed to provide epidemiological information on children with EBV‐associated diseases identified by positive EBV DNA in Hangzhou, a city in East China. All children admitted to the Children's Hospital of Zhejiang University School of Medicine from 2010 to 2015 with suspected EBV‐related diseases and serum EBV DNA tested by quantitative real‐time polymerase chain reaction were included. Of the 10 470 children, 1205 were determined to have positive EBV DNA, and the positive rate was 11.5%. 15.8% (973 of 6162) of the illnesses of patients aged 1 to 7 years were caused by EBV as compared to that of 6.6% (179 of 2708) of children older than 7 years ( P < .01) and 3.3% (53 of 1600) of of that of infants <1 year of age ( P < .01). Among positive EBV DNA patients, 80.7% of EBV infections occurred in children at the age stage of 1 to 7 years. IM was the most common EBV‐related disease, accounting for 75.7% of 581 hospitalized patients. Children aged 1 to 3 years were the age group most commonly hospitalized with EBV‐IM (32.7% of the cohort) and EBV‐hemophagocytic lymphohistiocytosis (HLH) (52.6%), while EBV‐lymphoma was more common in children over 9‐year old (58.3% of the cohort). The serum EBV‐DNA load was much higher in patients with EBV‐HLH than in patients with IM ( P < .05). This is a large sample study, which revealed the epidemiological characteristics of children with EBV‐associated diseases, including age, monthly and disease distribution.