Anti-CMV-IgM (Antibodies of the IgM class to cytomegalovirus, CMV, CMV). Cytomegalovirus IgG positive: is it dangerous and what to do in this case

Peculiarities

• Price: price list.
• Period of execution: 3-4 working days.
• Where can you donate: This analysis You can hand over at any medical office "DIAMED".
• Preparation for analysis: Stop taking 3 weeks before the test medicines. Blood is given in the morning on an empty stomach.

Description

Antibodies of the IgM class to cytomegalovirus (CMV, CMV).

Antibodies of the IgG class to cytomegalovirus (CMV, CMV).

IgG Avidity to cytomegalovirus virus (CMV, CMV). Characterization of the strength of the connection of specific antibodies with the corresponding antigens.

Functions.

In response to the introduction of cytomegalovirus (CMV) into the body, an immune restructuring of the body develops. 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 in cytomegalovirus infection (CMV) is unstable, slow. Reinfection with an exogenous virus or reactivation of a latent infection is possible. Due to prolonged persistence in the body, the virus acts on all parts of the patient's immune system. The protective reaction of the body is manifested primarily in the form of the formation of specific antibodies of the IgM and IgG classes to CMV. Specific antibodies are responsible for the lysis of the intracellular virus, and also inhibit its intracellular replication or spread from cell to cell. The sera of patients after primary infection contain antibodies that react with internal CMV proteins (p28, p65, p150). The serum of recovered people contains mainly antibodies that react with envelope glycoproteins.

Greatest diagnostic value has the definition of IgM, as an indicator of the activity of the process, which may indicate an acute current disease, reinfection, superinfection or reactivation. The appearance of anti-CMV IgM antibodies in a previously seronegative patient is indicative of a primary infection. In endogenous reactivation of an infection, IgM antibodies are formed irregularly (usually in quite low concentrations) or may be absent altogether. Detection of class G immunoglobulins also makes it possible to identify primary cytomegalovirus infection (CMVI), monitor the dynamics of persons with clinical manifestations of the infection, and help with retrospective diagnosis. In severe CMV infections, as well as in pregnant women and young children, 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 antibody dynamics. . Antibodies of the IgG class to cytomegalovirus (CMV, CMV) indicate a current or past cytomegalovirus infection.

The avidity index for cytomegalovirus (CMV) characterizes the strength of the binding of specific antibodies to the corresponding antigens and is an indicator of the formation of the human body's immune response to the infection.

features of the infection.

Cytomegalovirus (CMV) infection is a widespread viral defeat organism, which refers to the so-called opportunistic infections, usually occurring latently. Clinical manifestations are observed against the background of physiological immunodeficiency states(children of the first 3-5 years of life, pregnant women - more often in the 2nd and 3rd trimester), as well as in people with congenital or acquired immunodeficiencies (HIV infection, the use of immunosuppressants, oncohematological diseases, radiation, diabetes, etc.).

Cytomegalovirus is a virus of the herpes family of viruses. Like other members of the family, after infection, it remains in the body for almost a lifetime. Resistant in a humid environment. The risk group is made up of children 5-6 years old, adults 16-30 years old, as well as people practicing anal sex. Children are susceptible to airborne transmission from parents and other children with latent infections. 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 a variety clinical manifestations, but with full immunity it is clinically 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. Virus replication occurs in the tissues of the reticuloendothelial system, epithelium of the urogenital tract, liver, and mucous membranes. respiratory tract and digestive tract. With a decrease in immunity after organ transplantation, immunosuppressive therapy, HIV infection, as well as in newborns, CMV poses a serious threat, since the disease can affect any organ. possible development of hepatitis, pneumonia, esophagitis, gastritis, colitis, retinitis, diffuse encephalopathy, fever, leukopenia. The disease can be fatal.

Cytomegalovirus infection in pregnant women, examination during pregnancy

At primary infection a pregnant woman with cytomegalovirus (in 35-50% of cases) or reactivation of the infection during pregnancy (in 8-10% of cases) develops intrauterine infection. With the development of intrauterine infection for up to 10 weeks, there is a risk of malformations, spontaneous abortion is possible. When infected at 11 - 28 weeks, there is a delay prenatal development, hypo- or dysplasia of internal organs. If infection occurs at a later date, the lesion may be generalized, involve a specific organ (eg, fetal hepatitis) or appear after birth (hypertensive-hydrocephalic syndrome, hearing loss, interstitial pneumonitis, etc.). Manifestations of infection also depend on the immunity of the mother, virulence and localization of the virus.

To date, no vaccine has been developed against cytomegalovirus. Medical 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: it is impossible to remove cytomegalovirus from the body. But if in a timely manner, at the slightest suspicion of infection with this virus, you consult a doctor, perform the necessary tests, then you can long years keep the infection dormant. This will provide normal gestation pregnancy and delivery of a healthy child.

Special meaning laboratory diagnostics cytomegalovirus infection has in the following categories of subjects:

Sequential repeated determination of the level of IgG antibodies in newborns makes it possible to distinguish congenital infection (constant level) from neonatal infection (increase in titers). If the titer of IgG antibodies does not increase during a second (two weeks later) analysis, then there is no reason for alarm; if the titer of IgG increases, an abortion should be considered.

Indications for the purpose of the analysis:

1. Preparation for pregnancy;
2. Signs of intrauterine infection, feto-placental insufficiency;
3. The state of immunosuppression in HIV infection, neoplastic diseases, taking cytostatic drugs, etc.;
4. The clinical picture of infectious mononucleosis in the absence of an infection caused by the Epstein-Barr virus;
5. Hepato-splenomegaly of unclear nature;
6. Fever of unknown etiology;
7. Increased levels of hepatic transaminases, gamma-HT, alkaline phosphatase in the absence of markers viral hepatitis;
8. Atypical course of pneumonia in children;
9. Miscarriage (missed pregnancy, habitual miscarriages).

Material for research: serum.

Definition method: linked immunosorbent assay(IFA).

Reference values: In the "DIAMED" laboratory, when anti-CMV IgM, IgG antibodies are detected, the result is "positive", in case of their absence - "negative".

RESULT ON THE DETERMINATION OF Ig M:

Positive result:

1. Primary infection or reactivation of infection;
2. intrauterine infection possible.

Negative result:

1. CMV infection occurred more than 3 to 4 weeks ago;
2. Infection in the period of 3-4 weeks before the examination is excluded;
3. Intrauterine infection is unlikely.

Ig G RESULT:

Positive result:

1. CMV infection;
2. Intrauterine infection is possible, the likelihood of its occurrence is unknown.

Negative result:

1. CMV infection was not detected;
2. The infection has occurred within the previous 3 to 4 weeks;
3. Intrauterine infection is not possible (except in the presence of IgM).

RESULT ON THE DETERMINATION OF Ig G AVIDITY:

Less than 40% are low avid;

More than 70% are highly avid;

40-70% - "gray" zone - late stage acute period of infection.

IMPORTANT! CMV infection belongs to the group of TORCH infections (the name is formed initial letters in Latin names - Toxoplasma, Rubella, Cytomegalovirus, Herpes), which are considered potentially dangerous for the development of the child. Ideally, consult a doctor and go through laboratory examination for TORCH infection, a woman needs 2 to 3 months before the planned pregnancy, since in this case it will be possible to take appropriate medical or preventive measures and, if necessary, in the future to compare the results of studies before pregnancy with the results of examinations during pregnancy.

Cytomegalovirus is a virus belonging to the herpesvirus family. At this virus 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.

Symptoms are very similar to acute respiratory infections or SARS. The body temperature rises, the head hurts a lot and there are phenomena of general discomfort. An untreated virus can result in inflammation of the lungs and joints, brain damage, or other dangerous diseases. The infection is in the body all human life.

The year of discovery of the virus is 1956. It is still being actively studied, its action and manifestations. Every year brings new knowledge.

The contagiousness of the virus is low.

Ways of transmission: sexual, contact-household (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 an increase in body temperature, feelings of chills, fatigue and general malaise, and severe pain in the head. A mononucleosis-like syndrome has a happy ending - recovery.

There is a particular danger for two categories of people - those who have weak immunity and babies infected in utero from a sick mother.

An increase in the titer of antibodies in the blood to cytomegalovirus by four times and even more indicates the activation of cytomegalovirus.

What does cytomegalovirus IgG positive mean?

With a positive interpretation of the analysis for the determination of IgG antibodies to cytomegalovirus infection, what is the conclusion?

The human immune system successfully coped with a cytomegalovirus infection about a month ago, or even more.

This organism has formed a lifelong stable immunity. Carriers are about 90% of people, so there is no norm for 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 the presence of a virus in PCR analysis when examining material containing certain DNA.

From the tenth to the 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 can be maternal 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 herpetic. And she also happens often.

Even if infection occurs in early childhood but a person has a good life strong immunity, then cytomegalovirus infection may never manifest itself. A person is only a virus carrier all his life.

There are children who suffer greatly from cytomegalovirus:

• 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 greatly weakened immune system, or, for example, in patients with AIDS.

Infection is diagnosed most often by ELISA (enzyme-linked immunosorbent assay). This method can determine not only the presence of cytomegalovirus infection in the child's body. But also to say for sure whether it is congenital or acquired.

For newborns, cytomegalovirus is Infectious mononucleosis. Amazed lymphatic system- lymph nodes become enlarged and inflamed palatine tonsils, the liver and spleen enlarge, it becomes difficult to breathe.

In addition, congenital infection is characterized by:

• prematurity;
• strabismus;
• jaundice in newborns;
• violations of the swallowing and sucking reflexes.

Violation of nasal breathing threatens with such symptoms:

• loss of appetite and weight loss;
• sleep disorders;
• crying and anxiety.

Congenital infection of a child often occurs even in utero. But sometimes through birth canal mother or breast milk when feeding.

Most often there is a very dangerous asymptomatic course of cytomegalovirus infection. Even two months after birth.

For these children, complications are possible:

• in 20% of children with asymptomatic active cytomegalovirus, months later, the presence of severe convulsions, incorrect movements of the limbs, changes in the bones (for example, in the skull), insufficient body weight;
• after five years, 50% have speech impairment, intellect suffers, the cardiovascular system is affected, and vision is severely affected.

If the child became infected at a later time, and not during the neonatal period, when the the immune system, there are practically no consequences.

Most often asymptomatic or reminiscent of the classic children's SARS.

Characterized by:

• lethargy and drowsiness;
• cervical lymphadenitis;
• pain in the musculoskeletal system (muscles and joints);
• chills and subfebrile temperature.

It lasts two weeks - two months. Ends in self-healing. Very rarely, if the disease does not go away for two to three months, medical consultation and treatment is necessary.

Most early diagnosis 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 chronic form. Most often it is asymptomatic, but sometimes there are symptoms. A weak immune system contributes to the active manifestation of the disease.

Cytomegalovirus infection, unfortunately, affects women at any age. Provoking factors are cancer, HIV infection or AIDS, gastrointestinal pathology. Another such effect is observed from taking anticancer drugs and antidepressants.

AT 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, such clinical picture similar to infectious mononucleosis. It is characterized by headache, feeling unwell, hepatomegaly, atypical mononuclear cells in the blood.

Immunodeficiency (for example, HIV infection) causes a severe generalized form of cytomegalovirus infection. Are amazed internal organs, vessels, nerves and salivary glands. There is cytomegalovirus hepatitis, pneumonia, retinitis and sialodenitis.

Nine out of ten women with AIDS have cytomegalovirus infection. They are characterized bilateral pneumonia and phenomena of 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 organs of the MPS.

Cytomegalovirus during pregnancy

An infection from a person who has an acute form of the disease is the worst option for pregnant women.

There are no antibodies in the pregnant woman's blood.

The active virus of the infecting person easily passes through all barriers and adversely affects the child. According to statistics, this happens in half of the cases of infection.

If the factors that weaken the immune system exacerbate the latent virus carrier, 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 for more than later dates 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 attentive to their health. Cytomegalovirus is very dangerous for the fetus.

Cytomegalovirus IgM positive

IgM is the first protective barrier against all kinds of virus. They do not have a specification, but they are produced urgently as a response to the penetration of a cytomegalovirus infection into the body.

IgM analysis is carried out to determine:

• primary virus infection (maximum antibody titer);
• stages of aggravated cytomegalovirus (the number of the virus grows and the number of IgM grows);
• reinfection (a new strain of cytomegalovirus has produced infection).

Later, specific IgG antibodies are formed from IgM. If the strength of immunity does not fall, then IgG fights cytomegalovirus all their lives. The IgG antibody titer is highly specific. It can be used to determine the specification of the virus. Given that the analysis for IgM shows the presence of any virus in the test material.

The number of cytomegalovirus is subject to control by immunoglobulin G without allowing the picture of an acute illness to develop.

An IgM positive result with an IgG negative result indicates acute recent infection and lack of permanent immunity against CMV. aggravation chronic infection indicators are characteristic 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 can not cope, and non-specific IgM appear.

Presence of positive IgG and negative IgM best result analysis in a pregnant woman. She has specific immunity, which means that the child will not get sick.

If the situation is reversed, with positive IgM and negative IgG, then this is also not a problem. This indicates a secondary infection, which is being fought in the body, which means that there should be no complications.

Worse, if there are no antibodies at all, both classes. It speaks of a special situation. Although this situation is very rare.

AT modern society almost all women are infected.

Treatment of cytomegalovirus and treatment results

If a person has healthy immunity, then he himself will cope with the cytomegalovirus infection. It is possible not to carry out any therapeutic actions. Immunity will only be weakened if treated for a cytomegalovirus infection that does not manifest itself. Medical treatment necessary only when the immune defense fails and the infection is actively increasing.

Pregnant women also do not need to be treated if they have specific IgG antibodies in their blood.

At positive analysis to IgM, for translation acute condition in the latent course of the disease. It must always be remembered that drugs 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. Other test results must also be taken into account. It is especially necessary to monitor the presence of antibodies in the body of pregnant women and immunodeficient people.

Cytomegalovirus infection (CMVI) is a disease caused by a virus from the herpesvirus family. Cytomegaloviruses are dangerous not only for humans, but also for other mammals. Most often, traces of this virus can be found in salivary glands, although it can be present in any other human organs and tissues.

In a dormant state, cytomegalovirus is found in more than half of the entire population (according to some sources, up to 90%) and does not harm its carrier until his immunity is weakened for any reason.

What is cytomegalovirus?

The virus is common in people of all ages, countries and social statuses. The highest percentage of carriers is reported to be among the elderly, as well as among the populations of developing countries. CMVI poses a threat to infants and unborn children, because. under certain circumstances, may cause them birth defects and disorders of the immune system.

In people with normal immunity, infection with cytomegalovirus can be almost asymptomatic. Common complaints reported include:

• frequent colds accompanied by sore throat;
• mild hepatitis;
• mononucleosis.

The main danger of cytomegalovirus is not in itself, but indirectly affecting the state of the human immune system, thereby causing secondary infections. This is especially important for people whose immunity is deficient in various reasons: pregnancy (especially for fetuses), long-term use of antibiotics or other immunosuppressive drugs, old age, HIV-positive status, organ transplant, malignant tumors.

The exact mechanism of transmission of cytomegalovirus remains in question, but scientists suggest that it is associated with close contact and exchange of body fluids.

Indirect confirmation of this assumption can be the fact that most widespread the virus is noted inside families and in kindergartens. In particular, these may be:

• breast milk;
• sperm;
• saliva;
• blood.

To date, not enough has been developed effective vaccine against cytomegalovirus - the latest development has only 50% effectiveness. Specific treatment is carried out by introducing class G immunoglobulins to the patient. These are antibodies that effectively fight the disease, which has already been confirmed clinical trials and statistics. Also can be used non-specific treatment other antiviral drugs.

Introduction to antibodies and immunity in general

In most diseases, the body uses the same strategy to fight the pathogen - it produces specific antibodies that only infect viruses, without affecting other body cells. Once having fought with some type of virus, the body forever “remembers” it, continuing to produce antibodies.

It is for these compounds that the presence of immunity is determined - in the analyzes, the term "titers" refers to the amount of antibodies. Antibodies can be produced not only under the influence of the disease itself, but also with the introduction of a vaccine, in the process of the body's struggle with weakened viruses.

A blood test for cytomegalovirus shows antibodies of class G. G is a class of immunoglobulins specific to cytomegalovirus. In addition to it, there are immunoglobulins of classes A, E, D, M. The word "immunoglobulin" itself is indicated in the test results as Ig. Thus, in the results of tests for antibodies to cytomegalovirus, positive result or negative.

This reflects the presence or absence of cytomegalovirus in the body. A more specific result is given by an analysis for IgM bodies. If the analysis for cytomegalovirus IgM is positive, this means that the infection has entered the body relatively recently and the immune system is in the “fast stage” of the response, because. such bodies do not function permanently in the body after infection, like IgG, but exist only 4-5 months after infection.

If IgG antibodies to cytomegalovirus are found in the blood, this means that those viruses that were outside the cells of the body were successfully overcome by immunity about a month ago. The same viral particles that are inside the cells remain there forever, being in a "sleeping" state.

Self-copying of antibodies of the IgG class is due to the fact that the “dormant” virus from time to time throws out a small number of clones into the blood. reinfection cytomegalovirus is possible with a weakened immune system.

Thus, whatever the result of the analysis for the determination of antibodies, the IgG indicator will not reflect the disease. This can only mean that the organism has ever encountered a virus (if the result is positive), or that the virus has never been in it (if the result is negative). A positive cytomegalovirus is not dangerous for a person with normal immunity.

Deciphering the results of the analysis

When donating blood for antibodies to cytomegalovirus, the laboratory provides reference values ​​\u200b\u200band a transcript of the results, so there should be no problems with understanding the transcript. Usually, the decoding indicates IgG + or IgG-, respectively, for positive or negative results. The result is considered negative if less than 0.4 conventional titer units are found in the blood serum.

It should be noted that for this analysis there is no concept of a norm. The body of each person produces its own amount of antibodies, depending on what lifestyle he adheres to, how stable his immune system is, what diseases he had to endure earlier.

The norm in deciphering analyzes is a conditional indicator, relative to which a decision is made about the presence or absence of antibodies in the sample. This indicator can also vary depending on the errors of the equipment used.

The study is carried out according to the principle of enzyme immunoassay (ELISA). Detection of antibodies to cytomegalovirus occurs by sequential dilution of blood serum and subsequent staining of the solution. A quantitative value is assigned to the result according to the value of the dilution factor.

As mentioned earlier, positive IgG itself does not give an idea of ​​a threat to the body, but only of long-term contact with the infection.

To get a complete picture, it is also necessary to take tests for IgM and the avidity of IgG antibodies. The latter indicator reflects the stage of development of the infection. Based on the combination of three indicators, it is possible to draw a conclusion about the need for treatment and monitoring of the patient. The following combinations can be obtained:

In the event that as a result of the analysis ambiguous results were obtained, or if the examination is performed in a patient with an immunodeficiency, it is required to recheck the analyzes by PCR. In the case of immunodeficient patients, this need is dictated by the likelihood of superinfection.

What to do if IgG is detected?

As already mentioned, antibodies to cytomegalovirus themselves are a good sign This means that the body has successfully coped with the infection. However, if other indicators indicate that the infection has occurred quite recently, some precautions should be taken.

AT acute phase infections, the patient should protect all intimate contacts, avoid hugging, eating from the same dish, and, if possible, close contact with pregnant women, the elderly and infants. Due to the fact that the ways of transmission of cytomegalovirus have not been established reliably, it can be assumed that it is possible and airborne route transmission.

Is it necessary to sound the alarm if antibodies to cytomegalovirus are found in the blood of the expectant mother? After reading the article, you can learn about the features of the infection, possible risks for the expectant mother and child.

All infections caused by viruses from the HERPESVIRIDAE family (herpesviruses) have a similar pathogenesis: the disease persists, proceeds in a latent or chronic form. So is cytomegalovirus: it can “sleep” in the body for many years, not at all making itself felt or waking up (reactivating) from time to time.

Causes and symptoms of cytomegalovirus

Cytomegalovirus hominis (Human Cytomegalovirus) is a DNA-containing pathogen, which belongs to the HERPESVIRIDAE (Herpesviruses) family. The name of the virus, "giant cell", is due to the fact that the cells it affects can be multinucleated and have a huge size.

Cytomegalovirus is also different in that it can long time persist in the environment. This partly explains its high contagiousness.

IMPORTANT: According to the WHO (World Health Organization), 2 out of 10 adolescents and 4 out of 10 adults are carriers of a particular strain of Cytomegalovirus hominis.

The source of CMV infection is an infected person. Cytomegalovirus hominis is found in its saliva, tears, nasal secretions, semen, female genital secretions, urine and feces.

Transmitted by Cytomegalovirus hominis, regardless of strain:

• contact (including through objects)
• airborne
• through the placenta from mother to child
• organ transplant or blood transfusion

Infection with cytomegalovirus infection occurs very often, its gateway is the mucous membrane lining the genitals, upper respiratory tract and gastrointestinal tract. However, the body healthy person copes with it, so the disease in the vast majority of people proceeds in a latent form.

IMPORTANT: The incubation period of CMV infection is 30-60 days. If a person's immunity is strong, it suppresses the disease in 1-2 months. Suppresses, but does not cure: in an inactive form, Cytomegalovirus hominis can live in the host's body for years and reactivate under favorable circumstances, that is, in the case of a decrease in immunity. It is difficult and not always possible to distinguish between primary infection and reactivation of the virus.

Symptoms of the same infection appear in those who are in a state of immunodeficiency. Acquired cytomegalovirus disease is often referred to as mononucleosis-like syndrome and presents as follows:

• weakness
• subfebrile condition or fever
• myalgia (muscle pain)
• swollen lymph nodes

Since Cytomegalovirus hominis can infect the respiratory system and liver, some patients with acute CMV infection may present as influenza or viral hepatitis.

If the human immune system is strong, after 30-60 days, the production of anti CMV immunoglobulin, the symptoms of the disease fade.

IMPORTANT: A carrier of Cytomegalovirus hominis remains contagious for weeks and months after symptoms of CMV infection disappear.

In people with weak immunity, as well as in pregnant women and young children, cytomegalovirus can cause:

• retinitis (inflammation of the retina)
• pneumonia
• hepatitis
• enterocolitis
• ulcers of the esophagus, stomach, intestines
• inflammation of the genitals
• encephalitis

Symptoms of cytomegalovirus during pregnancy. What is cytomegalovirus reactivation during pregnancy?

The development of CMV in pregnant women is possible in two cases:

• with primary infection (the risk of transplacental infection is higher)
• in case of reactivation of a dormant virus in the body (the risk of transplacental infection is lower)

If the expectant mother is a carrier of the virus, but she does not have symptoms of the disease, infection of the child through the placenta may not occur.

Clinical forms of infection caused by Cytomegalovirus hominis are also different in expectant mothers.

If the disease is acute, the lungs, liver, eyes, genitals, and brain may be affected. A pregnant woman may have complaints about:

• weakness and fatigue
• specific discharge from the nose or genital tract
• swollen and sore lymph nodes

CMV infection affects normal flow pregnancy. If the disease is acute, the expectant mother is often diagnosed with:

• vaginitis
• colpitis
• uterine hypertonicity
• premature aging of the placenta
• oligohydramnios

CMV infection can also come back to haunt a pregnant woman:

• premature detachment of the placenta
• weakening of labor activity
• blood loss during childbirth
• postpartum endometritis

VIDEO: Cytomegalovirus infection and pregnancy

Cytomegalovirus during pregnancy: consequences for the fetus

Cytomegalovirus hominis can also affect a baby in the womb.

IMPORTANT: dangerous situation doctors consider that when intranatal infection of a child with cytomegalovirus occurs in the first trimester of pregnancy. There is a risk of fetal death or the occurrence of various severe malformations in it.

Perinatal pathologies caused by CMV infection are:

1. Regardless of the gestational age at which the infection occurred: stillbirth, prematurity, fetal malnutrition
2. Infection occurred at an early stage: malformations of the nervous system (microcephaly, hydrocephalus), respiratory organs (lung hypoplasia), digestive organs, urination, heart disease
3. Infection occurred at a later date: the birth of a child with pneumonia, jaundice various genesis, hemolytic anemia, nephritis, meningoencephalitis, other

A child with congenital CMV infection may appear completely healthy at first. But over time, they may appear:

• hearing impairment up to deafness
• visual impairment up to blindness
• decline in intelligence
• speech problems

Cytomegalovirus in pregnancy planning. Analysis for cytomegalovirus during pregnancy

A woman who is serious about planning a pregnancy consults a gynecologist, and already at this stage she is tested for TORCH infection, which allows her to identify a number of serious illnesses that can disrupt the course of pregnancy and affect the health of the child, or antibodies to them.

IMPORTANT: The "C" in TORCH stands for Cytomegalovirus hominis.

A serological blood test reveals the presence of anti-CMV immunoglobulins of class M and G and its titer in a woman.

Antibodies to cytomegalovirus - what does it mean? Deciphering the analysis for cytomegalovirus in pregnant women

The results of a test for Cytomegalovirus hominis in a pregnant woman will allow the doctor to answer three important questions:

• Is the mother-to-be infected with cytomegalovirus?
• if so, when did the infection occur?
• if yes, is the virus active

Indicators of cytomegalovirus during pregnancy, normal. What do cytomegalovirus titers mean during pregnancy?

An analysis that did not reveal IgM and IgG antibodies to Cytomegalovirus hominis is considered normal. This means that the woman is not infected. But there is absolutely no guarantee that infection will not occur in the pre-delivery period of time.

1. A high IgM titer in the absence of IgG indicates acute period CMV - infections and, accordingly, a high risk of infection of the fetus
2. A high titer of IgG in the absence of IgM indicates the presence of a virus and the possibility of reactivation.
3. Low titer of IgM and IgG - infection at the stage of attenuation
4. High titer of IgM and IgG - reactivation of Cytomegalovirus hominis

Treatment of cytomegalovirus. How to treat cytomegalovirus during pregnancy?

Unfortunately, it is impossible to completely eliminate Cytomegalovirus hominis once it enters the body. But medicine knows ways to mobilize a person's own immunity to fight it.
Pregnant women are usually prescribed antiviral and restorative drugs. These are drugs based on interferon or herbal preparations. Effective, for example, is the drug Proteflazid.

If there are no antibodies to cytomegalovirus in the blood of the expectant mother, she should take preventive measures:

• do not change sexual partner
• use condoms
• follow the rules of personal hygiene
• do not eat from someone else's dishes
• regularly clean the apartment
• take care of your own health

What to do if cytomegalovirus is found during pregnancy: tips and reviews

If Cytomegalovirus hominis is found in a pregnant woman, she should not consider this the end of the world. The key to a normal pregnancy is constant interaction with a doctor and strict adherence to his prescriptions.
In the acute form of the infection, the expectant mother should be tested to control the antibody titer every two weeks, and also regularly examined to monitor the development of the fetus.

VIDEO: Cytomegalovirus during pregnancy

You donated blood for enzyme-linked immunosorbent assay (ELISA) and found out that cytomegalovirus IgG antibodies were found in your bioliquid. Is this good or bad? What does this mean and what actions should be taken now? Let's understand the terminology.

What are IgG antibodies

Antibodies of the IgG class are a type of serum immunoglobulins involved in the body's immune response to a pathogen when infectious diseases. The Latin letters ig are an abbreviated version of the word "immunoglobulin", these are protective proteins that the body produces to resist the virus.

The body responds to the attack of infection by immune restructuring, forming specific antibodies of the IgM and IgG classes.

• Rapid (primary) IgM antibodies are formed in large quantities immediately after infection and “pounce” on the virus in order to overcome and weaken it.
• Slow (secondary) IgG antibodies gradually accumulate in the body to protect it from subsequent invasions of an infectious agent and maintain immunity.

If the ELISA test shows a positive cytomegalovirus IgG, then this virus is present in the body, and you have immunity to it. In other words, the body keeps dormant infectious agent under control.

What is cytomegalovirus

In the middle of the 20th century, scientists discovered a virus that causes inflammatory swelling of cells, which is why the latter are significantly larger than the surrounding healthy cells. Scientists called them "cytomegals", which means "giant cells". The disease was called "cytomegaly", and the infectious agent responsible for it acquired the name known to us - cytomegalovirus (CMV, in the Latin transcription CMV).

From the point of view of virology, CMV is almost no different from its relatives, the herpes viruses. It has the shape of a sphere, inside which DNA is stored. Entering the nucleus of a living cell, the macromolecule mixes with human DNA and begins to reproduce new viruses, using the reserves of its victim.

Once in the body, CMV remains in it forever. The periods of his "hibernation" are violated when a person's immunity is weakened.

Cytomegalovirus can spread throughout the body and infect several organs at once.

Interesting! CMV affects not only humans, but also animals. Each species is unique, so a person can only become infected with cytomegalovirus from a person.

"Gate" for the virus

Infection occurs through semen, saliva, mucus of the cervical canal, through blood, breast milk.

The virus replicates itself at the point of entry: on the epithelium of the respiratory tract, gastrointestinal tract or genital tract. It also replicates in local lymph nodes. Then it penetrates into the blood and spreads with it to the organs, in which cells are now formed, 3-4 times larger than ordinary cells. They have nuclear inclusions inside. Under the microscope, the infected cells resemble the eyes of an owl. They actively develop inflammation.

The body immediately forms an immune response that binds the infection, but does not completely destroy it. If the virus has won, signs of the disease appear one and a half to two months after infection.

To whom and why is an analysis for antibodies to CMV prescribed?

Determining how the body is protected from the attack of cytomegalovirus is necessary under the following circumstances:

• planning and preparation for pregnancy;
• signs of intrauterine infection of the child;
• complications during gestation;
• intentional medical suppression of immunity in certain diseases;
• an increase in body temperature for no apparent reason.

There may be other indications for immunoglobulin tests.

Ways to detect the virus

• A cytological study of the structure of the cell determines the virus.
• The virological method allows you to assess how aggressive the agent is.
• The molecular genetic method makes it possible to recognize the DNA of the infection.
• The serological method, including ELISA, detects antibodies in the blood serum that neutralize the virus.

How can I interpret the results of the ELISA test?

It seems that a negative result in both cases is the best, but it turns out that not for everyone.

Attention! It is believed that the presence of cytomegalovirus in the modern human body is the norm; in an inactive form, it is found in more than 97% of the world's population.

At-risk groups

• citizens with acquired or congenital immunodeficiency;
• patients who have survived organ transplants and are being treated for cancer: they artificially suppress the body's immune responses to eliminate complications;
• pregnant women: primary infection with CMV can cause miscarriage;
• babies infected in the womb or at the time of passage through the birth canal.

In these most vulnerable groups, with a negative value of IgM and IgG to cytomegalovirus in the body, there is no protection from infection. Consequently, it, without encountering opposition, can cause serious illnesses.

What diseases can provoke cytomegalovirus

In immunocompromised individuals, CMV causes inflammatory response in the internal organs:

• in the lungs;
• in the liver;
• in the pancreas;
• in the kidneys;
• in the spleen;
• in the tissues of the CNS.

According to WHO, diseases caused by cytomegalovirus are the second leading cause of death.

Does CMV pose a threat to expectant mothers?

If before pregnancy a woman survived a meeting with cytomegalovirus, then nothing threatens either her or her baby: the immune system blocks the infection and protects the fetus. This is the norm. AT exceptional cases the child becomes infected with CMV through the placenta and is born with immunity to cytomegalovirus.

The situation becomes threatening if the expectant mother becomes infected with the virus for the first time. In her analysis, antibodies to cytomegalovirus IgG will show negative result because the body did not have time to acquire immunity against it.
Primary infection of a pregnant woman was recorded on average in 45% of cases.

If this happened at the time of conception or in the first trimester of pregnancy, the risk of stillbirth, spontaneous abortion, or fetal abnormalities is likely.

In the later stages of gestation, CMV infection entails the development of a congenital infection in the baby with characteristic symptoms:

• jaundice with fever;
• pneumonia;
• gastritis;
• leukopenia;
• pinpoint hemorrhages on the baby's body;
• enlarged liver and spleen;
• retinitis (inflammation of the retina).
• malformations: blindness, deafness, dropsy, microcephaly, epilepsy, paralysis.

According to statistics, only 5% of newborns are born with symptoms of the disease and serious disorders.

If a baby becomes infected with CMV while feeding the milk of an infected mother, the disease in him may proceed without visible signs or manifest lingering runny nose, swollen lymph nodes, fever, pneumonia.

An exacerbation of cytomegalovirus disease in a woman preparing to become a mother also does not bode well for the developing fetus. The baby is also sick, and his body still cannot fully defend itself, and therefore the development of mental and physical defects is quite possible.

Attention! If a woman is infected with cytomegalovirus during pregnancy, this does NOT mean that she will definitely infect the child. She needs to see a specialist in time and undergo immunotherapy.

Why can herpes disease worsen during the months of pregnancy?

If antibodies to IgG in the test of a pregnant woman showed up as negative for cytomegalovirus, the doctor prescribes an individual emergency antiviral treatment for her.

So, the result of the analysis of a pregnant woman, in which cytomegalovirus IgG antibodies were detected, and IgM class immunoglobulins were not detected, indicates the most favorable situation for the expectant mother and her baby. But what about the ELISA test of a newborn?

Tests for IgG antibodies in infants

Positive IgG in infants is a sign of intrauterine infection. To confirm the hypothesis, an analysis is taken from an infant twice a month. An IgG titer exceeded by 4 times indicates neonatal (occurring in the first weeks of a newborn's life) CMV infection.

In this case, careful monitoring of the condition of the newborn is shown to prevent possible complications.

Virus detected. Whether it is necessary to be treated?

In the presence of generalized forms of infection (definition of a virus that has engulfed several organs at once), patients are prescribed drug therapy. Usually it is carried out in stationary conditions. Drugs against the virus: ganciclovir, foxarnet, valganciclovir, cytotec, etc.

Therapy of infection, when antibodies to cytomegalovirus turned out to be secondary (IgG), is not only not required, but even contraindicated for a woman carrying a child, for two reasons:

1. Antiviral drugs are toxic and cause a lot of complications, and means to maintain protective functions organisms contain interferon, which is undesirable during pregnancy.
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