Cytomegalovirus: symptoms in adults
When infected, the incubation period can range from 20 to 60 days.
Adults who test positive for cytomegalovirus IgG, IgM, and DNA may exhibit the following symptoms: • Signs of peripheral nerve damage;
• Manifestations similar to ARVI;
• Stomach and intestinal upset;
• Inflammation of the joints - with inflammation of unknown origin, testing for cytomegalovirus IgG, IgM and DNA is positive;
• Chronic fatigue, asthenia and vegetative-vascular dystonia;
• Skin rash;
• Damage to blood vessels of the eyes, brain;
• Signs of damage to the liver, kidneys, bronchi, adrenal glands, etc.
When the test for cytomegalovirus IgG, IgM and DNA is positive: transcript
Testing for IgG, IgM antibodies to cytomegalovirus and its DNA in adults is the most reliable way to identify the infection and start treatment on time.
It is especially important to determine infection in pregnant women. If the test result for cytomegalovirus IgG is positive, the risk of intrauterine infection cannot be excluded. Its likelihood is higher if IgG antibodies to cytomegalovirus are detected together with IgM, and also if the IgG concentration exceeds the reference values, which range from 0 to 6 U/ml.
If the cytomegalovirus IgG test result is positive, contact with the virus is confirmed. If the test for cytomegalovirus IgG is positive together with IgM, then we can think about an acute period of infection. If the test for cytomegalovirus IgG is positive, and IgM is positive in a titer of 1:200 or more, the likelihood of a recent primary infection is very high.
A negative result for both antibodies allows one to exclude infection or suspect a seronegative version of it, and may also indicate severe immune suppression.
Cytomegalovirus in children
Even during fetal development, cytomegalovirus in children can provoke birth defects and health problems. Therefore, tests for IgG antibodies to cytomegalovirus and for the detection of DNA to the virus are included in the list of tests for TORCH infections (herpes, toxoplasma, rubella and CMV), which are necessary for all women during pregnancy or when planning it.
If CMV infection occurs in the early stages of pregnancy, the risk of miscarriage is very high. In cases where the infection enters the body in late pregnancy, cytomegalovirus in children may not manifest itself for a long time. The child remains a carrier of the virus and faces periodic exacerbations due to decreased immunity. IgG antibodies to cytomegalovirus are detected in his blood and the IgG cytomegalovirus test is positive. IgG and IgM antibodies to cytomegalovirus are found in 10-15% of adolescents.
Antibodies to cytomegalovirus IgG, CMV IgG quantity.
Antibodies to cytomegalovirus IgG, CMV IgG quantitative
- allows you to determine the presence of IgG antibodies to cytomegalovirus (CMV or CMV), which indicates a current or recent infection. The duration of the incubation period ranges from 15 days to 3 months. With this infection, non-sterile immunity occurs (that is, complete elimination of the virus is not observed). Immunity to cytomegalovirus infection (CMVI) is unstable and 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. When a person comes into contact with CMV, his immune system exhibits a protective response by producing IgM and IgG antibodies against CMV.
IgG antibodies to cytomegalovirus are specific immunoglobulins that are produced in the human body during the period of pronounced clinical manifestations of cytomegalovirus infection and indicate current or recent infection.
Cytomegalovirus infection
is a widespread viral infection of the body, which belongs 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.
In healthy people with normal immunity, the primary infection occurs without complications (and is often asymptomatic). In rare cases, a picture of infectious mononucleosis develops (about 10% of all cases of infectious mononucleosis), clinically indistinguishable from mononucleosis caused by the Epstein-Barr virus. Replication of the virus occurs in the tissues of the reticuloendothelial system, epithelium of the urogenital tract, liver, mucous membrane of the 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 in immunodeficiency states
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, carry out 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. Confirming or excluding the fact of recent infection is especially important when examining pregnant women, since it is with primary infection during pregnancy that the risk of vertical transmission of infection and the development of fetal pathology is high.
If an intrauterine infection develops before 10 weeks, there is a risk of developmental defects and possible spontaneous termination of pregnancy. When infected at 11–28 weeks, intrauterine growth retardation and hypo- or dysplasia of internal organs occur. If infection occurs at a later date, the lesion 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 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 and carry out the necessary tests, then you can keep the infection in a “dormant” state for many years. This will ensure a normal pregnancy and the birth of a healthy child.
Laboratory diagnosis of cytomegalovirus infection is of particular importance in the following categories of subjects:
Women preparing for pregnancy
1. Latent course of the disease 2. Difficulty in differential diagnosis of primary infection and recurrent infection during examination during pregnancy 3. Severe consequences of 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.
CMV and TORCH
CMV infection is part of the group of TORCH infections (the name is formed by the initial letters of 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 infection 2–3 months before a planned pregnancy, since in this case it will be possible to take appropriate therapeutic or preventive measures, and, if necessary, compare the results of studies before pregnancy in the future 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 of infectious mononucleosis in the absence of infection caused by the Epstein-Barr virus;
- hepato-splenomegaly of unknown nature;
- fever of unknown etiology;
- increased levels of liver transaminases, gamma-GT, alkaline phosphatase in the absence of markers of viral hepatitis;
- atypical course of pneumonia in children;
- miscarriage (frozen pregnancy, recurrent miscarriages).
Preparation
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;
- CP <= 9.0 – negative;
- CP 9.0–11.0 is doubtful.
Exceeding reference values:
- CMV infection;
- intrauterine infection is possible, the likelihood of its occurrence is unknown.
Within reference values:
- No CMV infection was detected;
- infection occurred within the previous 3–4 weeks;
- intrauterine infection is impossible (except in the presence of IgM).
“Doubtful
” is a borderline value that does not allow reliably (with a probability of more than 95%) to classify the result as “Positive” or “Negative”. It should be borne in mind that such a result is possible with a very low level of antibodies, which can occur, in particular, in the initial period of the disease. Depending on the clinical situation, repeat testing of antibody levels after 10–14 days may be useful to assess changes.
*Positivity rate (PR) is the ratio of the optical density of a 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: treatment
With a diagnosis that is confirmed when testing for cytomegalovirus IgG, IgM and DNA is positive, treatment should be comprehensive. First of all, if the test for IgG, IgM and DNA is positive, treatment should be aimed at strengthening the human immune system.
With active manifestations of cytomegalovirus, treatment is also aimed at improving liver function and reducing the symptoms of infection (headache, upset stomach, fever, rash).
If cytomegalovirus is diagnosed, treatment may be required against the background of reduced immunity, as well as as a preventive measure for new exacerbations of the infection.
Complexes with this research
TORCH infections.
Avidity of IgG antibodies Diagnosis of TORCH infections with determination of avidity of IgG antibodies 5,920 ₽ Composition Miscarriage Identification of the main causes of miscarriage 40,070 ₽ Composition
Entry into IVF Examination when a woman enters the IVF procedure 23,020 ₽ Composition
IN OTHER COMPLEXES
- Examination during pregnancy. 1st trimester 16,690 RUR
- Pregnancy planning. Diagnosis of infections RUB 8,620
- IVF planning RUB 12,990
