Onpoaree N, Leelakanok N, Sanpavat A, Sintusek P. Epstein-Barr virus infection in children with liver transplantation. World J Hepatol 2026; 18(2): 113686 [DOI: 10.4254/wjh.v18.i2.113686]
Corresponding Author of This Article
Palittiya Sintusek, MD, PhD, Associate Professor, Center of Excellence in Thai Pediatric Gastroenterology, Hepatology and Immunology, Division of Gastroenterology, Department of Pediatrics, King Chulalongkorn Memorial Hospital, Chulalongkorn University, 1873 Rama IV, Pathumwan, Bangkok 10330, Thailand. palittiya.s@chula.ac.th
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Feb 27, 2026 (publication date) through Feb 12, 2026
Times Cited of This Article
Times Cited (0)
Journal Information of This Article
Publication Name
World Journal of Hepatology
ISSN
1948-5182
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Onpoaree N, Leelakanok N, Sanpavat A, Sintusek P. Epstein-Barr virus infection in children with liver transplantation. World J Hepatol 2026; 18(2): 113686 [DOI: 10.4254/wjh.v18.i2.113686]
Norrapat Onpoaree, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
Nattinee Leelakanok, Department of Radiology and Biomedical Imaging, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
Anapat Sanpavat, Department of Pathology, Chulalongkorn University, Bangkok 10330, Thailand
Palittiya Sintusek, Center of Excellence in Thai Pediatric Gastroenterology, Hepatology and Immunology, Division of Gastroenterology, Department of Pediatrics, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok 10330, Thailand
Author contributions: Onpoaree N and Sintusek P reviewed the literature and wrote the manuscript; Leelakanok N interpreted the radiological data and provided the radiological images; Sanpavat A interpreted the histopathological data and provided the histopathology images; Sintusek P provided the endoscopic images; all authors approved the final manuscript.
Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Palittiya Sintusek, MD, PhD, Associate Professor, Center of Excellence in Thai Pediatric Gastroenterology, Hepatology and Immunology, Division of Gastroenterology, Department of Pediatrics, King Chulalongkorn Memorial Hospital, Chulalongkorn University, 1873 Rama IV, Pathumwan, Bangkok 10330, Thailand. palittiya.s@chula.ac.th
Received: September 1, 2025 Revised: September 28, 2025 Accepted: December 16, 2025 Published online: February 27, 2026 Processing time: 165 Days and 1.5 Hours
Abstract
Epstein-Barr virus (EBV) infection commonly occurs in children, particularly in developing countries. Most children infected with EBV are asymptomatic, though some develop significant complications, including EBV-associated malignancies, hemophagocytic lymphohistiocytosis, and multiple sclerosis. In immunocompromised children, including those with liver transplantation, EBV infection manifests with a diverse spectrum of presentations, varying from asymptomatic to post-transplant lymphoproliferative disorder, which can evolve into lymphoma. Therefore, close monitoring, early detection, and prompt management are crucial. This review aimed to investigate the pathogenesis and manifestations of EBV in healthy children and those who underwent liver transplantation. The proposed algorithm for early EBV detection and management, along with case studies, is provided to help pediatricians increase their index of suspicion.
Core Tip: Epstein-Barr virus (EBV) infection is common and can cause serious complications in pediatric liver transplant recipients. Young children who are EBV-seronegative are at especially increased risk because primary infection or viral reactivation may progress to post-transplant lymphoproliferative disorder. Routine EBV viral load monitoring, timely immunosuppressive therapy adjustment, and early intervention are crucial to reduce morbidity and mortality. A deeper understanding of EBV pathogenesis, combined with individualized management strategies, is essential for improving long-term outcomes in this high-risk population.
