Liver and intrahepatic bile ducts - nontumor
Viral hepatitis
Epstein-Barr virus hepatitis (EBV)

Author: Komal Arora, M.D. (see Authors page)

Revised: 3 November 2017, last major update May 2012

Copyright: (c) 2002-2017,, Inc.

PubMed Search: Epstein-Barr virus hepatitis[TIAB]

Cite this page: Arora, K. Epstein-Barr virus hepatitis (EBV). website. Accessed July 21st, 2018.
Definition / general
  • Affects immunocompetent and immunocompromised
  • Usually acute self limited disease resembling infectious mononucleosis; rarely causes hepatic failure and death in patients with immunodeficiency syndromes
  • Elevated transaminase levels (80%), high EBV serum viral load; elevated bilirubin in only 7%
  • In some cases, infiltrating CD8+ T cells but not hepatocytes, are infected with EBV (Hum Pathol 2001;32:757)
  • May cause polymorphic B cell hyperplasia or lymphoma in immunocompromised
Microscopic (histologic) description
  • Predominantly sinusoidal infiltrate of atypical T lymphocytes with minimal necrosis
  • Presence of atypical lymphocytes may coincide with Downey cells in peripheral blood
  • Associated with viral associated hemophagocytic syndrome, with prominent erythrophagocytosis by sinusoidal Kupffer cells and portal histiocytes
  • Variable mitotic figures and small epithelioid granulomas
  • No bile duct injury or venulitis
Microscopic (histologic) images

Images hosted on other servers:

without hepatocyte

regeneration with
binucleated figures
and mitotic activity

Positive stains
  • EBV antigen, EBV encoded RNA (EBER)