Background:
Immune thrombocytopenia (
ITP) is characterized by non-chronic (transient, <12 months) and chronic (≥12 months) decline in the number of platelets. Herpes
virus infections have been shown, in many studies, to be associated with the development of
ITP. However, it remains unclear whether the herpes
virus infection status is associated with the chronic
ITP. Methods: We reviewed 480 primary pediatric patients with
ITP in the period from January 2017 to December 2019. The prevalence of herpes virus
antibodies including the Cytomegalovirus (CMV), Herpes simplex virus 1 (HSV-1), Herpes simplex virus 2 (HSV-2), and Epstein Barr virus were recorded. The levels of serum
complement C3 and C4, T (CD3+, CD4+, CD8+), B (CD19+) lymphocytes, and natural killer (CD16+ 56+) cells were also analyzed. Multivariate analysis was used to evaluate the associations between chronic
ITP and herpes
virus infection status. Results: Compared with non-chronic, patients with chronic
ITP had older age (≥3 years), lower levels of
hemoglobin and
complement C3, and lower probability of CMV and HSV-2
infections (
IgM positive; p < 0.05). Patients with herpes
virus infection had lower serum platelet counts (p < 0.001), lower
complement C3 levels and lower CD4+/CD8+ cells ratio (p < 0.05). Furthermore, platelet counts were positively correlated with CD4+/CD8+ cells ratios (r = 0.519; p = 0.0078), and negatively correlated with T cells (CD3+: r = -0.458, p = 0.0213; CD8+: r = -0.489, p = 0.0131). Multivariate analysis showed that age (OR, 1.644; 95%CI, 1.007-2.684; p = 0.047) was an adverse risk factor for chronic
ITP and CMV
IgM positive (OR, 0.241; 95%CI, 0.072-0.814; p = 0.022) had lower risk of chronic
ITP development, while other herpes
virus infection statuses and clinical features were not. Conclusion: Although herpes
virus infections were associated with the onset of
ITP, our findings indicated that herpes
virus infection status might not be a risk factor for chronic
ITP.