Antibodies to cytomegalovirus lgM, CMV IgM quantitative- allows you to determine the presence of IgM antibodies to cytomegalovirus (CMV or CMV).
When a person comes into contact with CMV, they the immune system exhibits a protective response by producing antibodies IgM classes and IgG against CMV.
Duration incubation period from 15 days to 3 months. With this infection, non-sterile immunity occurs (that is, complete elimination of the virus is not observed). Immunity under cytomegalovirus infection(CMV) unstable, slow. Reinfection with an exogenous virus or reactivation of a latent infection is possible. Due to long-term persistence in the body, the virus affects all parts of the patient’s immune system. Specific antibodies are responsible for the lysis of the intracellular virus and also inhibit its intracellular replication or spread from cell to cell. Sera from patients after primary infection contain antibodies that react with internal proteins of CMV (p28, p65, p150). The serum of recovered people contains mainly antibodies that react with membrane glycoproteins.
Greatest diagnostic value has a definition of IgM as an indicator of process activity, which may indicate an acutely ongoing disease, reinfection, superinfection or reactivation. The appearance of anti-CMV IgM antibodies in a previously seronegative patient indicates a primary infection. During endogenous reactivation of an infection, IgM antibodies are formed irregularly (usually in fairly low concentrations) or may be completely absent. Detection of class G immunoglobulins also makes it possible to determine primary cytomegalovirus infection (CMVI), monitor over time individuals with clinical manifestations of infection, and help with retrospective diagnosis. For severe CMV infection, as well as in pregnant women and children early age the production of antibodies to CMV is slowed down. This is manifested by the detection of specific antibodies in low concentrations or the absence of positive dynamics of antibodies.
Cytomegalovirus infection- it is widespread viral infection organism, which refers to the so-called opportunistic infections, which usually occur latently. Clinical manifestations are observed against the background of physiological immunodeficiency states (children in the first 3–5 years of life, pregnant women - more often in the 2nd and 3rd trimester), as well as in persons with congenital or acquired immunodeficiencies (HIV infection, use of immunosuppressants, oncohematological diseases, radiation, diabetes and so on.).
Cytomegalovirus- is part of the herpes virus family. Like other representatives of this group, it can persist in a person throughout his life. The risk group includes children 5–6 years old, adults 16–30 years old, as well as people who practice anal sex. Children are susceptible to airborne transmission from parents and other children with latent forms of infection. For adults, sexual transmission is more common. The virus is found in semen and other body fluids. Vertical transmission of infection (from mother to fetus) occurs transplacentally and during childbirth.
CMV infection is characterized by diversity clinical manifestations. U healthy people with normal immunity, the primary infection occurs without complications (and is often asymptomatic). In rare cases, a picture develops infectious mononucleosis(about 10% of all cases of infectious mononucleosis), clinically indistinguishable from mononucleosis caused by the Epstein-Barr virus. Virus replication occurs in the tissues of the reticuloendothelial system, epithelium of the urogenital tract, liver, mucosa respiratory tract and digestive tract. When immunity is reduced after organ transplantation, immunosuppressive therapy, HIV infection, as well as in newborns, CMV poses a serious threat, since the disease can affect any organ. The development of hepatitis, pneumonia, esophagitis, gastritis, colitis, retinitis, diffuse encephalopathy, fever, leukopenia is possible. The disease can be fatal.
Cytomegalovirus is dangerous in cases of immunodeficiency and during pregnancy is potentially dangerous for the development of the fetus. Therefore, 5–6 months before a planned pregnancy, it is necessary to undergo a TORCH examination in order to assess the state of immunity in relation to these viruses, if necessary, provide treatment, or provide prevention and control. When a pregnant woman is initially infected with cytomegalovirus (in 35–50% of cases) or the infection is reactivated during pregnancy (in 8–10% of cases), an intrauterine infection develops. During development intrauterine infection for up to 10 weeks there is a risk of developmental defects, spontaneous abortion is possible. When infected, there is a delay between 11 and 28 weeks intrauterine development, hypo- or dysplasia of internal organs. If infection occurs at a later stage, the damage may be generalized, affecting a specific organ (for example, fetal hepatitis) or appear after birth (hypertensive-hydrocephalic syndrome, hearing impairment, interstitial pneumonia, etc.). Manifestations of infection also depend on maternal immunity, virulence and localization of the virus.
To date, a vaccine against cytomegalovirus has not been developed. Drug therapy allows you to increase the period of remission and influence the recurrence of infection, but does not allow you to eliminate the virus from the body.
It is impossible to completely cure this disease: cytomegalovirus cannot be removed from the body. But if you promptly, at the slightest suspicion of infection with this virus, consult a doctor, have necessary tests, then you can long years keep the infection in a “dormant” state. This will ensure normal pregnancy and birth. healthy child.
Special meaning laboratory diagnostics cytomegalovirus infection has in the following categories of subjects:
Women preparing for pregnancy
1. Latent course of the disease
2. Difficulty differential diagnosis primary infection and recurrent infection during examination during pregnancy
3. Severe consequences intrauterine infection in newborns
Pregnant women
1. Severe consequences of intrauterine infection in newborns
2. Immunodeficiency states (generalized forms)
Consecutive repeated determination of the level of IgG antibodies in newborns makes it possible to distinguish congenital infection (constant level) from neonatal infection (increasing titers). If the titer of IgG antibodies does not increase during repeated (after two weeks) analysis, then there is no reason for alarm; if the titer of IgG increases, the issue of abortion should be considered.
СMV and TORCH
CMV infection is part of the group of TORCH infections (the name is formed by the initial letters in the Latin names - Toxoplasma, Rubella, Cytomegalovirus, Herpes), which are considered potentially dangerous for the development of a child. Ideally, a woman should consult a doctor and undergo laboratory testing for TORCH infections 2–3 months before the planned pregnancy, since in this case it will be possible to take appropriate therapeutic or preventive measures, and also, if necessary, in the future compare the results of studies before pregnancy with the results of examinations during pregnancy.
Indications:
- preparation for pregnancy;
- signs of intrauterine infection, feto-placental insufficiency;
- state of immunosuppression due to HIV infection, neoplastic diseases, taking cytostatic drugs, etc.;
- clinical picture infectious mononucleosis in the absence of infection caused by the Epstein-Barr virus;
- hepato-splenomegaly of unknown nature;
- fever unknown etiology;
- increased levels of liver transaminases, gamma-GT, alkaline phosphatase in the absence of markers viral hepatitis;
- atypical course of pneumonia in children;
- miscarriage (frozen pregnancy, recurrent miscarriages).
It is recommended to donate blood in the morning, between 8 am and 12 pm. Blood is drawn on an empty stomach, after 4–6 hours of fasting. It is allowed to drink water without gas and sugar. On the eve of the examination, food overload should be avoided.
Interpretation of results
Units of measurement: UE*
A positive result will be accompanied by an additional comment indicating the sample positivity rate (SP*):
- CP >= 11.0 - positive;
- KP<= 9,0 - отрицательно;
- CP 9.0–11.0 - doubtful.
Negative:
- CMV infection occurred more than 3–4 weeks ago;
- infection in the period 3–4 weeks before the examination is excluded;
- intrauterine infection is unlikely.
- primary infection or reactivation of infection;
- intrauterine infection is possible.
*Positivity rate (PR) is the ratio of the optical density of the patient's sample to the threshold value. CP - positivity coefficient, is a universal indicator used in enzyme immunoassays. CP characterizes the degree of positivity of the test sample and can be useful to the doctor for the correct interpretation of the result obtained. Since the positivity rate does not correlate linearly with the concentration of antibodies in the sample, it is not recommended to use CP for dynamic monitoring of patients, including monitoring the effectiveness of treatment.
Cytomegalovirus (CMV, cytomegalovirus, CMV) is a type 5 herpesvirus. To identify the stage of an infectious disease and its chronicity, 2 research methods are used - PCR (polymerase chain reaction) and ELISA (enzyme-linked immunosorbent assay). They are prescribed when symptoms appear and infection with cytomegalovirus infection is suspected. If the results of a blood test show positive cytomegalovirus igg, what does this mean and what danger does it pose to humans?
Antibodies IgM and IgG to cytomegalovirus - what are they?
When examining for infections, different immunoglobulins are used, they all play a certain role and perform their functions. Some fight viruses, others fight bacteria, and others neutralize excess immunoglobulins.
To diagnose cytomegaly (cytomegalovirus infection), 2 classes of immunoglobulins are distinguished from 5 existing ones (A, D, E, M, G):
- Immunoglobulin class M (IgM). It is produced immediately upon penetration of a foreign agent. Normally, it contains approximately 10% of the total amount of immunoglobulins. Antibodies of this class are the largest; during pregnancy they are present exclusively in the blood of the expectant mother, and are unable to reach the fetus.
- Immunoglobulin class G (IgG). It is the main class, its content in the blood is 70-75%. It has 4 subclasses and each of them is endowed with special functions. It is largely responsible for the secondary immune response. The production begins a few days after immunoglobulin M. It remains in the body for a long time, thereby preventing the possibility of a recurrence of the infection. Neutralizes harmful toxic microorganisms. It is small in size, which facilitates penetration to the fetus during pregnancy through the “baby spot”.
Immunoglobulins of the igg and igm classes help identify CMV carriers Cytomegalovirus igg positive - interpretation of results
The titres, which may differ depending on the laboratory, help decipher the test results. Classification into “negative/positive” is carried out using indicators for the concentration of immunoglobulin G:
- over 1.1 honey/ml (international units in millimeters) – positive;
- below 0.9 honey/ml – negative.
Table: “Antibodies to cytomegalovirus”
ELISA determines the avidity of immunoglobulins to cytomegalovirus Positive IgG antibodies they talk about a past collision of the body with a virus, a previous cytomegalovirus infection.
Komarovsky about positive IgG in children
When a baby is born, blood is immediately taken for analysis in the maternity ward. Doctors will immediately determine the presence of cytomegalovirus infection in a newborn.
If cytomegaly is acquired, then parents will not be able to distinguish the disease from a viral infection, since their symptoms are identical (increased body temperature, signs of respiratory diseases and intoxication). The disease itself lasts up to 7 weeks, and the incubation period is up to 9 weeks.
In this case, it all depends on the child’s immunity:
- With a strong immune system, the body will fight back the virus and will not be able to continue its development, but at the same time those same positive IgG antibodies will remain in the blood.
- In case of weakened immunity, other antibodies will join the analysis, and a disease with a sluggish head start will give complications to the liver, spleen, kidneys and adrenal glands.
During this period, it is important for parents to monitor the baby’s drinking regime and do not forget to give vitamins.
Maintaining immunity - effective fight against type 5 virus High igg avidity during pregnancy
During pregnancy, immunoglobulin G avidity is of particular importance.
- With low IgG avidity, we are talking about primary infection.
- IgG antibodies have high avidity (CMV IgG) - this indicates that the expectant mother has already had CMV disease before.
The table shows possible options for positive immunoglobulin G in combination with IgM during pregnancy, their meaning and consequences.
| IgG in a pregnant woman |
IgM in a pregnant woman |
Interpretation of the result, consequences |
| + –
(doubtful) |
+ | If IgG (+/-) is doubtful, then a repeat test is prescribed after 2 weeks. Since the acute form of IgG is negative for a pregnant woman, it is most dangerous. The severity of complications depends on the timing: the earlier the infection occurs, the more dangerous it is for the fetus. In the first trimester, the fetus freezes or leads to the development of its anomalies. For the second and third trimesters, the risk of danger is lower: pathologies of the internal organs of the fetus, the possibility of premature birth, or complications during labor are noted. |
| + | + | Repeated form of CMV. If we are talking about the chronic course of the disease, even during the period of exacerbation, the risk of complications is minimal. |
| + | – | Chronic form of CMV, after which immune protection remains. The likelihood that antibodies will penetrate to the fetus is very low. Treatment is not required. |
CMV is dangerous during pregnancy with primary infection When planning a pregnancy, it is necessary to undergo tests to detect CMV in order to avoid unpleasant consequences during pregnancy. Normal values are considered IgG (-) and IgM (-).
Do I need treatment?
Whether treatment is necessary or not depends directly on the stage of the disease. The goal of therapy is to transfer the virus from the active stage to the inactive stage.
In the chronic course of the disease, there is no need to prescribe medications. It is enough to maintain immunity with the help of vitamins, healthy food, giving up bad habits, walking in the fresh air and timely fight against other diseases.
If a positive immunoglobulin class G indicates a recurrence (exacerbation of infection during chronic course) or acute form disease, it is important for the patient to undergo a course of treatment, which includes:
- antiviral agents;
- immunoglobulins;
- immunomodulators.
In general, high avidity of immunoglobulin G is most dangerous for children infected in the womb, pregnant women and those with immunodeficiency. But as practice shows, for the most part it is enough to adhere to preventive measures to successfully combat the pathogen. Exclusively when the body’s defenses are reduced, complex treatment with drugs is required.
Synonyms: CMV IgM, Cytomegalovirus Antibody IgM, Antibodies to CMV IgM, Antibodies to herpes virus type 5 IgM
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Period of execution
The analysis will be ready within 1 day, excluding Saturday and Sunday (except for the day of taking the biomaterial). You will receive the results by email. mail immediately when ready.
Completion time: 2 days, excluding Saturday and Sunday (except for the day of taking biomaterial)Preparing for analysis
In advanceDo not take a blood test immediately after radiography, fluorography, ultrasound, or physical procedures.
The day before24 hours before blood collection:
Limit fatty and fried foods, do not drink alcohol.
Avoid heavy physical activity.
For at least 4 hours before donating blood, do not eat food, drink only clean, still water.
On the day of deliveryDo not smoke 60 minutes before blood collection.
Be in a calm state for 15-30 minutes before taking blood.
Analysis information
Cytomegalovirus (CMV, Antibodies to CMV IgG, Cytomegalovirus Antibody IgG, CMV IgG) is a virus belonging to the herpes family and is widespread. People of all ages are susceptible to this infection. Infection with the virus occurs through sexual contact, nutrition, airborne droplets, in utero (from mother to fetus), as well as through direct contact with infected biological fluids, through blood transfusion and organ transplantation.
In most cases, the infection is asymptomatic, but in newborns and people with immunocompromised conditions, cytomegalovirus can cause serious complications. Severe cytomegalovirus infection is also observed in patients with congenital or acquired cellular defects of the immune system, cancer patients, organ transplant patients and AIDS patients.
Research method - Chemiluminescent immunoassay
Material for research - Blood serum
Composition and results
Antibodies to cytomegalovirus IgM
Cytomegalovirus infection is caused by a virus belonging to the herpes virus family. This widespread infection is characterized by lifelong persistence of the virus in the body, and in some cases, reactivation of the virus and relapse of infection may occur. In the United States, the incidence of this viral infection reaches about 60–70%, and in some parts of Africa it can reach 100%. Most people (40–90%) acquire primary cytomegalovirus infection in childhood or adulthood. Antibodies to CMV are detected in the blood of 40-100% of adults, and the frequency of detection of seropositive results is inversely correlated with the socioeconomic status of the person.
The infection is transmitted through close contact through infected body secretions: saliva, urine, cervical and vaginal secretions, semen, milk and blood. Cytomegalovirus infection usually occurs in a mild asymptomatic form. However, if a woman is initially infected during pregnancy, there is a high risk of intrauterine transmission. One of the first places for intrauterine infection of the fetus belongs to CMV infection. When infected intrauterinely, cytomegalovirus infection often leads to miscarriage, fetal death immediately after birth, or the birth of a child with congenital CMV infection. Intrauterine infection manifests itself almost immediately after the birth of a child and leads to the following malformations: hydrocele, underdeveloped brain, jaundice, enlarged liver and spleen, hepatitis, heart defects, pneumonia, congenital deformities. The born child may suffer from mental retardation, cerebral palsy, epilepsy, deafness, and muscle weakness. Less commonly, congenital cytomegalovirus infection manifests itself only in the 2nd to 5th year of a child’s life with deafness, blindness, speech inhibition, psychomotor impairment, and mental retardation. Such serious disorders lead to the fact that primary cytomegalovirus infection, detected in the early stages of pregnancy, is an indication for its termination. The proportion of prenatally infected people is approximately 0.2-2.5%.
Approximately 10% of seropositive women experience reactivation of CMV infection during pregnancy, but the rate of fetal infection in cases of reactivation is about 1%, compared with a 40% chance of vertical transmission in cases of primary infection in a pregnant woman. After primary CMV infection, the patient may be reinfected with exogenous virus or reactivation of latent CMV infection may occur. In adults, the infection is asymptomatic; in people with reduced immunity, CMV can occur with severe diseases of the liver, lungs, kidneys and heart. The risk of developing a severe form of the disease also exists for patients with immunodeficiency conditions: patients in organ transplant departments, HIV-infected patients in whom CMV infection is severe and poses a threat to life. For the treatment of such patients, only CMV seronegative blood products should be used.
The first step in diagnosing primary acute CMV infection is usually the detection of anti-CMV-specific IgG and IgM antibodies. An increase in antibodies to CMV IgM indicates an acute, recent or reactivated infection. To confirm the diagnosis of primary CMV infection, CMV IgG antibody avidity analysis is used as an additional test. A positive result for IgM antibodies in combination with a low avidity index of IgG antibodies indicates a primary CMV infection that occurred within 4 months before the test. Only on the basis of clinical and laboratory examination data (determination of antibodies to CMV in the blood, detection of cytomegalovirus DNA by PCR) can a doctor make a diagnosis of cytomegalovirus infection.
Interpretation of the results of the study "Antibodies to cytomegalovirus IgM"
Interpretation of test results is for informational purposes only, is not a diagnosis and does not replace medical advice. Reference values may differ from those indicated depending on the equipment used, the actual values will be indicated on the results form.
- S/CO< 0,9 – результат отрицательный
- S/CO 0.9 – 1.1 result is doubtful (gray zone)
- S/CO > 1.1 – positive result
A positive result can be with primary infection, reinfection and long-standing infection with long-term persistence. increased level IgM antibodies. Questionable result: when low levels antibodies, the result can be assessed as doubtful. If IgG antibodies to CMV are detected in a given sample, the avidity of these antibodies must be examined to obtain information about the duration of the disease. A negative test result for antibodies of the IgM and IgG classes does not always exclude an acute infection; the test must be repeated after 2-3 weeks.
Unit of measurement: Unit
Reference values:
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Cytomegalovirus belongs to the herpes virus family, namely. A blood test for the virus will help detect it.
Cytomegalovirus affects different types of cells:
- salivary glands;
- kidney;
- liver;
- placenta;
- eyes and ears.
But, although the list is impressive, in most cases cytomegalovirus is not dangerous to human health!
What is the danger of cytomegalovirus?
- hearing loss;
- impairment or even loss of vision;
- mental retardation;
- the occurrence of seizures.
Such consequences can occur both during the primary infection and during activation. You just need to remember the likelihood of such serious consequences occurring.
An infant who becomes infected during pregnancy may have: external manifestations cytomegalovirus infection:
- intracerebral calcifications;
- ventriculomegaly (enlarged lateral ventricles of the brain);
- the liver and spleen are enlarged;
- excess fluid occurs in the peritoneum and chest cavity;
- microcephaly (small head);
- petechiae (small hemorrhages on the skin);
- jaundice.
What is analysis on igg?
If the igg is positive, this is evidence that the patient has developed immunity to the virus, but at the same time the person is its carrier.
This does not mean that cytomegalovirus is active or that the patient is in danger. The primary role will be played physical state and the patient's immunity.
Most important It has positive test for a pregnant woman, since the baby’s body is still developing and does not produce antibodies to cytomegalovirus.
During the study of igg for cytomegalovirus, samples are taken from the patient’s body to find specific antibodies to cytomegalovirus igg. Igg is an abbreviation for the Latin word “immunoglobulin”.
This is a type of protective protein produced by the immune system to fight the virus.
The immune system begins to produce special antibodies for each new virus that appears in the body.
As a result, upon reaching , a person may already possess a whole “bouquet” of such substances. The letter G denotes a certain class of immunoglobulins, marked in humans with the letters A, D, E, G, M.
Thus, an organism that has not yet encountered the virus is unable to produce antiviral antibodies. This is why the presence of antibodies in a person indicates that the body has previously been exposed to the virus.
Please note: antibodies of the same type, which are designed to fight different viruses, have significant differences. This is why the results of cytomegalovirus tests on igg are quite accurate.
How is the analysis deciphered?
An important feature of cytomegalovirus is that after the initial damage to the body, it remains in it forever. No treatment will help get rid of its presence.
The virus functions virtually without harm during internal organs, blood and salivary glands, and its carriers do not even suspect that they are carriers of the virus.
What are the differences between immunoglobulins M and G?
Igm combines fast “large” antibodies produced by the body in order to respond to the virus as soon as possible.
Igm do not provide immunological memory, dying off within six months, and the protection that they are supposed to provide is eliminated.
igg refers to antibodies that the body clones from the moment they appear. This is done with the aim of maintaining protection against a particular virus throughout a person's life.
These cytomegalovirus antibodies are smaller in size and have a later production time. Typically, they are produced from igm antibodies after the infection has been suppressed.
That is why, having detected cytomegalovirus igm in the blood, which reacts to , it can be argued that the person became infected with the virus relatively recently and at the moment there may be an exacerbation of infection.
To get more full information, additional research indicators need to be studied.
Antibodies to cytomegalovirus igg
What additional tests can be done?
It may consist not only of information about cytomegalovirus, but also carry other necessary data. Specialists interpret the data and prescribe treatment.
To better understand the values, it is worth familiarizing yourself with the laboratory test indicators:
- Іgg– , igm+: specific igm antibodies were found in the body. With a high degree of probability, the infection occurred recently, and now there is an exacerbation of the disease;
- igg+, igm– means: the disease is inactive, although the infection occurred a long time ago. Since immunity has already developed, virus particles that re-enter the body are quickly destroyed;
- igg– , igm– – evidence of a lack of immunity to cytomegalovirus, since this virus has not yet been recognized by the body;
- igg+, igm+ – evidence of reactivation of cytomegalovirus and exacerbation of infection.
Another important indicator is called immunomodulins:
- below 50% is evidence of primary infection;
- 50 – 60% – the result is uncertain. The analysis should be repeated after 3 - 4 weeks;
- over 60% – there is immunity to the virus, although the person is a carrier or the disease has become chronic;
- 0 or negative result – the body is not infected.
If a person does not have immune system diseases, a positive one should not be a cause for concern.
At any stage of the disease, good immunity is a guarantee of an imperceptible and asymptomatic course of the disease.
Only occasionally does cytomegalovirus manifest itself with the following symptoms:
- general malaise.
It is important to remember that intensive and aggravated infection, even in the absence of external signs, it is recommended to reduce your activity for several weeks:
- appear less often in public places;
- communicate as little as possible with children and pregnant women.
At this stage, the virus is actively spreading, capable of infecting another person and requiring serious treatment for cytomegalovirus.
?
The greatest danger to the fetus occurs when the virus enters the female body during pregnancy. The danger increases if a woman becomes infected for the first time and is between 4 and 22 weeks pregnant.
If we are talking about reactivation of cytomegalovirus during pregnancy, the risk of infection for the fetus is minimal, but during pregnancy, cytomegalovirus infection can lead to the following consequences:
- birth of a mentally retarded child;
- The baby develops seizures, hearing or vision loss.
But one should not panic: the tragic consequences of cytomegalovirus are registered in 9% of cases with primary cytomegalovirus infection and 0.1% with re-infection.
Thus, the vast majority of women with such an infection give birth to healthy children!
Situations typical for pregnant women:
- If, even before pregnancy, a blood test showed antibodies to cytomegalovirus), then such a woman will never have a primary infection during pregnancy, since it has already occurred in the past - this is evidenced by antibodies in the blood.
- A blood test for antibodies was taken for the first time during pregnancy and antibodies to the virus were detected. In such cases, reactivation of the infection may occur during pregnancy, and the probability of serious damage to the fetus is 0.1%.
- The blood test was taken before pregnancy. The woman did not have antibodies to cytomegalovirus (igg-, cmv igm-).
Based on other medical publications, it can be argued: unfortunately, in domestic medicine, everything bad that happens to a child is usually attributed to cytomegalovirus infection.
Therefore, they are appointed repeated tests for CMV IgG and CMV IgM, as well as a PCR test for CMV mucus from the cervix.
If there is evidence of constant levels CMV igg and the absence of CMV igm in the cervix, we can safely deny that possible complications pregnancies are caused by cytomegalovirus.
Treatment of cytomegalovirus infection
It should be emphasized: none of the available treatment methods completely eliminates the virus.
If cytomegalovirus is asymptomatic, women with normal immunity do not need treatment.
Therefore, even if cytomegalovirus or antibodies to it were detected in a patient with good immunity, there are no indications for treatment.
Efficiency of use, polyoxidonium, etc. is not a panacea.
It can be argued: immunotherapy for cytomegalovirus infection, as a rule, is driven not so much by medical as by commercial considerations.
Treatment of cytomegalovirus in people with weakened immune systems is reduced to the use of (ganciclovir, foscarnet, cidofovir).
Cytomegalovirus penetrates the child’s cells immediately, remaining there for life, existing in an inactive state.
Children aged 2–6 months are infected with virtually no symptoms or any serious problems for good health.
But if a child becomes infected in the first months of life, infection can provoke a real tragedy.
We are talking about congenital infection, when the child became infected in the mother’s stomach during childbirth.
Which children are more dangerous from the virus?
- children who have not yet been born become infected during the period of intrauterine development;
- with a weakened immune system;
- children of all ages with weakened or absent immunity.
Congenital infection with cytomegalovirus carries the risk of affecting the child with serious damage to the nerves, digestive system, blood vessels and musculoskeletal system.
There is a possibility of irreversible damage to the organs of hearing and vision.
Diagnosed using laboratory analysis. Enzyme immunoassay is widely used in the Russian Federation today.
Preventive measures
Using condoms reduces the risk of acquiring infection during sexual intercourse.
Those with a congenital infection should avoid casual intimate relationships during pregnancy.
Cytomegalovirus is a herpetic type microorganism that is opportunistic and latently lives in the bodies of 90% of people. When the immune system is weakened, it begins to actively multiply and leads to the development of infection. To diagnose the disease, enzyme immunoassay is mainly used for cytomegalovirus IgM- determination of the presence of antibodies to the infectious agent in the blood.
Indications for the study
As a rule, cytomegalovirus does not pose a danger to a person with normal immunity and is asymptomatic; Sometimes mild symptoms of general intoxication of the body appear, which do not lead to the development of complications. However, for pregnant women and people with immunocompromised acute infection may pose a danger.
An enzyme immunoassay for antibodies to CMV is performed if the following symptoms are observed:
- increased body temperature;
- rhinitis;
- a sore throat;
- enlarged lymph nodes;
- inflammation and swelling of the salivary glands, in which the virus is concentrated;
- inflammation of the genital organs.
Most often, cytomegalovirus is difficult to distinguish from a common acute respiratory disease. It is worth noting that a pronounced manifestation of symptoms indicates a weakened immune system, so in this case you should additionally check for immunodeficiency.
The easiest way to distinguish cytomegalovirus from a cold is by the timing of the disease. Symptoms of acute respiratory infections disappear within a week, herpetic infection may remain in acute form for 1–1.5 months.
Thus, the indications for prescribing the analysis are as follows:
- Pregnancy.
- Immunodeficiency (caused by HIV infection, taking immunosuppressants, or congenital).
- The presence of the above symptoms in a person with normal immunity (the disease must first be differentiated from the Epstein-Barr virus).
- Suspicion of CMV in a newborn child.
Given the possible asymptomatic course of the disease, during pregnancy the test should be performed not only in the presence of symptoms, but also for screening.
The immune system first responds to the entry of any foreign microorganisms into the blood by producing antibodies. Antibodies are immunoglobulins, large protein molecules with a complex structure that are able to bind to proteins that make up the shell of viruses and bacteria (they are called antigens). All immunoglobulins are divided into several classes (IgA, IgM, IgG, etc.), each of which performs its own function in the body’s natural defense system.
IgM class immunoglobulins are antibodies that are the first protective barrier against any infection. They are produced urgently when they enter the body. CMV virus, do not have specification and have a short lifespan - up to 4–5 months (although residual proteins that have a low coefficient of binding to antigens may remain 1–2 years after infection).
Thus, an analysis for IgM immunoglobulins allows you to determine:
- primary infection with cytomegalovirus (in this case, the concentration of antibodies in the blood is maximum);
- exacerbation of the disease - IgM concentration increases in response to sharp increase number of viral microorganisms;
- reinfection - infection with a new strain of the virus.
Based on the remnants of IgM molecules, over time, IgG immunoglobulins are formed, which have a specification - they “remember” the structure of a particular virus, persist throughout life and do not allow the infection to develop unless the overall strength of the immune system is reduced. Unlike IgM, IgG antibodies against different viruses have clear differences, so analysis for them gives a more accurate result - they can be used to determine which virus has infected the body, while analysis for IgM only provides confirmation of the presence of infection in a general sense.
IgG antibodies are very important in the fight against cytomegalovirus, since it is impossible to completely destroy it with the help of medications. After the exacerbation of the infection ends, a small number of microorganisms remain in the salivary glands, mucous membranes, and internal organs, which is why they can be detected in samples biological fluids using polymerase chain reaction (PCR). The virus population is controlled precisely by IgG immunoglobulins, which prevent cytomegaly from becoming acute.
Decoding the results
Thus, enzyme immunoassay makes it possible to accurately determine not only the presence of cytomegalovirus, but also the period elapsed since infection. It is important to evaluate the presence of both major types of immunoglobulins, so IgM and IgG antibodies are considered together.
The results of the study are interpreted as follows:
| IgM | IgG | Meaning |
| – | – | A person has never encountered cytomegalovirus, so the immune system is “not familiar” with it. Considering that almost all people are infected with it, the situation is very rare. |
| – | + | Normal for most people. This means that there was contact with the virus in the past, and the body has developed a permanent defense against it. |
| + | – | Acute primary infection - the infection occurred recently, “fast” immunoglobulins were activated, but there is no permanent protection against CMV yet. |
| + | + | Exacerbation chronic infection. Both types of antibodies are activated when the body has encountered the virus previously and has developed permanent protection, but it does not cope with its task. Such indicators indicate a serious weakening of the immune system. |
Special attention positive result Pregnant women should be tested for IgM antibodies. If IgG immunoglobulins are present, there is nothing to worry about; acute infection poses a danger to the development of the fetus. Complications in this case occur in 75% of cases.
In addition to the actual presence of antibodies when enzyme immunoassay The avidity coefficient of proteins is assessed - their ability to bind to antigens, which decreases as they are destroyed.
The results of the avidity study are deciphered as follows:
- >60% - immunity to cytomegalovirus is developed, infectious agents are present in the body, that is, the disease occurs in a chronic form;
- 30–60% - relapse of the disease, an immune response to the activation of a virus that was previously in a latent form;
- <30% - первичное инфицирование, острая форма заболевания;
- 0% - no immunity, there was no CMV infection, there are no pathogens in the body.
It should be borne in mind that a person with a strong immune system does not need to worry about positive test results - cytomegalovirus does not require drug treatment, the body is quite capable of coping with the infection on its own. However, if the results indicate an acute phase of the disease, you should limit contact with healthy people, especially pregnant women, as there is a high probability of spreading the virus.
Positive IgM result during pregnancy
For women planning a pregnancy or already carrying a child, it is very important to know about a past infection with cytomegalovirus, as this can affect the development of the fetus. An enzyme immunoassay for antibodies comes to the rescue with this.
Test results during pregnancy are assessed differently. The safest option is positive IgG and negative IgM - there is nothing to worry about, since the woman has immunity against the virus, which will be passed on to the child, and there will be no complications. The risk is also small if positive IgM is detected - this indicates a secondary infection that the body is able to fight, and there will be no serious complications for the fetus.
If no antibodies of either class are detected, the pregnant woman should be very careful. It is important to follow measures to prevent infection with cytomegalovirus:
- avoid sexual intercourse without using contraception;
- avoid sharing saliva with other people - do not kiss, do not share dishes, toothbrushes, etc.;
- maintain hygiene, especially when playing with children, who, if they are infected with cytomegalovirus, are almost always carriers of the virus, since their immunity is not yet fully formed;
- See a doctor and get tested for IgM for any manifestations of cytomegalovirus.
It is important to remember that it is much easier to become infected with the virus during pregnancy due to the fact that a woman’s immunity naturally weakens during pregnancy. This is a mechanism of protection against rejection of the embryo by the body. Like other latent viruses, old cytomegalovirus can become active during pregnancy; this, however, only in 2% of cases leads to infection of the fetus.
If the result for IgM antibodies is positive and for IgG antibodies is negative, the situation is most dangerous during pregnancy. The virus can enter the fetus and infect it, after which the development of the infection may vary depending on the individual characteristics of the child. Sometimes the disease is asymptomatic, and permanent immunity against CMV develops after birth; in 10% of cases, the complication is various pathologies of the development of the nervous or excretory system.
Particularly dangerous is infection with cytomegalovirus during pregnancy of less than 12 weeks - an underdeveloped fetus cannot resist the disease, which leads to miscarriage in 15% of cases.
An IgM antibody test only helps determine the presence of the disease; The risk to the child is assessed through additional tests. Based on a number of factors, appropriate pregnancy management tactics are developed to help minimize the likelihood of complications and congenital defects in the child.
Positive result in a child
An embryo can become infected with cytomegalovirus in several ways:
- through sperm during fertilization of the egg;
- through the placenta;
- through the amniotic membrane;
- during childbirth.
If the mother has IgG antibodies, then the child will also have them until about 1 year of age - initially they are there, since during pregnancy the fetus shares a common circulatory system with the mother, then it is supplied with breast milk. As breastfeeding stops, the immune system weakens and the child becomes susceptible to infection from adults.
Positive IgM in a newborn indicates that the child was infected after birth, but the mother does not have antibodies to the infection. If CVM is suspected, not only an enzyme-linked immunosorbent assay is performed, but also PCR.
If the child’s body’s own defenses are not enough to fight the infection, complications may develop:
- slowdown in physical development;
- jaundice;
- hypertrophy of internal organs;
- various inflammations (pneumonia, hepatitis);
- lesions of the central nervous system - mental retardation, hydrocephalus, encephalitis, problems with hearing and vision.
Thus, the child should be treated if IgM antibodies are detected in the absence of IgG immunoglobulins inherited from the mother. Otherwise, the body of a newborn with normal immunity will cope with the infection on its own. Exceptions are children with serious oncological or immunological diseases, the course of which may affect the functioning of the immune system.
What to do if the result is positive?
A person’s body with a healthy immune system is able to cope with the infection on its own, so if an immune response to cytomegalovirus infection is detected, nothing can be done. Treatment of a virus that does not manifest itself in any way will only lead to a weakening of the immune system. Medicines are prescribed only if the infectious agent has begun to actively develop due to an insufficient reaction of the body.
Treatment is also not necessary during pregnancy if there are IgG antibodies. If only the IgM test is positive, medication is necessary, but it is intended to contain the acute infection and convert the cytomegalovirus into a latent form. It should be remembered that medications for CMV are also unsafe for the body, so they can only be used if prescribed by a doctor - self-medication will lead to various adverse consequences.
Thus, positive IgM indicates an active stage of CMV infection. It should be considered in conjunction with other test results. Particular attention to the test indications should be paid to pregnant women and people with weakened immune systems.
