Acyclovir and ganciclovir exposure and short-term outcomes in hospitalized children with EBV-associated mononucleosis-like illness: a retrospective cohort study using inverse probability of treatment weighting

Background

Epstein-Barr virus (EBV)-associated mononucleosis-like illness in children involves marked immune activation and variable clinical severity. Although supportive care remains standard for immunocompetent children, acyclovir and ganciclovir are frequently used in hospitalized patients with severe manifestations. However, their real-world effectiveness remains uncertain. This study aimed to characterize real-world antiviral treatment patterns and evaluate the associations of acyclovir and ganciclovir exposure with short-term clinical outcomes in hospitalized children with EBV-associated mononucleosis-like illness.