From the Research
Yes, Respiratory Syncytial Virus (RSV) can cause elevated liver function tests (LFTs). While RSV primarily affects the respiratory system, it can lead to systemic inflammation that impacts other organs, including the liver. This liver involvement typically manifests as mildly to moderately elevated transaminases (ALT and AST) and is more common in severe RSV infections, particularly in infants, young children, and immunocompromised adults. The mechanism behind this elevation likely involves inflammatory cytokine release during infection and potential direct viral effects on liver cells.
Key Findings
- A study published in the Journal of Clinical Medicine in 2023 1 found that liver function test abnormalities are frequent among patients with COVID-19 and seasonal respiratory viruses, including RSV, and are associated with poor clinical outcome.
- The study also found that hepatocellular injury, although less frequent, had a strong association with adverse clinical outcomes in RSV infection, with an odds ratio of 5.29 (CI 1.2-22) 1.
- Another study published in the World Journal of Hepatology in 2022 2 found that high ALT levels were associated with lengthy hospital stays and positive urine cultures in patients with acute bronchiolitis.
Management
- Management of RSV infection with elevated LFTs focuses on supportive care for the primary RSV infection.
- If LFT elevations are severe or persistent beyond the expected recovery period, additional evaluation should be considered to rule out other causes of liver dysfunction.
Prognosis
- The prognosis for patients with RSV infection and elevated LFTs is generally good, with most patients experiencing resolution of LFT abnormalities within 1-2 weeks without specific liver-directed treatment.
- However, patients with hepatocellular injury or other underlying liver conditions may be at higher risk for adverse outcomes and require closer monitoring and management.