Doctor Maria Nikolaeva
Treatment of cytomegalovirus begins with confirmation of the diagnosis and determination of the attending physician in the specialized department. The basis of therapy is antiviral drugs, but symptomatic agents are also used to alleviate the condition of a person.
Cytomegalovirus infection (CMVI) is an infectious disease, which is classified as a viral pathology, often develops in young people and middle-aged patients. It is possible to get rid of this disease only with an integrated approach to a person and the selection of an individual strategy for diagnosis and therapy.
Several specialists can deal with the treatment of cytomegalovirus infection in adults at once, these are:
- infectious disease specialist;
- immunologist;
- therapist.
Depending on the course of cytomegalovirus infection, narrow specialists can also be involved in the treatment - a gastroenterologist, a neuropathologist, a dermatovenereologist. Damage to the genital organs during primary infection is extremely rare, however, it still occurs. In such cases, it is necessary to carry out differential diagnosis with sexually transmitted diseases.
The necessary conditions for the development of an active inflammatory process are a decrease in the reactivity of the immune system. Therefore, when detecting CMVI, you should undergo a mandatory consultation with an immunologist. Identification of concomitant pathology allows not only to correct the human condition, but also to prevent the development of relapses in the future.
Cytomegalovirus (CMV, CMV) is a virus closely related to the herpes virus. The main danger of this virus is that it can cause congenital diseases in the unborn child if the infection develops during pregnancy.
How does infection with cytomegalovirus occur?
You can become infected with cytomegalovirus through close contact with a person who is infected and releases viruses into the environment:
- during the kiss
- when using the same cutlery (forks, spoons), cups, etc. at the same time.
- if a person who sheds the virus sneezes or coughs near you
- during sex
A child can become infected with cytomegalovirus from the mother before birth (during pregnancy), or after birth, during breastfeeding.
Who can become infected with cytomegalovirus, and how to understand that a person is infected?
According to some studies, from 40 to 100% of the country's population may be infected with cytomegalovirus. The lower the standard of living in the country, the higher the percentage of the infected population.
Cytomegalovirus infection can occur at any age, and young children are a common source of infection.
Unfortunately, it is far from always possible to identify a person who is infected with cytomegalovirus. The fact is that in most people, cytomegalovirus infection is asymptomatic, or causes symptoms similar to those of a common cold.
Thus, a person infected with cytomegalovirus may not even be aware of it, and infect the people around him. Including you, you may have once been infected with cytomegalovirus, but do not know about it.
How dangerous is cytomegalovirus?
For adults with good immunity, CMV does not pose any threat. Immediately after cytomegalovirus enters the body, our immunity produces special antibodies that prevent the virus from multiplying and causing any health problems. Thus, not having time to penetrate into the human body, the virus "falls asleep" and most often never "wakes up" again. Activation (awakening) of the virus is possible only with serious immune disorders that most people do not encounter in their lives (HIV infection, long-term treatment with steroid hormones, organ or bone marrow transplantation, chemotherapy and radiotherapy for oncological diseases).
Under these conditions, CMV can cause quite serious disorders: liver inflammation, pneumonia, gastritis, intestinal inflammation, etc.
How dangerous is cytomegalovirus during pregnancy?
Cytomegalovirus infection during pregnancy can cause low birth weight, congenital diseases, and delayed psychomotor development in the unborn child.
In connection with the potential threat posed by cytomegalovirus, before planning pregnancy and during pregnancy, a woman needs to be especially careful about her health or even undergo a special examination.
Do I need to be tested for CMV when planning a pregnancy?
Testing for cytomegalovirus is included in a group of tests called (or TORCH infections). This group of infections includes the following bacteria or viruses that can cause birth defects in an unborn baby:
- cytomegalovirus
- others (including syphilis)
In no country in the world, the diagnosis of cytomegalovirus before planning a pregnancy is mandatory, but you can take this test of your own free will or on the recommendation of your doctor.
With this analysis, you will be able to find out what risks await you and how to reduce the likelihood of complications during pregnancy.
What tests are taken to detect CMV when planning a pregnancy?
The most effective method of screening for cytomegalovirus when planning pregnancy is serology (ELISA), namely, the detection of antibodies (immunoglobulins) to cytomegalovirus.
The analysis will show if there are class G (IgG) and class M (IgM) immunoglobulins in the body, and if so, their level.
What do immunoglobulins (IgG, IgM) say?
Immunoglobulins can tell the doctor if a person is infected with cytomegalovirus, and if infected, when the infection occurred, and what state the virus is currently in (dormant or active).
How to understand the results of the analysis for antibodies to cytomegalovirus when planning a pregnancy?
After receiving the results of the analysis for antibodies to cytomegalovirus, you can find one of the following options:
- Antibodies IgG to cytomegalovirus - negative
If the antibody test does not detect antibodies to cytomegalovirus, this means that your body has never met this infection and you are not immune to the virus. You can start planning your pregnancy now, but during pregnancy you will need to avoid contact with possible spreaders of cytomegalovirus. The necessary actions in this case are described below, in the section:
- IgM antibodies to cytomegalovirus - negative
If the analysis for antibodies to cytomegalovirus reveals only IgG, this means that you have been infected with the virus for a long time and your immune system keeps this infection under control.
In this case, you can safely plan a pregnancy. There is a risk that CMV is activated during pregnancy and passed on to the unborn child, but it is not large and does not exceed 1%. That is, out of 100 women with IgG antibodies to cytomegalovirus, only 1 during pregnancy will “wake up” the virus and enter the fetus. Unfortunately, it is impossible to predict such a situation, so during pregnancy you will need to carefully monitor your well-being. You will need to see a doctor if you experience symptoms similar to those of a cold.
- IgG antibodies to cytomegalovirus - negative
If the analysis for antibodies to CMV reveals only IgM, this means that you have been infected with cytomegalovirus quite recently (several weeks or months ago) and at the moment your immune system is trying to overcome the virus. It is recommended to postpone pregnancy planning in this situation for several months until IgM disappears in the blood and IgG appears. IgM usually disappear 8-10 weeks after the appearance.
- IgG antibodies to cytomegalovirus - positive
- IgM antibodies to cytomegalovirus - positive
If a blood test for antibodies reveals both classes of antibodies (IgG and IgM), then there may be two options: either you were infected with cytomegalovirus a few months ago, or you were infected with cytomegalovirus a long time ago, but at the moment the virus has “woken up” (reactivation of the infection).
What is IgG avidity for cytomegalovirus?
In some laboratories, a parameter such as the avidity of IgG antibodies is determined. Using this parameter, you can specify how long ago the infection with cytomegalovirus occurred. The higher the avidity of antibodies, the earlier the infection occurred, and the more favorable this situation is for you.
If the avidity is high (more than 60%), then the infection took place a long time ago and the infection does not pose a threat to the planned pregnancy. If avidity is low (less than 50%), then you have recently been infected with cytomegalovirus, no more than 3 months ago.
What if I am not immune to cytomegalovirus?
If you have not been found to have antibodies to cytomegalovirus, you need to be especially careful about your health during pregnancy planning and during pregnancy.
If you become infected with cytomegalovirus during pregnancy, the risk of passing this infection to the fetus is 30-40%.
To reduce the risk of infection during pregnancy, you need to practice strict personal hygiene: avoid contact or kissing with young children and adults who have symptoms of a cold, use separate forks, spoons and cups, wash hands thoroughly after contact with children or with baby urine (for example, if you already have one child and you change his diapers).
If during pregnancy you develop symptoms of a cold (fever, swollen lymph nodes, sore throat, etc.), you will need to take repeated tests for antibodies to cytomegalovirus.
Some experts believe that a CMV test should be taken prophylactically every 1-2 months throughout pregnancy.
Is there a vaccine against cytomegalovirus?
Unfortunately, no such vaccine exists yet.
What if I have IgM? How to be treated?
The presence of IgM in the blood indicates that the virus is currently active, and your immune system has not yet overcome the infection.
Whether it is necessary to be treated in this case? There is no single answer to this question, but most experts are of the following opinion:
If there are no symptoms of infection, and changes are detected only by tests, then antiviral drugs are not prescribed. If the infection is asymptomatic, then your body is successfully coping with it and it does not need to be helped by pills. You just need to give the immune system time until it develops immunity to cytomegalovirus. To speed up the process of immunity formation, your gynecologist may recommend general tonic drugs, immunity boosters (immunomodulators) and vitamins.
If there are symptoms of a cytomegalovirus infection, then antiviral treatment may be required. Immunomodulators and vitamins are also added to antiviral drugs.
What drugs are used in the treatment of cytomegalovirus infection when planning pregnancy?
The choice of drugs and dosage are determined by the attending physician. We list the most popular antiviral and immunomodulating agents:
- Acyclovir (Zovirax)
- Ganciclovir
- Valganciclovir
- Valaciclovir (Valtrex, Virdel)
- Allokin-alpha
- Viferon
- Cycloferon and others
Attention: these drugs are used in the treatment of non-pregnant women only.
Is it possible to recover, get rid of this virus?
Once infected with cytomegalovirus, you can no longer get rid of it. In most people infected with CMV, the virus remains in the body for life.
The goal of treatment (if given at all) is to develop immunity to the virus, not to eliminate cytomegalovirus from the body.
Cytomegalovirus - CMV treatment is a rather difficult task. As, in fact, all viral diseases caused by pathogens adapted to modern drugs.
Poses a potential threat to human health. The virus is one of the most common opportunistic pathogens. When exposed to certain factors, it is activated and causes a vivid clinical picture of cytomegaly. In some people, the virus is in an opportunistic state throughout life, not showing up at all, but causing impaired immune defenses.
Of particular danger is the disease for infants and young children, when the virus covers all organs or systems, leading to serious complications, up to the death of the patient. There are still no known effective drugs for the complete expulsion of the virus from the body. If you become infected with cytomegalovirus, drug treatment is carried out to achieve a long-term therapeutic remission in a chronic course and eliminate local manifestations of the infection.
What you need to know about the virus
Cytomegaly appears to be an infectious disease of viral etiology. In some sources, there is a different name - cytomegalovirus infection (in the abbreviation CMV).
Cytomegalovirus is a member of a large group of herpesviruses. The cells affected by the viral agent increase significantly in size, hence the name of the disease - cytomegaly (translated from Latin - "giant cell"). The disease is transmitted through sexual, domestic or blood transfusion routes. The most unfavorable is the transplacental route of transmission.
The symptom complex resembles the development of a persistent cold, which is accompanied by a runny nose, malaise and general weakness, pain in the articular structures, increased salivation due to inflammation of the salivary glands. Pathology rarely has vivid symptoms, mainly proceeding in the latent phase. With generalized forms of damage to the body by viral agents, drug treatment and antiviral drugs are prescribed. There is no alternative effective treatment.
Many people are carriers of cytomegalovirus infection without even knowing it. Only 30% of the viral disease has a chronic course, exacerbated by local symptoms in the form of a herpetic rash, as well as general malaise. Antibodies to cytomegalovirus exist in 13-15% of adolescents, 45-50% in adult patients. The viral agent is often activated after exposure to factors that reduce immunity.
Cytomegalovirus poses a great danger to persons who have undergone organ or bone marrow transplantation, who have congenital forms of the disease or HIV status. The condition is dangerous during pregnancy, leads to serious consequences for the fetus: anomalies in the development of internal organs or systems, deformities and physical disability, miscarriage. For this, a collegial decision of the attending pediatrician and other narrow specialists is necessary.
Cytomegalovirus - treatment
The feasibility of therapy is proportional to the severity of the course and the potential danger to the patient's body. After some diagnostic measures, the risks of a possible threat are determined, an assessment is made of the pathological process. With signs of generalization, drug correction is prescribed. With a short episode of virus activation and while maintaining the patient's normal state of health, no special treatment is carried out. With a burdened clinical history of the patient, the doctor monitors the general condition, controls the level of antigen in the blood as part of laboratory diagnostics.
Often a completely healthy person who has had a virus without any consequences acquires strong immunity. The viral agent itself, at the same time, remains in the body forever, transforms into a conditionally pathogenic form. There is a chronization of the pathology with periods of short-term exacerbations, subject to a pronounced decrease in immune defense. The goals of drug correction of the disease are:
- reducing the negative impact of the virus;
- relief of existing symptoms;
- ensuring stable remission in chronic disease.
Important! In humans, against the background of absolute health, the virus is asymptomatic, and the disease stops on its own. Many patients do not notice when the virus is activated and when its pathogenic activity is reduced.
The main indications for starting treatment
Unfortunately, cytomegalovirus is not treated completely. Medications can only strengthen local immunity and prevent new episodes of exacerbation. Therapy is prescribed in the following cases:
- immunodeficiency diseases of any origin;
- generalized spread of the viral agent;
- preparation of organ transplantation, for chemotherapy in oncological diseases;
- complicated clinical history of the patient (pathology of internal organs or system);
- pregnancy of a woman (often the first trimester);
- preparation for the treatment of encephalitis, meningeal infections.
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The effect of cytomegalovirus on the fetus and woman during pregnancy
Before determining treatment tactics, a differential diagnosis of cytomegalovirus infection with influenza conditions, SARS and other infectious diseases is carried out. It is the similarity of the symptoms of cytomegaly with the classic manifestations of the common cold and untimely or inadequate treatment that provokes the development of severe complications.
What funds can be assigned
So, during the examination, cytomegaloverus was diagnosed - drug treatment will be prescribed in most cases. Conservative and drug therapy are the only ways to correct the condition of patients with CMVI. Pharmaceutical forms are numerous: ointments (liniments) for external use, tablets for oral use, injections for intravenous administration, drops, suppositories.
To eliminate exacerbations of a viral disease, the following groups of drugs are prescribed:
- symptomatic (pain relief, elimination of inflammatory foci, vasoconstriction in the nose, in the sclera);
- antiviral (the main task is to suppress the pathogenic activity of the virus: Panavir, Cidofovir, Ganciclovir, Foscarnet);
- drugs to eliminate complications (multiple groups and pharmacological forms);
- immunomodulators (strengthening and restoration of the immune system, stimulation of the body's natural defenses: Viferon, Leukinferon, Neovir);
- immunoglobulins (binding and removal of viral particles: Cytotect, Neocytotect).
Drugs for the treatment of cytomegalovirus are prescribed in a complex manner. Additionally, vitamin complexes with an enriched mineral composition are prescribed to restore the overall resistance to colds and other chronic pathologies that lead to a decrease in immunity. In systemic autoimmune diseases, as a rule, lifelong drug therapy is prescribed.
Important! With cytomegaly in men, a high therapeutic effect was proved by Ganciclovir, Foscarnet, Viferon, in women - Acyclovir, Cycloferon and Genferon.
Drug treatment has a number of disadvantages due to side effects. The toxicogenic effect is often expressed in dyspeptic disorders, decreased appetite, and the appearance of allergies. Iron deficiency anemia often develops.
Antivirals
To achieve the maximum therapeutic effect, guanosine analogues are prescribed:
- Virolex;
- Acyclovir;
- Zovirax.
The active substance quickly penetrates the cells of the virus, destroys their DNA. These drugs are characterized by high selectivity and low toxicogenic properties. The bioavailability of Acyclovir and its analogues varies from 15 to 30%, and with increasing doses it decreases by almost 2 times. Medicines based on guanosine penetrate into all cellular structures and tissues of the body, in rare cases causing nausea, local allergic manifestations, and headaches.
In addition to Acyclovir, its analogues are prescribed Ganciclovir and Foscarnet. All antiviral agents are often combined with immunomodulators.
Interferon inducers
Interferon inducers stimulate the secretion of interferons within the body. It is important to take them in the first days of an exacerbation of the infection, since on day 4-5 or later their use is practically useless. The disease is running, and the body is already producing its own interferon.
Inductors inhibit the development of CMV, are often well tolerated by the body, promote the synthesis of immunoglobulin G, natural interferons, interleukins. Known drugs containing interferon include Panavir. The drug has a pronounced anti-inflammatory effect, helps with severe pain, reduces the intensity of unpleasant symptoms.
Viferon also helps with viral activity, has a convenient form of suppositories for rectal administration, which is convenient in the treatment of children of any age. Of the interferon inducers, Cycloferon, Inosine-pranobex and its analogues Isoprinosine, Groprinosin are isolated. The latter drugs have a low degree of toxicity, suitable for the treatment of children and pregnant women.
Immunoglobulin preparations
Immunoglobulins are protein compounds in the human body and warm-blooded animals that transport antibodies to pathogenic agents during biochemical interaction. When exposed to CMV, a specific immunoglobulin Cytotect is prescribed, which contains antibodies to cytomegalovirus. Among other things, the composition of the drug includes antibodies to the herpes virus type 1.2, to the Epstein-Barr virus. Therapy with immunoglobulins is necessary to restore the general protective resources of the body to the penetration of viral agents.
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Manifestation and treatment of cytomegalovirus infection in children
Another effective remedy for cytomegalovirus is Intraglobin (III generation), Octagam or Alphaglobin (IV generation). The latter types of drugs meet the most stringent requirements, suitable for patients with severe renal dysfunction (including pre-dialysis and dialysis periods).
To achieve maximum therapeutic results, immunoglobulins are prescribed in the form of injections (Pentaglobin). Medicines in the form of injections directly affect the root of the problem, quickly eliminate the symptoms of a generalized manifestation of the disease. In addition, the chemical composition of new generation drugs is not disturbed before interacting with altered cells.
List of the most effective drugs
Despite the wide range of remedies for the relief of CMV symptoms, doctors always build individual therapeutic tactics. Before prescribing a specific medicine, it should be clarified which symptoms of the infection are present in a particular patient. This takes into account: the patient's clinical history, age, weight, general somatic status, complications and other factors that may interfere with proper treatment.
For therapy, the following popular means are used:
- Foscarnet. Refers to antiviral drugs for the treatment of severe forms of pathology complicated by cytomegaly. It is prescribed for reduced immunity. The active substance destroys the pathogenic cell, breaks the biological chain of the virus, stops the reproduction of viral agents.
- Ganciclovir. Antiviral agent for the treatment of cytomegalovirus with a complicated course (diseases of the kidneys, liver, respiratory organs, generalized inflammatory foci). It is widely used to prevent congenital infections, especially if the virus in the mother's body is in the phase of active reproduction. Release form tablets and crystalline powder.
- Cytotec. Being an immunoglobulin, the drug is prescribed for the complex elimination of the infection. The tool compares favorably with low toxicity, the absence of specific and absolute contraindications. The drug is used to prevent large-scale damage by cytomegalovirus in various social groups. Among the side effects are back pain, hypotension, stiffness in the movement of the joints, dyspeptic disorders. If negative conditions appear, the medication is stopped and the doctor is consulted for an alternative prescription.
- Neovir. Belongs to a large group of immunomodulators. Available in solution for injection. It is used for therapeutic correction and prevention of the disease in children or adults with autoimmune diseases, other pathologies, which during the period of exacerbation greatly reduce local immunity. The dosage is determined individually in each case.
- Viferon. Widely used in pediatric practice. Available in the form of suppositories for rectal administration. It is used in the complex therapy of infectious diseases of any origin, complicated or simple in course. Effective for pneumonia, bronchitis, colds as a prevention of possible CMV. Among the side effects are allergic manifestations (itching in the perianal region, urticaria).
- Bischofite. Anti-inflammatory agent for the prevention and treatment of cytomegaly, herpes infection. Available as a gel in a tube or a balm in a glass container. Can be used as a topical remedy for blisters, rashes and inflammation. When applied externally, it resembles the effect of using mineral water, healing mud.
Be sure to use vitamins and other tonics that stimulate the work of many internal structures of the body. The most necessary for viral infections include vitamins C and B9.
Vitamin C is a powerful antioxidant, has regenerative properties, restores cells that are involved in the inhibition of the activity of pathogenic agents. B vitamins are necessary for the normal functioning of the nervous system, support the normal function of the bone marrow, and are responsible for the resistance of the immune system to external or internal negative factors.
Timely diagnosis and detection of severe forms of infection will reduce the level of complications, prevent the generalization of the pathological process. When stopping an exacerbation with a medical method, it is important to take into account a number of important criteria, to conduct a differential diagnosis. Preventive measures during a woman's pregnancy, in young children, as well as the correct treatment tactics will save patients from unpleasant manifestations of cytomegalovirus for a long time.
Higher medical education, venereologist, candidate of medical sciences.
It is hardly possible to meet a person who would never be sick in his life. Sometimes it is difficult to determine the cause of poor health. Under the common cold, pathogens of a wide variety of ailments, including CMV (cytomegaloviruses), are masked.
Cytomegalovirus is a member of the human herpesvirus family. Many are familiar with the disgusting "fever" on the lips. It is caused by the simplexvirus, the cousin of CMV. A distinctive feature of CMV from its brethren is that it affects the internal organs of a person - the kidneys, heart, liver.
A person can be a carrier of the virus for a long time without realizing it. It would seem that if there is no cause for concern, then why is CMV under such scrutiny of scientists? And the thing is that everyone's susceptibility to the virus is different. If for some people the causative agent of cytomegalovirus infection is just an uninvited guest, then for others it can lead to disability and even death.
Who is he?
So, the “culprit” of cytomegalovirus infection is human CMV from the herpesvirus family. It spreads throughout the body, but still the main refuge of the pathogen is the salivary glands.
The geography of the virus is vast: it has been found in absolutely all regions of our planet. Carriers can be people of any socioeconomic group. But the virus is still more common among people of low social status, as well as those living in poor developing countries.
Cytomegalovirus has a complex structure and belongs to human herpesviruses type 5
According to statistics, from 50% to 100% of people (depending on the region) are infected with CMV. This is indicated by antibodies found in the blood of earthly inhabitants. The virus can enter the human body at any time during its life. People with reduced immunity are especially susceptible to infection:
- -infected;
- Taking drugs that weaken the immune response;
- Have undergone a bone marrow or internal organ transplant.
Cytomegalovirus can be both a consequence and a cause of a decrease in immunity.
A more dangerous form of CMV infection is intrauterine.
Possible modes of CMV transmission
CMV infection is not very contagious. To acquire the virus, numerous contacts or long-term close contact with the virus carrier are necessary. Nevertheless, most of the inhabitants of the Earth are infected with it.
The main ways of infection:
- Sexual. The virus is concentrated in semen, vaginal and cervical mucus.
- Airborne. Transmitted by coughing, sneezing, talking, kissing.
- Transfusion of blood or its components that contain leukocytes.
- Organ transplantation from infected donors.
- To the fetus from an infected mother.
We are all in a society of our own kind who cough and sneeze, are born to infected women, have multiple sexual partners, receive blood and organs from donors or become one themselves. Therefore, 90 percent can be assumed to have a probability of detecting CMV in a smear, blood, breast milk, saliva, etc.
What is important is not the detection of the virus at all, but the detection of its active form. A sleeping dog, until awakened, is not dangerous. The pathogen “wakes up” only when conditions favorable for it appear in the body.
Options for the development of infection
1) In people with normal immunity
"Uninvited guests" can go unnoticed for a long time. Sometimes there are symptoms resembling SARS. The first signs of the disease appear 20–60 days after the introduction of the virus into the body. But there is a global difference between CMVI and a respiratory disease: if ARVI disappears in the worst case in a week, then a cytomegalovirus infection can remind of itself for a month or more. And the symptoms, at first glance, are very similar:
- Runny nose;
- elevated temperature;
- Weakness;
- Enlarged lymph nodes;
- Headache;
- Chills;
- Inflammation of the joints;
- Enlargement of the liver and spleen;
- The appearance of a rash on the skin.
It should be emphasized that all these manifestations are a normal immune response to CMV activity. After all, elevated temperature is fatal for the virus. And the sites of inflammation are the last refuge of DNA particles. If you completely get rid of the symptoms, the disease becomes protracted. It is necessary to deal with the consequences of infection only in case of their dangerous development.
Good immunity contributes to the formation of antiviral antibodies in the blood, which leads to a quick recovery. However, viruses have been found in human biological fluids for a long time. For many years, pathogenic pathogens are in the body in an inactive form. Their sudden disappearance is also not ruled out.
2) People with weak immune systems
Weak immunity is a paradise for a “sleeping” virus. In such an organism, he does whatever he wants. The disease in patients with reduced immunity can occur with varying degrees of severity. Complications are possible in the form of:
- Pleurisy;
- pneumonia;
- Arthritis;
- Damage to internal organs;
- Myocarditis;
- encephalitis;
- Vegetative disorders.
Sometimes there may be:
- Eye diseases;
- Inflammatory processes of the brain (up to death);
- Paralysis.
In women, the disease is manifested by erosion of the cervix, inflammation of the genitourinary system. If a woman is pregnant at the same time, then there is a real threat to the fetus. In men, the urethra, testicular tissue may be affected.
But all these complications appear rarely - mainly in people with a reduced immune response.
3) Congenital CMV infection
If during pregnancy (in the first trimester) the fetus becomes infected, a miscarriage may occur. At a later date, cytomegaly develops. It manifests itself in prematurity, pneumonia, enlarged liver, kidney, spleen. Developmental delay, hearing and vision impairment, and dental anomalies may occur.
Diagnostic methods
For the diagnosis of CMVI, the patient's complaints, signs of the disease and the results of laboratory analysis are studied. To make a diagnosis, several laboratory tests are performed at the same time. Researched:
- Saliva;
- Liquor;
- Wash water obtained as a result of lavage of the bronchi and lungs;
- Biopsies;
- Urine;
- Breast milk;
- Blood;
It is important that no more than four hours elapse from sampling to the start of the study.
Main research methods:
- Detection of antibodies to cytomegalovirus ().
The most accessible laboratory technique is seeding. It does not require sophisticated equipment. With the help of the sowing method, not only the presence of a pathogenic pathogen is determined, but also its type, degree of aggressiveness, form. A very useful addition to the study is the testing of medicinal preparations directly on the colonies of the resulting culture. After all, each case of infection is individual.
The most sensitive method is PCR (polymerase chain reaction). It detects even a small piece of DNA.
The advantage of the PCR technique is to detect infection:
- Early;
- Persistent;
- Latent.
Disadvantages of the technique:
- Low predictive value;
- Little specificity.
Last time ELISA method is often used(enzymatic immunoassay). With its help, the CMV antigen is detected, as well. If class M antibodies were detected as a result of a blood test, then a conclusion is made about the primary infection. With intrauterine infection, IgM antibodies are detected in the first 2 weeks of a child's life. A subsequent positive test indicates an acquired infection.
The appearance of IgG antibodies indicates a past illness. What is the standard for this indicator? The presence of an IgG titer in the blood is already the norm, since almost all people sooner or later encounter such a virus. In addition, the presence of antibodies indicates a good immune response - the body reacted to the introduction of the virus and defended itself.
ELISA algorithm for suspected CMV
More accurate is quantitative analysis. Caution should be taken to the growth of IgG titer, which may indicate the progression of pathology. It is important to diagnose the infection as quickly as possible, to identify the stage of the disease, its form and the duration of the infection process.
It should be noted that M and G class antibodies are not always detected. They may not be found in the blood of immunosuppressed patients.
How to treat CMVI?
Unfortunately, it is impossible to completely destroy viruses in the body.. Yes, and it is not necessary. 95% of earthlings have CMVI pathogens, and many people simply do not notice them. They do not notice while the CMV is “sleeping”. And in order to “wake them up”, you have to try very hard - to reach the extreme degree of beriberi, protein starvation or catch HIV.
Treatment of cytomegalovirus infection is required in its active form. But it consists, first of all, in the correction of the immune system. After all, it is in people with a weakened immune response that CMV “wakes up” and begins to destroy the body.
In what cases is treatment prescribed?
- With primary infection with pronounced symptoms of pathology;
- When an immunodeficiency state is detected;
- Pregnant or planning pregnancy in case of primary infection or in case of exacerbation of the disease.
Treat CMV infection strictly according to indications. The detection of a virus in the body cannot be the basis for drug therapy. Self-medication with medicines is unacceptable!
Antiviral drugs may be prescribed, such as ganciclovir, foscarnet, famciclovir. However, they have a hepatotoxic effect and are poorly tolerated by patients. They should not be given to infants and pregnant women. Therefore, funds from the interferon group are more actively used: roferon, intron A, viferon.
To prevent relapses are prescribed panavir And neovir.
In the treatment of CMVI, immunoglobulin enriched with antibodies to this pathogen can be prescribed. Such drugs include cytotect, neo-cytotec.
In case of severe symptoms - pneumonia, encephalitis - a complex of therapeutic measures is carried out aimed at eliminating these symptoms.
Video: cytomegalovirus in the program “Live healthy!”
The specifics of the development of CMVI in children
Most often, the first meeting of a person with CMV occurs in childhood. This does not always happen during fetal development. The child grows up among numerous virus carriers, communicates with children and adults. Avoiding infection in such conditions is almost impossible.
But it's even good. Babies, having met with pathogenic factors in early childhood, acquire immunity to them.
Only 15% of healthy children show symptoms of cytomegalovirus infection. There may be various signs of discomfort.
How to determine the infection in newborns?
Often the baby is born outwardly healthy, without any symptoms of infection. Sometimes there are some temporary signs that pass safely.
Manifestations and complications of CMVI and in general in newborns
Temporary symptoms include:
- Reduced body weight;
- Pathological changes in the spleen;
- Bluish rash on the skin;
- Liver damage;
- Jaundice;
- Lung diseases.
However, a small number of newborns have more persistent disorders that may remain for life.
Common symptoms of CMV include:
- visual impairment;
- Mental retardation;
- Small head;
- Poor coordination of movement;
- Hearing loss.
Sometimes persistent symptoms of CMV show up after several years.
In newborns, the disease is a little different than in older children and adults. Severe symptoms appear in less than 20% of infants. And only a quarter of them require therapeutic treatment.
Any of the manifestations is a reason to visit a pediatrician. Symptoms usually resolve without treatment, but complications do occur, albeit rarely.
Why is CMVI dangerous for children?
The most vulnerable categories for CMVI are newborns with immature immunity, as well as children with immunodeficiency.
The most severe consequences of infection in these children:
- CNS damage. There are signs of encephalitis: convulsions, increased drowsiness. Hearing damage (up to deafness) is possible.
- Chorioretinitis is an inflammatory eye disease. The retina is predominantly affected. May lead to blindness.
- Cytomegalovirus pneumonia. It is considered the main cause of death in immunocompromised patients.
- Severe encephalitis can lead to the death of a child.
The virus poses a threat to children with leukemia and other cancers, as well as those preparing for organ transplants. Such children must be diagnosed with CMVI. Especially the study is necessary for exacerbation of symptoms of infection.
How to prevent the development of CMV infection in children?
After reading this article, parents of healthy children do not have to run to the pharmacy for antiviral drugs! Only babies with a low immune response should be protected from CMV. If the mother was diagnosed with primary infection, then it is she who should take immunoglobulins. And breast milk transports them to the baby's body.
But still, nothing better has been invented yet than the development and maintenance of children's own immunity through hardening, physical activity, eating vegetables and fruits. For children leading a healthy lifestyle, a pathogenic pathogen that enters the body is not terrible.
Video: pediatrician about cytomegalovirus infection
