Cytomegaloviral hepatitis in children: current state of the problem

Cytomegalovirus infection is an infectious disease caused by the highly common herpes virus type 5, characterized by polytropic lesions of organs and systems, complex immunological reactions on the part of the macroorganism, with the formation of a long, often lifelong persistence of the virus in the body. Currently, there is an increase in the incidence of cytomegalovirus infection in all countries of the world. According to epidemiological data, most people become infected with cytomegalovirus during their lives. Thus, in Europe and the United States, 40-60% of the adult population is seropositive for cytomegalovirus; in developing countries, the prevalence of cytomegalovirus infection is even higher – 80% of children and almost the entire adult population. Among pregnant women, specific antibodies to cytomegalovirus are determined from 40% in developed to 100% in developing countries. The frequency of intrauterine transmission of cytomegalovirus ranges from 0,2-2,2%, averaging 1% in the population. The variety of clinical forms, from a subclinical course to the development of severe life-threatening forms in special, immunocompromised groups of patients, makes cytomegalovirus infection a complex and urgent problem of modern medicine. One of the main «target organs» for cytomegalovirus is the hepatobiliary system. A small number of observations, limited data on the pathogenesis of the development of liver damage in cytomegalovirus infection in children, as well as the lack of uniform regulatory documents for the diagnosis and treatment of these conditions in pediatric practice served as the basis for writing this article. The paper provides relevant data on the pathogenesis, clinical picture, diagnosis, as well as approaches to the treatment of cytomegalovirus hepatitis in children.

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