Abstract: Objective To compare and analyze the clinical features and prognosis of neonatal cytomegalovirus (CMV) infection and infant hepatitis syndrome (IHS). Methods From January 2018 to December 2020, 58 newborns with simple CMV infection (CMV group), 58 with IHS (IHS group) were enrolled. Among the newborns with IHS, 17 IHS newborns with non-CMV infection were collected as NCMV-IHS group, 41 IHS newborns with CMV infection were selected as the CMV-IHS group, and 58 healthy newborns were selected as the normal control group (NC group). The general clinical data, clinical manifestations, serum CMV-IgM and urine CMV-DNA test results of each group were compared, the serum total bilirubin (TBIL), γ-glutamyl transpeptidase (γ-GT), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and albumin (Alb) levels of each group were detected and compared. Results The ratios of jaundice, lymphadenopathy, hepatomegaly and splenomegaly in the IHS group were 93.10%, 25.86%, 81.03%, and 70.69%, respectively, which were higher than 50.00%, 5.17%, 12.07%, and 10.34% in the CMV group (P<0.05), and the ratios of jaundice and splenomegaly in the CMV-IHS group were higher than those in the NCMV-IHS group (P<0.05). The positive rates of CMV-IgM and CMV-DNA in the IHS group were 36.21% and 70.69%, respectively, and those in the CMV group were 44.83% and 84.48%, which were significantly higher than the 1.72% and 1.72% in the NC group (P<0.05). The serum levels of TBIL, γ-GT, ALT and AST in CMV group and IHS group were higher than those in the NC group, and these in IHS group were higher than those in CMV group (P<0.05); serum level of Alb in IHS group was lower than that in the CMV group and NC group (P<0.05). The ALT of the CMV-IHS group was (127.85±36.79) U/L, significantly higher than (106.01±31.03) of the NCMV-IHS group, while the Alb was (34.93±3.02) g/L in the CMV-IHS group, which was lower than (39.19±3.59) g/L of the NCMV-IHS group (P<0.05). 58 cases (100.00%) and 57 cases (98.28%) in the CMV group and IHS group were cured and discharged. After 6 months of follow-up, 5 cases (12.50%) in the CMV-IHS group had IHS recurrence, there was no recurrence in the NCMV-IHS group, the difference between the two groups was statistically significant (P<0.05). Conclusion Simple CMV infection lacks typical symptoms, while IHS infants have the main clinical manifestations including jaundice, hepatosplenomegaly, and CMV infection can induce IHS. The overall prognosis of neonatal CMV and IHS is good, but CMV infection may increase the risk of IHS recurrence.

Key words: Cytomegalovirus infection, Hepatitis syndrome, Newborns, Prognosis