Clinical characteristics and associated factors of cholestasis in infant's ≤3 months with cytomegalovirus infection.

OBJECTIVE

The clinical characteristics and contributing factors of cholestasis in infants with cytomegalovirus (CMV) infection remain incompletely understood. This study aimed to investigate the clinical features and associated factors of cholestasis in infants with CMV infection.

METHODS

This retrospective case-control study enrolled infants aged ≤3 months with confirmed CMV infection. Infants with cholestasis were classified as cases, and age-matched infants without cholestasis were randomly selected as controls in a 1:1 ratio. Clinical and laboratory characteristics were compared between groups. Factors independently associated with cholestasis were identified using multivariable logistic regression analysis, and a predictive nomogram was constructed accordingly. Furthermore, an exploratory phenotype axis framework was applied to delineate the multidimensional clinical characteristics of CMV-infected infants.

RESULTS

A total of 64 infants with CMV infection and cholestasis were included. Compared with controls, infants with cholestasis had a later onset and longer duration of jaundice, a lower rate of passing hearing screening, and longer hospital stays (all p < 0.05). Multivariable logistic regression revealed that delayed onset of jaundice was independently associated with cholestasis (aOR 1.247, 95% CI 1.101-1.412), whereas breastfeeding (aOR 0.408, 95% CI 0.159-0.840), higher total protein levels (aOR 0.882, 95% CI 0.797-0.976), and higher CD4+/CD8+ ratios (aOR 0.589, 95% CI 0.365-0.951) were inversely associated with the occurrence of cholestasis. Exploratory analysis indicated that infants with cholestasis exhibited a higher overall burden across multidimensional clinical phenotypes.

CONCLUSION

In infants with CMV infection, delayed onset of jaundice was independently associated with cholestasis, whereas higher total protein levels, higher CD4+/CD8+ ratios, and breastfeeding were associated with a lower risk.