Cytomegalovirus is a herpetic type infection, diagnosed in a child or adult by a blood test for igg, igm antibodies. Carriers of this infection are 90% of the world's population. It manifests itself with a significant decrease in immunity and is dangerous for intrauterine development. What are the symptoms of cytomegaly, and when is drug treatment necessary?
What is cytomegalovirus infection
Cytomegalovirus infection- This is a herpetic type virus. It is called hepres type 6 or CMV. The disease caused by this virus is called cytomegaly. With it, infected cells lose the ability to divide and greatly increase in size. Inflammation develops around the infected cells.
The disease can be localized in any organ - sinuses (rhinitis), bronchi (bronchitis), bladder(cystitis), vagina or urethra (vaginitis or urethritis). However, more often the CMV virus chooses genitourinary system, although its presence is detected in any fluid media of the body ( saliva, vaginal discharge, blood, sweat).
Conditions of infection and chronic carriage
Like other herpes infections, cytomegalovirus is chronic virus. It enters the body once (usually in childhood) and is stored there for the rest of one’s life. The form of storage of the virus is called carriage, while the virus is in a latent, dormant form (stored in the ganglia spinal cord). Most people do not realize they carry CMV until their immune system fails. The dormant virus then multiplies and produces visible symptoms.
To a significant decrease in immunity in healthy people They cite unusual situations: organ transplant operations (accompanied by taking medications that purposefully reduce immunity - this prevents rejection of a transplanted foreign organ), radiation and chemotherapy (in the treatment of oncology), long-term use hormonal drugs(contraceptives), alcohol.
Interesting fact: The presence of cytomegalovirus infection is diagnosed in 92% of examined people. Carriage - chronic form virus.
How the virus is transmitted
Just 10 years ago, cytomegalovirus infections were considered sexually transmitted. CMV was called " kissing disease", believing that the disease is transmitted through kisses. Modern research proved that cytomegalovirus is transmitted in various household situations- using shared utensils, towels, and shaking hands (if there are cracks, abrasions, or cuts on the skin of the hands).
The same medical research found that children are most often infected with cytomegalovirus. Their immunity is at the stage of formation, so viruses penetrate into children's body, cause disease or form a carrier state.
Herpetic infections in children manifest visible symptoms only with low immunity ( at frequent illnesses, vitamin deficiency, serious immune problems). With normal immunity, exposure to the CMV virus is asymptomatic. The child becomes infected, but no symptoms (fever, inflammation, runny nose, rash) follow. The immune system copes with foreign invasion without raising the temperature (forms antibodies and remembers the program for their production).
Cytomegalovirus: manifestations and symptoms
External manifestations of CMV are difficult to distinguish from ordinary acute respiratory infections. The temperature rises, a runny nose appears, and the throat hurts. May increase The lymph nodes. The complex of these symptoms is called mononucleosis syndrome. It accompanies many infectious diseases.
Distinguish CMV from respiratory infection possible due to prolonged periods of illness. If a common cold goes away in 5-7 days, then cytomegaly lasts longer - up to 1.5 months.
There are special signs of cytomegalovirus infection (they rarely accompany ordinary respiratory infections):
- Inflammation salivary glands (in them the CMV virus multiplies most actively).
- In adults - inflammation of the genital organs(for this reason, CMV has long been considered a sexually transmitted infection) - inflammation of the testicles and urethra in men, uterus or ovaries in women.
Interesting to know: cytomegalovirus in men often occurs without visible symptoms if the virus was localized in the genitourinary system.
CMV is different long period incubation. When infected with herpes infection type 6 ( cytomegalovirus) signs of the disease appear 40-60 days after the virus enters.
Cytomegaly in infants
The danger of cytomegaly for children is determined by the state of their immunity and the presence of breastfeeding. Immediately after birth, the child is protected from various infections by the mother’s antibodies (they entered his blood during intrauterine development, and continue to do so during breastfeeding). Therefore, in the first six months or a year (the time of predominantly breastfeeding), the baby is protected by the mother’s antibodies. Cytomegalovirus in children under one year of age does not cause any symptoms due to the presence of maternal antibodies.
Infection of a child becomes possible by reducing the number of breastfeedings and incoming antibodies. The source of infection becomes the closest relatives (by kissing, bathing, general care- Let us remind you that the majority of the adult population is infected with the virus). The reaction to primary infection can be strong or invisible (depending on the state of immunity). Thus, by the second or third year of life, many children develop their own antibodies to the disease.
Is cytomegalovirus dangerous in an infant?
With normal immunity - no. With a weak and insufficient immune response - yes. It can cause long-term extensive inflammation.
About communication symptoms of CMV and immunity, Dr. Komarovsky also says: “ Cytomegalovirus in children does not pose a threat if the immune system is normal. Exceptions from the general group are children with special diagnoses - AIDS, chemotherapy, tumors».
If a child was born weakened, if his immunity is impaired by taking antibiotics or other potent drugs, infection with cytomegalovirus causes an acute infectious disease - cytomegaly(symptoms of which are similar to long-term acute respiratory infections).
Cytomegaly in pregnant women
Pregnancy is accompanied by a decrease in maternal immunity. This is a normal reaction female body, which prevents the rejection of the embryo as a foreign organism. Row physical and chemical processes and hormonal changes are aimed at reducing the immune response and limiting the action of immune forces. Therefore, it is during pregnancy that dormant viruses can be activated and cause relapses of infectious diseases. So, if cytomegalovirus did not manifest itself in any way before pregnancy, then during pregnancy it can increase the temperature and form inflammation.
Cytomegalovirus in a pregnant woman can be the result of a primary infection or a secondary relapse. Primary infection poses the greatest danger to the developing fetus.(the body does not have time to give a worthy response and the CMV virus penetrates the placenta to the child).
Recurrences of infection during pregnancy are not dangerous in 98% of cases.
Cytomegaly: danger and consequences
Like any herpetic infections, the CMV virus is dangerous for a pregnant woman (or rather, for the child in her womb) only during primary infection. Primary infection forms various malformations, deformities or defects of the brain, pathologies of the central nervous system.
If infection with the CMV virus or another herpetic type pathogen occurred long before pregnancy (in childhood or adolescence), then this situation is not terrible for the child in the womb, and even useful. During primary infection, the body produces a certain amount of antibodies, which are stored in the blood. In addition, a program of protective reaction to this virus is developed. Therefore, the relapse of the virus is brought under control much faster. For a pregnant woman the best option- become infected with CMV in childhood and develop certain mechanisms to combat the infection.
The most dangerous situation for a child is a woman’s sterile body before conception. You can get infections anywhere (more than 90% of the planet's population are carriers of herpes viruses). At the same time, infection during pregnancy causes a number of disturbances in the development of the fetus, and infection in childhood passes without serious consequences.
Cytomegaly and uterine development
The CMV virus poses the greatest danger to a child in the womb. How does cytomegalovirus affect the fetus?
Infection of the fetus is possible during initial exposure to the virus during pregnancy. If infection occurs before 12 weeks, a miscarriage occurs in 15% of cases.
If infection occurs after 12 weeks, a miscarriage does not occur, but the child develops symptoms of the disease (this happens in 75% of cases). 25% of children whose mothers become infected with the virus during pregnancy for the first time are born completely healthy.
Cytomegalovirus in a child: symptoms
What symptoms can be used to suspect congenital cytomegaly in a child:
- Retarded physical development.
- Severe jaundice.
- Enlarged internal organs.
- Foci of inflammation ( congenital pneumonia, hepatitis).
The most dangerous manifestations of cytomegaly in newborns are damage to the nervous system, hydrocephalus, mental retardation, loss of vision, hearing.
Analyzes and decoding
The virus is found in any body fluid - blood, saliva, mucus, urine in children and adults. Therefore, analysis to determine CMV infection can be taken from blood, saliva, semen, and also in the form of a smear from the vagina and pharynx. In the samples taken, they look for cells affected by the virus (they differ large sizes, they are called “huge cells”).
Another diagnostic method examines the blood for the presence of antibodies to the virus. If there are specific immunoglobulins that are formed as a result of the fight against the virus, it means there has been an infection and there is a virus in the body. The type of immunoglobulins and their quantity can indicate whether this is a primary infection or a relapse of an infection that was previously ingested.
This blood test is called enzyme immunoassay (abbreviated as ELISA). In addition to this analysis, there is a PCR test for cytomegalovirus. It allows you to reliably determine the presence of infection. For PCR analysis, a vaginal smear or amniotic fluid sample is taken. If the result shows the presence of infection, the process is acute. If PCR does not detect the virus in mucus or other secretions, there is no infection (or relapse of infection) now.
Analysis for cytomegalovirus: Igg or igm?
The human body produces two groups of antibodies:
- primary (they are designated M or igm);
- secondary (they are called G or igg).
Primary antibodies to cytomegalovirus M are formed when CMV first enters the human body. The process of their formation is not related to the severity of symptoms. Infection may be asymptomatic, but igm antibodies will be present in the blood. In addition to the primary infection, type G antibodies are formed during relapses when the infection got out of control and the virus began to actively multiply. Secondary antibodies are produced to control the dormant virus stored in the ganglia of the spinal cord.
Another indicator of the stage of infection formation is avidity. It diagnoses the maturity of antibodies and the primacy of infection. Low maturity (low avidity - up to 30%) corresponds to primary infection. If the analysis for cytomegalovirus shows high avidity ( more than 60%), then this is a sign of chronic carriage, the latent stage of the disease. Average indicators ( from 30 to 60%) - correspond to a relapse of infection, activation of a previously dormant virus.
Note: deciphering a blood test for cytomegalovirus takes into account the number of antibodies and their type. These data make it possible to draw conclusions about the primary or secondary nature of the infection, as well as about the level of the body’s own immune response.
Blood for cytomegalovirus: interpretation of results
The main test to determine the presence of CMV infection is a blood antibody test (ELISA). Almost all women are tested for cytomegalovirus during pregnancy. The results of the analysis look like a list of types of antibodies and their quantities:
- Cytomegalovirus igg igm - “-” (negative)- this means that there has never been contact with the infection.
- "Igg+, igm-"- this result is obtained in most women when they are examined when planning pregnancy. Since CMV carriage is almost universal, the presence of group G antibodies indicates familiarity with the virus and its presence in the body in a dormant form. "Igg+, igm-" - normal indicators , which allow you not to worry about possible infection virus during pregnancy.
- “Igg-, igm+” - presence of acute primary disease (igg is absent, which means that the body has encountered an infection for the first time).
- “Igg+, igm+” - presence of acute relapse(against the background of igm there are igg, which indicates an earlier acquaintance with the disease). Cytomegalovirus G and M are signs of relapse of the disease and the presence of decreased immunity.
The worst outcome for a pregnant woman is cytomegalovirus igm positive. During pregnancy, the presence of group M antibodies indicates an acute process, primary infection or relapse of infection with the manifestation of symptoms (inflammation, runny nose, fever, enlarged lymph nodes). It’s even worse if, against the background of igm+, the cytomenalovirus igg has a “-”. This means that this infection entered the body for the first time. This is the most depressing diagnosis for an expectant mother. Although the probability of complications in the fetus is only 75%.
Interpretation of ELISA analysis in children
Cytomegalovirus igg in children is usually detected in the first year of life, especially in breastfed babies. This does not mean that the child became infected with CMV from the mother. This means that along with milk, maternal immune bodies enter his body, which protect against acute manifestations infections. Cytomegalovirus igg in a breastfed child is the norm, not a pathology.
Is it necessary to treat cytomegalovirus?
Healthy immunity itself controls the amount of CMV and its activity. If there are no signs of illness, treatment for cytomegalovirus is not necessary. Therapeutic measures are necessary when an immune failure occurs and the virus becomes active.
Chronic cytomegalovirus during pregnancy is characterized by the presence of type G antibodies. This is a chronic carriage and is present in 96% of pregnant women. If found cytomegalovirus igg, treatment is not necessary. Treatment is necessary in acute stage illness when visible symptoms appear. At the same time, it is important to understand that complete cure CMV virus impossible. Therapeutic measures are aimed at limiting the activity of the virus, transferring it to a dormant form.
The titer of group G antibodies decreases over time. For example, cytomegalovirus igg 250 is detected if the infection occurred in the last few months. A low titer means that the primary infection occurred quite a long time ago.
Important: high titer analysis for cytomegalovirus immunoglobulin g indicates a relatively recent infection with the disease.
From point of view pharmaceutical industry It is necessary to treat everyone who has antibodies to CMV (of any type and titer). After all, this is primarily profit. From the point of view of a woman and her child in the womb, treatment of a dormant infection in the presence of igg antibodies- the event is not useful, and possibly harmful. Drugs to support immunity contain interferon, which is not recommended for use during pregnancy without special indications. Antiviral drugs are also toxic.
How to treat cytomegalovirus during pregnancy
Treatment of cytomegalovirus occurs in two directions:
- Means for general immunity boosting (immunostimulants, modulators) - drugs with interferon (Viferon, Genferon).
- Specific antiviral drugs(their action is directed specifically against herpes virus type 6 - CMV) - foscarnet, ganciclovir.
- Vitamins (injections of B vitamins) and vitamin-mineral complexes are also indicated.
How to treat cytomegalovirus in children? The same drugs are used (immune stimulants and antivirals), but in reduced dosages.
How to treat cytomegalovirus with folk remedies
To treat any viruses ethnoscience uses natural antimicrobial agents:
- garlic, onion;
- propolis (alcohol and oil tinctures);
- silver water;
- hot spices
- herbal treatment - garlic greens, raspberry leaves, wormwood, echinacea and violet flowers, ginseng rhizomes, rhodiola.
Services treatment room are paid additionally. Cost - 60 rub.
Material for research: Blood serum
Research method: Linked immunosorbent assay
Preparation: Blood from a vein can be donated after a 4-hour fasting period. The day before and on the day of blood donation, intensive physical activity, drinking alcohol, smoking. You can drink water.
Description:High quality and quantitation antibodiesIgMAndIgGto cytomegalovirus Cytomegalovirus infection - infection caused by herpes virus type 5 (cytomegalovirus). It is part of the group of infections of the TORCH complex, including rubella, toxoplasmosis, as well as pathology caused by herpes virus types 1 and 2. Infections included in the TORCH complex pose a serious threat to the health of the child, fetus, and patients with immunodeficiency. The virus is transmitted from a patient through close contact with biological fluids, sexual contact, transplacental from mother to fetus, during childbirth, breastfeeding. CMV is capable of infecting and damaging cells of various tissues and organs.
In persons with healthy immune system the disease is usually asymptomatic. The main manifestations include low-grade fever, headache, myalgia, pharyngitis. Symptoms of congenital infection are characterized by jaundice, pneumonia, enlarged liver and kidneys. There is hearing loss, vision pathology, mental retardation, severe violations CNS leading to microcephaly. To date serological diagnostics is the main tool for verifying and determining the stage of infection, including the determination of specific IgM and IgG antibodies, as well as the calculation of the avidity index for positive results of two classes of immunoglobulins.
Antibodies IgM class are the main indicator of both the acute stage of infection and reinfection/reactivation. It is important to consider that this class of antibodies can circulate in the body for more than a year. In some cases, in uninfected subjects it is possible to detect false positive results IgM. Thus, the study of IgM antibodies should be carried out exclusively in combination with other serological methods.
Antibodies of class G appear after IgM and remain in the body for a long time. They are detected during the acute, chronic and latent stages of infection. The detection of antibodies together with IgM, as well as a 4-fold increase in IgG concentration with an interval of 2 weeks, may indicate an acute stage of CMV infection. In these cases, to clarify the stage infectious process it is necessary to determine the antibody avidity index. The use of “direct” methods for detecting the virus, such as PCR, is also recommended.
Indications for the study:
examination of women planning pregnancy
pregnant women who do not have antibodies to CMV (every 3 months)
pregnant women with signs of current infection
immunodeficiency
patients with suspected acute CMV infection (picture infectious mononucleosis, prolonged low-grade fever, enlarged liver and spleen, pneumonia of unknown origin)
questionable result of the previous examination
Interpretation:
Reference values:
|
ResultIgM |
Interpretation |
|
|
Positivity index >1.0 |
"positively" |
Presence of antibodies |
|
Positivity index 0.8 – 1.0 |
"doubtful" |
Zone of uncertainty |
|
Positivity Index<0,8 |
"negative" |
Absence of antibodies |
|
ResultIgG |
Interpretation |
|
|
>0.25 IU/ml |
"positively" |
Presence of antibodies, quantity |
|
0.2 – 0.25 IU/ml |
"doubtful" |
Zone of uncertainty |
|
<0,2 МЕ/мл |
"negative" |
Absence of antibodies |
IgG(-)IgM(-) - repeated testing is required during pregnancy (once every 3 months).
IgG(+)IgM(-) - immunity after past infection, no further testing required. If an active infection is suspected, re-send the sample after 10-14 days to monitor the IgG titer.
IgG(-)IgM(+) - retesting after 3 weeks to exclude a false positive result or the onset of an active infection.
IgG(+)IgM(+) - an acute stage of infection is possible, an avidity test is performed.
Doubtful - the result does not allow one to draw a conclusion about the presence or absence of antibodies; it is recommended to re-take the test after 14 days.
Antibodies to cytomegalovirus, which belongs to the group of herpes viruses (type 5), are detected using enzyme-linked immunosorbent assay (ELISA), immunochemiluminescent blood tests, and the polymerase chain reaction method. Based on the results of the study, both the presence or absence of herpesvirus in the blood and the type (primary or secondary) of infection of the patient are determined.
Test for antibodies to cytomegalovirus
For the qualitative determination of antibodies (immunoglobulins) during diagnosis, serological ELISA is used, based on the interaction of blood serum antibodies with antigens. Antigens of suspected pathogens are added to the sample and the formation of immune (antigen-antibody) complexes is monitored.
In IHLA, phosphors glowing in ultraviolet are added to the immunological reaction, the level of luminescence of which is measured by instruments.
PCR is a reaction that enlarges the test part of the sample and allows one to detect the presence or absence of infection in the body.
Decoding the results
In humans, two types of antibodies are produced against cytomegalovirus (CMV), belonging to the G- and M-class. Activation of cytomegalovirus infection is indicated by a more than 4-fold increase in the diagnostic IgG titer. This type of antibody indicates a primary or worsened infection; to clarify, an IgM test is performed.
The results of the enzyme immunoassay and immunochemiluminescence test are interpreted as follows:
- immunoglobulins of the IgG and IgM types are absent - there is no immunity to cytomegalovirus, there is a risk of primary infection;
- Anti-CMV is present (type G) - immunity is present, which does not exclude the transition to the acute phase of the infection;
- the presence of type M in the blood plasma means that a primary infection has entered the body that requires treatment;
- antibodies to cytomegalovirus IgG and IgM were detected - a secondary exacerbation of the viral infection occurred.
The value of the positivity rate (antibody concentration in the sample) detected during testing is indicated on the form in milliliters (ml), nanograms (ng) or ng/ml. The reference value of the study is used as a reference point, representing the average value of the indicator being determined and used as the norm for a given test system.
If the result is weakly positive, the ELISA test is repeated a week later. If the level of type M antibodies decreases, the virus is suppressed by the body; an increase in the number of markers means the progression of the disease. If questionable results are obtained, the analysis is performed several times.
When analyzed using the polymerase reaction method, the result indicates the presence or absence of viral DNA in the sample. If the result is negative, there remains a high probability of infection with cytomegalovirus.
Avidity of antibodies to cytomegalovirus
Avidity characterizes the level of pathogenicity of the virus, depending on the strength of binding of antigens to antibodies, which is determined by the degree of activity by the avidity index:
- high (over 60%) avidity indicates that the body has overcome the infection and developed immunity;
- with low avidity (less than 50%), we are talking about primary infection.
In terms of ease of diagnosis, IgG serological markers are more often studied.
Peculiarities
In adults
The level of immunoglobulin concentration varies depending on age and gender; normally its parameters are within the following limits:
- 0.5-2.5 units. IgM - in men;
- 0.7-2.9 IgM - in women;
- from 16.0 IgG.
Cytomegalovirus is a virus belonging to the herpesvirus family. This virus has a high prevalence in the human population.
Ten to fifteen percent of adolescents and forty percent of adults have antibodies to cytomegalovirus in their blood.
The incubation period is quite long - up to two months. During this period, the disease is always asymptomatic. Then a pronounced manifest beginning. Which is provoked by stress, hypothermia, or simply reduced immunity.
The symptoms are very similar to acute respiratory infections or acute respiratory viral infections. The body temperature rises, the head hurts severely, and general discomfort occurs. An untreated virus can result in inflammation of the lungs and joints, brain damage or other dangerous diseases. The infection remains in the body throughout a person’s life.
The year the virus was discovered is 1956. It is still being actively studied, its action and manifestations. Every year brings new knowledge.
The contagiousness of the virus is low.
Routes of transmission: sexual, household contact (through kisses and saliva), from mother to child, through blood products.
Infected people are usually asymptomatic. But sometimes, in those who suffer from poor immunity, the disease manifests itself as a mononucleosis-like syndrome.
It is characterized by increased body temperature, feelings of chills, fatigue and general malaise, and severe pain in the head. Mononucleosis-like syndrome has a happy ending - recovery.
There is a particular danger for two categories of people - those with weak immunity and infants infected in utero from a sick mother.
An increase in the titer of antibodies in the blood to cytomegalovirus by four times or even more indicates activation of cytomegalovirus.
What does cytomegalovirus IgG positive mean?
If the analysis for the determination of IgG antibodies to cytomegalovirus infection is positive, what conclusion is drawn?
The human immune system successfully coped with cytomegalovirus infection about a month ago, or even more.
This organism has developed a lifelong, stable immunity. About 90% of people are carriers, so there is no norm of antibodies to this virus. There is also no concept of increased or decreased level.
Determination of antibodies to cytomegalovirus is only necessary to establish the correct diagnosis.
Cytomegalovirus infection is considered to be the presence of a virus in a PCR analysis, when material containing certain DNA is examined.
From the tenth to fourteenth day after infection, IgG antibodies to cytomegalovirus infection appear in the blood. Antibodies easily pass through the placenta. Therefore, newborns are not always infected; it may be the mother's immunoglobulins.
The level of immunoglobulin in the blood is checked after three weeks to clarify the diagnosis and the severity of the process. The process is considered active if the level of immunoglobulins increases.
Cytomegalovirus in children
Cytomegalovirus infection is very similar to herpes infection. And it happens often too.
Even if the infection occurred in early childhood, but a person has good strong immunity all his life, then a cytomegalovirus infection may never manifest itself. A person is only a virus carrier all his life.
There are children who suffer greatly from cytomegalovirus:
- those exposed to intrauterine infection, since the placental barrier is not an obstacle to cytomegalovirus;
- newborns with weak and unstable immunity;
- at any age, with a severely weakened immune system, or, for example, in patients with AIDS.
Infection is most often diagnosed using ELISA (enzyme-linked immunosorbent assay). This method can determine not only the presence of cytomegalovirus infection in the child’s body. But it’s also possible to say for sure whether it is congenital or acquired.
For newborns, cytomegalovirus is infectious mononucleosis. The lymphatic system is affected - the lymph nodes become enlarged, the tonsils become inflamed, the liver and spleen become enlarged, and it becomes difficult to breathe.
In addition, congenital infection is characterized by:
- prematurity;
- squint;
- jaundice of newborns;
- disorders of swallowing and sucking reflexes.
Poor nasal breathing can cause the following symptoms:
- loss of appetite and weight loss;
- sleep disorders;
- crying and worrying.
Congenital infection of a child most often occurs in utero. But sometimes through the mother's birth canal or breast milk during feeding.
Most often, a very dangerous asymptomatic course of cytomegalovirus infection is observed. Even two months after being born into this world.
For such children, complications are possible:
- 20% of children with asymptomatic, actively occurring cytomegalovirus after months are characterized by the presence of severe convulsions, abnormal movements of the limbs, changes in the bones (for example, in the skull), and insufficient body weight;
- after five years, 50% have speech impairment, intellect suffers, the cardiovascular system is affected and vision is severely affected.
If a child becomes infected at a later time, and not during the neonatal period, when the immune system is already well formed, then there are practically no consequences.
Most often, it is asymptomatic or reminiscent of classic childhood ARVI.
Characterized by:
- lethargy and drowsiness;
- cervical lymphadenitis;
- pain in the musculoskeletal system (muscles and joints);
- chills and low-grade fever.
This lasts two weeks - two months. Ends with self-healing. Very rarely, if the disease does not go away for two to three months, medical consultation and treatment is necessary.
The earliest diagnosis of cytomegalovirus infection and timely treatment significantly reduce the risk of complications. It is best to start treatment within seven to nine days after infection. Then the cytomegalovirus infection will not leave a trace.
Cytomegalovirus in women
Cytomegalovirus infection in females occurs in a chronic form. Most often this is asymptomatic, but sometimes symptoms are present. A weak immune system contributes to the active manifestation of the disease.
Unfortunately, cytomegalovirus infection affects women at any age. Provoking factors are cancer, HIV infection or AIDS, and gastrointestinal pathologies. Another similar effect is observed from taking antitumor drugs and antidepressants.
In its acute form, the infection is characterized by damage to the cervical lymph nodes.
Then there is an increase in the submandibular, axillary and inguinal lymph nodes. As I already said, this clinical picture is similar to infectious mononucleosis. It is characterized by headache, general poor health, hepatomegaly, and atypical mononuclear cells in the blood.
Immunodeficiency (for example, HIV infection) causes a severe, generalized form of cytomegalovirus infection. Internal organs, blood vessels, nerves and salivary glands are affected. Cytomegalovirus hepatitis, pneumonia, retinitis and sialadenitis occur.
Nine out of ten women with AIDS have cytomegalovirus infection. They are characterized by bilateral pneumonia and encephalitis.
Encephalitis is characterized by dementia and memory loss.
Women with AIDS and cytomegalovirus suffer from polyradiculopathy. Such women are characterized by damage to the kidneys, liver, pancreas, eyes and MPS organs.
Cytomegalovirus during pregnancy
An infection that comes from a person who has an acute form of the disease is the worst option for pregnant women.
There are still no antibodies in the pregnant woman's blood.
The active virus of an infecting person passes through all barriers without difficulty and has a detrimental effect on the child. According to statistics, this happens in half of infections.
If factors that weaken the immune system aggravate latent virus carriage, then this is a less dangerous situation.
There are already immunoglobulins (IgG) in the blood, the virus is weakened and not so active. The virus is dangerous by infecting the fetus in only two percent of cases. Early pregnancy is more dangerous in terms of infection. Pregnancy often ends in spontaneous miscarriage. Or the fetus develops abnormally.
Infection with cytomegalovirus infection later in pregnancy leads to polyhydramnios or premature birth (“congenital cytomegaly”). Unfortunately, it is impossible to completely destroy cytomegalovirus in the body. But you can make it inactive. Therefore, pregnant women and those planning to become pregnant should be especially careful about their health. Cytomegalovirus is very dangerous for the fetus.
Cytomegalovirus IgM positive
IgM is the first protective barrier against all kinds of viruses. They do not have a specification, but they are produced urgently, as a response to the penetration of cytomegalovirus infection into the body.
An IgM test is carried out to determine:
- primary infection by the virus (maximum antibody titer);
- stages of aggravated cytomegalovirus (the number of the virus is growing and the number of IgM is growing);
- reinfection (a new strain of cytomegalovirus has caused infection).
Later, from IgM, specific antibodies, IgG, are formed. If the strength of the immune system does not decrease, then IgG will fight cytomegalovirus all their lives. The IgG antibody titer is highly specific. From it you can determine the specification of the virus. Despite the fact that an IgM test shows the presence of any virus in the material being tested.
The number of cytomegalovirus is subject to control by immunoglobulin G, preventing the development of a picture of an acute disease.
If the results are “IgM positive” and “IgG negative”, this indicates an acute recent infection and the absence of permanent immunity against CMV. An exacerbation of a chronic infection is characterized by indicators when IgG and IgM are present in the blood. The body is in a stage of serious deterioration of immunity.
There has already been infection in the past (IgG), but the body cannot cope, and nonspecific IgM appears.
The presence of positive IgG and negative IgM is the best test result for a pregnant woman. She has specific immunity, which means the child will not get sick.
If the situation is the opposite, with positive IgM and negative IgG, then this is also not scary. This indicates a secondary infection that is being fought in the body, which means there should be no complications.
It’s worse if there are no antibodies at all, of both classes. This indicates a special situation. Although this situation is very rare.
In modern society, almost all women are infected with the infection.
Treatment of cytomegalovirus and treatment results
If a person has a healthy immune system, then he can cope with cytomegalovirus infection on his own. You may not carry out any therapeutic actions. Immunity will only be weakened if treated for a cytomegalovirus infection that does not manifest itself. Drug treatment is necessary only when the immune defense fails and the infection actively intensifies.
Pregnant women also do not need treatment if they have specific IgG antibodies in their blood.
With a positive test for IgM, to transfer the acute condition into a latent course of the disease. You must always remember that medications for cytomegalovirus infection have many side effects. Therefore, only a knowledgeable specialist can prescribe them; self-medication should be avoided.
The active stage of infection is the presence of positive IgM. It is necessary to take into account other test results. It is especially necessary to monitor the presence of antibodies in the body for pregnant and immunodeficient people.
Seeing a positive cytomegalovirus IgG indicator in their tests, many visitors to the dermatovenerologist begin to become very concerned about their health.
After all, positive tests usually mean the presence of a serious pathology in the body, which will take a long and difficult time to treat. However, cytomegalovirus is rather an exception to the rule.
What are the features of this virus, and how to evaluate the results of the antibody test, patients often ask.
When is treatment definitely necessary, and when is there absolutely no threat?
What kind of virus is this
Cytomegalovirus is better known to people under the more convenient and memorable abbreviation CMV. This pathogen belongs to the herpes group, and in fact is the fifth strain of the herpes virus.
CMV is a representative of a weak group of antigens.
This means that when infected, symptoms of the disease may be completely absent or very mild. It is not surprising that in this situation, most patients do not even suspect that they are infected with a viral agent. Naturally, in this case, the results of the study come as a great shock to them.
It is important to remember the following things about CMV:
- It is no longer possible to completely get rid of an infection once it has entered the body;
- you cannot get rid of the pathogen, but it can be driven into a state of hibernation so that it will not remind you of itself;
- Most children become infected with the virus through contact with infected people through airborne droplets;
- adults are more resistant, and therefore they are characterized mainly by sexual infection.
CMV can exist in the human body for years without manifesting itself. A person often does not even suspect that he is a carrier of the virus.
The essence of the study
Many patients do not understand the essence of antibody testing. This is not surprising, since it can be difficult for a person who is not familiar with immunology to understand such things.
It's simple. What happens if a pathogenic microorganism enters the human body?
The body begins, with the help of the immune system, to synthesize special proteins called immunoglobulins. A person can produce five such proteins.
In the analysis for CMV, classes G and M are important.
These proteins have the ability to fight viral particles. Preventing them from actively multiplying in the human body and causing significant harm.
Patients are often interested in the question of the differences between class G immunoglobulins and class M immunoglobulins. Here, as doctors note, there is nothing complicated either.
The first class is slow immunoglobulins. They are formed in the body in order to constantly maintain the immune system working against a particular virus.
The second class is fast proteins. They are formed in order to provide an immune response, as they say, here and now. It is impossible to provide permanent immunity with their help, since they die quite quickly.
When examining, doctors pay attention to both classes.
If cytomegalovirus IgM is positive, then contact with the virus occurred recently. If class G is detected, then the infection is quite old. In order to perform the test, blood is mainly taken from a vein.
The rules for preparing for the study do not differ from the rules that should be followed for standard blood tests from a vein for other reasons. Arrive at the appointment in the morning on an empty stomach. Before the study, do not drink alcohol and follow a light diet that protects the body from adverse effects.
When to relax
As doctors note, human immunity can be of two types: competent and incompetent. If the immune system is competent, then the body’s immune system adequately responds to encounters with various pathogenic microorganisms. That is, it can provide complete protection against them. If the patient is completely healthy and his immune system is working correctly, he should not worry even if the test results for CMV are positive.
The statute of limitations for infection also does not matter. The body itself will suppress the virus. The maximum you can encounter is a slight malaise for a couple of days, accompanied by fever and sometimes a sore throat.
It is important to remember that if class M immunoglobulins are detected, then the infectious process is in an active stage. During this period, the virus can be transmitted from an infected person through airborne droplets. Even if there are no symptoms of the disease, it is worth reducing the level of social activity.
The main thing is to avoid pregnant women, since CMV poses a particular danger in their condition.
What to do if the test is positive in a pregnant woman
First of all, the doctor pays attention to the presence of IgM. These proteins indicate relapse of the disease or recent infection. Their appearance in the blood of a pregnant woman in the first 12 weeks after conception is especially dangerous.
The virus has a pronounced teratogenic effect, and it is necessary to urgently take measures aimed at treating the patient. However, to make an adequate decision, the doctor also needs to assess the amount of IgG in the pregnant woman.
If proteins of this class are contained in the body, then the danger is not so great. After all, CMV can worsen during pregnancy.
However, there is active immunity to infection, and the likelihood of infection of the fetus exists only during childbirth. If IgG is absent, the situation is more dire. The fact is that in this case the infection is primary. Accordingly, the body cannot fully protect itself from the effects.
As a result, the entire mother’s body, including the fetus, will be affected. Usually the consequences of such an infection are irreparable.
The danger of positive results in a child
If a child's test results are evaluated, his age must be taken into account. The infection is most dangerous for newborns. If IgG is present in their blood, then the infection occurred in the womb. In this case, the child requires special attention from a doctor. It must be directed first of all to find out whether any congenital abnormalities have developed due to the infection.
If any abnormalities are detected, parents are informed about this and prevention of further complications begins. If there are no deviations, the child is monitored and measures are also taken to prevent complications. If signs of the presence of CMV are detected in an older child, there is no need to worry about his health.
Older children, like adults, are able to cope with cytomegalovirus, and most often they do not need outside help.
The main thing is to monitor the child’s condition and get tested to understand when strong immunity to the infection has formed. Viral particles of herpes type 5 pose the greatest danger to children even at the stage of intrauterine development. In this case, with early infection, they can lead to damage to the nervous system, blindness, and other pathologies. Intrauterine fetal death is also common.
Features of immunodeficiency
In addition to children, there is another special group of patients. For them, a positive test for cytomegalovirus can be dangerous. These patients are people with immunodeficiency. Moreover, not only immunodeficiency acquired as a result of HIV infection is taken into account. But also problems with the protective system that were present from birth due to genetic defects.
Such patients often develop the following complications of CMV:
- liver damage accompanied by hepatitis and jaundice;
- lung damage in the form of cytomegalovirus pneumonia, which affects about 90% of all AIDS patients;
- various pathologies of the gastrointestinal tract;
- cytomegalovirus encephalitis, which is accompanied by loss of consciousness, severe headaches, mental depression, and sometimes paralysis;
- inflammatory processes in the retina of the eye, which can lead to blindness without timely medical care.
Even if IgG is detected in the blood of a patient with immunodeficiency, you should be on guard. Due to insufficient activity of the body's defenses, the infection can enter the acute phase with the development of complications at any time.
What to do
Many patients wonder what to do if the test result is positive. If a person does not have a state of immunodeficiency, then after a short consultation with a doctor he can calmly forget that he is infected.
As already mentioned, for healthy people without problems with the body’s natural defenses, the pathogen does not pose a threat.
Another thing is immunocompromised people. They should get advice from their doctor about starting to take antiviral medications. With their help, it will be possible to suppress the activity of the virus and avoid the development of complications.
The choice of drugs is made strictly individually. It is not recommended for healthy people to drink them, as they have a fairly wide range of side effects.
Cytomegalovirus is an infection that poses a threat to certain groups of people. If we are talking about a person without problems with immunity, he should not worry even if the examination for this pathogen showed positive results.
It is important to remember that pregnant women are at particular risk!
