ABSTRACT Non‐hepatotropic viruses (NHVs), as a category of pathogens not primarily targeting the liver, can also cause hepatic injury. Liver injury associated with Epstein‐Barr virus (EBV) and cytomegalovirus (CMV) infections, in particular, often attracts significant clinical attention. This retrospective cohort study analyzed the seroprevalence and clinical features of EBV and CMV infections among patients in Beijing from 2020 to 2024, with a focus on the impact of immunosuppression status on liver injury patterns. The CMV IgM positivity rate was 4.00% (646/16,201), and the EBV IgM positivity rate was 7.84% (1007/12,838), both showing significant upward annual trends ( p 300 cells/μL had higher ALT and AST levels, supporting an immune‐mediated injury mechanism. These findings indicate that immune status and virus type jointly shape the clinical spectrum of EBV/CMV‐related liver injury. The dissociation between severe liver injury and favorable prognosis in non‐immunosuppressed patients underscores the role of immune pathology, while poorer outcomes in immunosuppressed patients are driven by CD4 + T‐cell depletion, impaired viral clearance, and extrahepatic complications.
Du et al. (Sun,) studied this question.