DETECTION OF REOVIRUS RNA IN HEPATOBILIARY TISSUES FROM PATIENTS WITHEXTRAHEPATIC BILIARY ATRESIA AND CHOLEDOCHAL CYSTS

Extrahepatic biliary atresia (EHBA) and choledochal cysts (CDC) are im portant causes of obstructive jaundice in pediatric patients. Viruses in general, and reoviruses in particular, have long been considered as possible etiologic agents responsible for inciting the inflammatory p rocess that leads to these infantile obstructive cholangiopathies, In an effort to determine whether reovirus infection is associated with t hese disorders, we used a sensitive and specific reverse-transcriptase polymerase chain reaction (RT-PCR) technique designed to amplify a po rtion of the reovirus L1 gene segment from extracts of liver and/or bi liary tissues. These tissues were obtained at the time of liver biopsy or surgical procedures from 23 patients with EHBA, 9 patients with CD C, and 33 patients with other hepatobiliary diseases. Hepatic and bili ary tissues obtained at autopsy from 17 patients who died without know n liver or biliary disease were also analyzed. Reovirus RNA was detect ed in hepatic and/or biliary tissues from 55% of patients with EHBA an d 78% of patients with CDC, Reovirus RNA was found also in extracts of hepatic and/or biliary tissue from 21% of patients with other hepatob iliary diseases and in 12% of autopsy cases. The prevalence of reoviru s RNA in tissues from patients with EHBA and CDC was significantly gre ater than that in patients with other hepatobiliary diseases (chi(2) P = .012 EHBA vs. OTHER, P = .001 CDC vs. OTHER), or AUTOPSY cases (chi (2) P = .006 EHBA vs, AUTOPSY, P < .001 CDC vs. AUTOPSY).