Cytomegalovirus infection - the norm Anti-CMV iG and the danger of the virus. What does cytomegalovirus IgG positive mean?

Cytomegalovirus infection, cytomegaly, is a common, often congenital disease that is provoked by cytomegalovirus, CMV.

Testing for CMV infection shows a positive result in 90% of people who are tested.

Anyone can be a carrier, regardless of age or gender. It is asymptomatic until the immune system in people weakens.

Reasons for activation:

HIV infection, AIDS;
chronic existing diseases;
pregnancy. Planning, course, postpartum period;
malignant neoplasms;
arterial hypertension;
periodic dialysis procedures;
consequences of transplantation.

The body’s protective reaction when ingested by cytomegalovirus is the appearance of antibodies to CMV, immunoglobulin IgM and IgG. It is their indicators in the blood that are taken into account when determining the degree and form, and drawing up a possible prognosis for the course of the disease.

The infection can have unpredictable consequences for infants, as well as for the intrauterine condition of the fetus.

It has several definitions, such as human herpesvirus type 5, CMV, cytomegalovirus. The pathogenic microorganism penetrates DNA, infects human cells and proceeds in a chronic form. Together with the bloodstream, it quickly spreads throughout the body and enters important organs and systems of human life.

Methods of infection with cytomegalovirus:

airborne route. Cough, sneeze, kiss;
transplantation. Transplantation of infected organs;
presence of CMV in the donor’s blood;
from mother to fetus through the placenta;
unprotected sexual intercourse.

In a healthy body it does not manifest itself for a long time, so it is often diagnosed in an already advanced stage. The incubation period of this disease is up to 60 days.

Cytomegalovirus manifests its first symptoms as a normal infection:

bladder, kidneys, adrenal glands;
reproductive system. Systematic manifestations of diseases, the source of which cannot be determined;
biliary tract. Disturbance of the mucous membrane of the hepatic epithelium;
gastrointestinal tract. Inflammation of the pancreas;
respiratory organs. Pneumonia, bronchitis;
respiratory. Reminds me of ARVI, flu, or a lingering cold. Characterized by weakness, migraines, fever.

Leads to a severe inflammatory process of all internal organs and a decrease in the immune system. Makes it impossible to treat concomitant diseases with antibiotics and other medications. When contacting a specialist, a special analysis is prescribed to determine the cause of CMV complications.

Cytomegaly in children and adults

Cytomegalovirus infection or cytomegaly causes a reaction in the body from the immune system to the presence of foreign cells. Protective protein antibodies, such as IgM, IgG, as well as lymphocytes: CD 4, CD 8, begin to be produced.

The immunoglobulin M level indicates primary infection. After 2 months it changes to G, which indicates a chronic course or cytomegaly.

It has its own varieties depending on the form of infection:

congenital. In most cases, a person infected in the womb may not know about the presence of CMV in the body for the rest of his life. In rare cases, when the mother has suffered the initial exposure to the virus, it causes jaundice in infants, inflammation of the retina with subsequent loss of vision, minor skin hemorrhages, and rashes. Threat of intrauterine growth retardation and miscarriage;
acquired. The source of infection can be breastfeeding in childhood. In adult life - sexual intercourse, organ transplantation, blood transfusion;
mononucleosis-like syndrome. Characterized by the same symptoms as the Ebstein-Barr virus. Accompanied by the presence of fever, pain in the muscles, joints, and enlarged lymph nodes. Less commonly causes rubella, hepatitis and pneumonia;
persons included in a special risk group. In HIV-infected patients, cytomegalovirus leads to encephalitis, bleeding in the gastrointestinal tract, jaundice, and lesions of the genitourinary organs. Complete dysfunction of all systems and death are possible. During organ transplantation, donor material is rejected.

In most cases, cytomegalovirus causes a deterioration in a person’s health, exacerbation of existing diseases and often leads to death. This is especially true for people with reduced immunity, newborns, as well as people in the period after organ transplantation, who are forced to suppress the body’s protective cells.

Tests for CMV

Since a person does not have any specific health concerns, he can only be a carrier of cytomegalovirus infection all his life and not know about it.

Even too frequent manifestations of inflammatory processes can end quickly and not cause suspicion. And general standard tests are not always able to determine the presence of serious cellular damage by foreign microorganisms.

Reasons why analysis for cytomegalovirus is mandatory:

planning and course of pregnancy;
risk of miscarriage;
suspicion of intrauterine infection of the fetus;
taking anti-tumor drugs;
HIV infections;
upcoming donation;
transplantation;
long-term course of inflammatory processes in the body in adults and children.

In these cases, cytomegaly is determined. And further treatment depends on continued research into the virus, its form and the duration of infection of the body. But, unfortunately, the infection itself can only be suppressed to a latent state.

To prevent its occurrence, you will have to undergo regular examinations and frequently undergo appropriate tests. If necessary, be registered with a dispensary.

Enzyme immunoassay for cytomegalovirus

An immunological method, like an ELISA blood test, allows you to study the exact chemical composition and presence of antibodies that the body produces in the event of penetration of foreign cells. When conducting the study, special titers are used, which indicate how many times a positive reaction was detected in the blood and its serum when diluted.

A complete breakdown of the analysis for cytomegalovirus provides the ratio of IgM, IgG antibodies in the blood:

IgM “-”, IgG “-”. Complete lack of response from the immune system. A person is susceptible to infection;
IgM “-”, IgG “+”. The risk of infection is minimal, depends on immunity;
IgM “+”, IgG “-”. The formation of the virus in the body begins. Treatment required;
IgM “+”, IgG “+”. Exacerbation. Requires immediate additional examination and treatment.

At the moment, this method of determining the disease is considered the most reliable. With proper laboratory testing, the result is 100%. Sometimes a repeat examination is prescribed if any of the two antibodies are absent in the results. In this case, the analysis is considered false.

PCR analysis for cytomegalovirus

The use of polymerase chain reaction is often quite effective if the material being tested is taken correctly. May have an error in the course of latent or chronic forms of cytomegalovirus.

To conduct a CMV analysis, any body secretion is collected: urine, semen, saliva, sputum, blood, feces. It can also be fluids: cerebrospinal fluid, pleural fluid. Scrapings and smears from the external organs of the excretory genitourinary system.

Rules for conducting PCR analysis for cytomegalovirus:

exclusion of sexual intercourse. 3 days before collection of material;
do not use antibacterial liquids and hygiene items;
before or after 2 days after the menstrual cycle;
You cannot visit the toilet 3 hours before taking the material.

DNA is isolated from the sample taken for research. Using special synthetic reactions, similar, previously obtained fragments of the virus are selected. A positive result means the presence of CMV, a negative result means the absence.

Rare cases of false negative indicators indicate a small amount of cytomegalovirus or its asymptomatic stage.

RIF analysis for cytomegalovirus

Another method for detecting CMV is indirect immunofluorescence. Determines the presence of an indicator in the blood, such as PP65. This is the value of the protein shell found in leukocytes.

When carrying out this analysis, the degree of connecting bonds between antibodies and antigens and the avidity index are taken into account:

35% - 40%. Primary entry of the virus;
40% - 60%. False result. Repeated analysis is carried out after 2 weeks;
60% - 70%. Chronic infection.

The percentages of IgG immunoglobulins in relation to cytomegalovirus infection are indicated. The higher the number, the more protein cells the body secretes to fight the viral disease.

There is no single generally accepted norm for the production of IgG type antibodies. It is calculated individually depending on the age and individual characteristics of the virus carrier.

Treatment of cytomegalovirus

In most cases, the acute form of infection on the body does not require therapy. A person can independently cope with the symptoms and characteristics of the disease.

Treatment is prescribed in case of a threat to life or deterioration of health, disruption of the functioning of organs and systems.

Antiviral drug "Ganciclovir". Penetrates DNA into cells, reduces the amount of cytomegalovirus, hepatitis B, and herpes in the blood. It is prescribed intravenously. Daily dose – 2 times within 1 hour, 5 mg/kg. The drug is diluted with 5% glucose solution. Course duration is 2-3 weeks.

Intravenous antiviral injections "Panavir". At the initial stage of the disease, the daily dosage is 400 mcg every 48 hours. In severe cases - 600 mcg every 48 hours for the first week. The next 7 days - 400 mcg every 72 hours.

Immunoglobulin "Cytotect". Has a directed effect against cytomegalovirus infection. It is prescribed intravenously. Dosage – 50 IU/kg. The number of injections is only as recommended by a doctor.

It is impossible to completely get rid of cytomegalovirus infection. The goal of treatment is to reduce cells affected by the virus and restore the body, increasing the level of immunity. If the course is successfully completed, the antibodies eliminate the activity of the infection to a latent form.

Cytomegalovirus (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 cytomegalovirus infection occur?

You can become infected with cytomegalovirus through close contact with a person who is infected and releases viruses into the environment:

during a kiss
while using the same cutlery (forks, spoons), cups, etc.
if someone who is secreting the virus sneezes or coughs next to 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 can you tell if 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 a country, the higher the percentage of the infected population.

Infection with cytomegalovirus can occur at any age, and young children are a common source of infection.

Unfortunately, it is not 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. You, too, may have already been infected with cytomegalovirus at some point, but you don’t know about it.

How dangerous is cytomegalovirus?

For adults with good immunity, CMV poses no threat. Immediately after cytomegalovirus enters the body, our immune system produces special antibodies that prevent the virus from multiplying and causing any health problems. Thus, before it has time to penetrate the human body, the virus “falls asleep” and most often never “wake up” again. Activation (awakening) of the virus is possible only in case of serious immune disorders, which 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 cancer).

In 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 the birth of a low-birth-weight child, congenital diseases and delayed psychomotor development in the unborn child.

Due to 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.

Is it necessary to get tested for CMV when planning a pregnancy?

Testing for cytomegalovirus is included in a group of tests called TORCH infections. This group of infections includes the following bacteria or viruses that can cause congenital diseases in the unborn child:

cytomegalovirus
others (including syphilis)

In no country in the world is diagnosis for cytomegalovirus before planning a pregnancy mandatory, but you can take this test at your own request or on the recommendation of your doctor.

With this analysis, you can 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 pregnancy?

The most effective method of testing for cytomegalovirus when planning pregnancy is serology (ELISA), namely, the detection of antibodies (immunoglobulins) to cytomegalovirus.

The analysis will show whether there are immunoglobulins of class G (IgG) and class M (IgM) in the body and, if so, their level.

What do immunoglobulins (IgG, IgM) mean?

Immunoglobulins can tell the doctor whether a person is infected with cytomegalovirus, and if so, when the infection occurred, and what state the virus is currently in (dormant or active).

How to understand the results of a test for antibodies to cytomegalovirus when planning pregnancy?

After receiving the results of the test for antibodies to cytomegalovirus, you may find one of the following options:

IgG antibodies to cytomegalovirus – negative

If an antibody test does not detect antibodies to cytomegalovirus, this means that your body has never encountered 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 test 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 is keeping this infection under control.

In this case, you can safely plan your pregnancy. There is a risk that CMV is activated during pregnancy and transmitted 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 have the virus “wake up” and enter the fetus’ body. Unfortunately, it is impossible to predict this 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 test for antibodies to CMV reveals only IgM, this means that you became infected with cytomegalovirus very 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 disappears 8-10 weeks after 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 became infected with cytomegalovirus several months ago, or you became infected with cytomegalovirus a long time ago, but at the moment the virus has “woke up” (reactivation of the infection).

What is IgG avidity for cytomegalovirus?

Some laboratories determine a parameter such as the avidity of IgG antibodies. Using this parameter, you can clarify how long ago the infection with cytomegalovirus occurred. The higher the avidity of the antibodies, the earlier the infection occurred, and the more favorable this situation is for you.

If avidity is high (more than 60%), it means that the infection occurred a long time ago and the infection does not pose a threat to the planned pregnancy. If avidity is low (less than 50%), it means that you were infected with cytomegalovirus recently, no more than 3 months ago.

What should I do 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 when planning pregnancy and during pregnancy.

If you become infected with cytomegalovirus during pregnancy, the risk of transmitting this infection to the fetus is 30-40%.

To reduce the risk of infection during pregnancy, you need to strictly follow the rules of personal hygiene: try not to contact or kiss young children and adults who have cold symptoms, use separate forks, spoons and cups, wash your hands thoroughly after contact with children or with baby urine (for example, if you already have one child and change his diapers).

If during pregnancy you develop cold symptoms (fever, swollen lymph nodes, sore throat, etc.), you will need to be retested for antibodies to cytomegalovirus.

Some experts believe that CMV testing should be done prophylactically every 1-2 months throughout pregnancy.

Is there a vaccination against cytomegalovirus?

Unfortunately, such a vaccine does not yet exist.

What should I do if I have IgM? How to treat?

The presence of IgM in the blood indicates that the virus is currently active and your immune system has not yet overcome the infection.

Is treatment necessary 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 analysis, then antiviral drugs are not prescribed. If the infection is asymptomatic, it means your body is successfully coping with it and does not need to be helped with pills. You just need to give the immune system time until it develops immunity to cytomegalovirus. To speed up the process of developing immunity, your gynecologist may recommend general health-improving medications, immunity-enhancing drugs (immunomodulators) and vitamins.

If there are symptoms of cytomegalovirus infection, 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 medications and dosage are determined by the attending physician. We list the most popular antiviral and immunomodulatory 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 and get rid of this virus?

Once you become infected with cytomegalovirus, you will no longer be able to get rid of it. Most people infected with CMV remain in their bodies for the rest of their lives.

The goal of treatment (if it is prescribed at all) is to develop immunity to the virus, but not to eliminate cytomegalovirus from the body.

Description

Determination method Enzyme-linked immunosorbent assay (ELISA).

Material under study Blood serum

IgG antibodies to cytomegalovirus (CMV, CMV).

In response to the introduction of cytomegalovirus (CMV) into the body, immune restructuring of the body develops. 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. The body's protective reaction manifests itself, first of all, in the form of the formation of specific antibodies of the IgM and IgG classes to CMV. IgG antibodies to cytomegalovirus (CMV) indicate current or past cytomegalovirus infection. Features of infection. Cytomegalovirus (CMV) 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 of 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 a virus of the herpes virus family. Like other members of the family, after infection it remains in the body almost for life. Stable in humid environments. The risk group includes children 5 - 6 years old, adults 16 - 30 years old, as well as people who practice anal sex. Children are susceptible to airborne transmission from parents and other children with latent forms of infection. For adults, sexual transmission is more common. The virus is found in semen and other body fluids. Vertical transmission of infection (from mother to fetus) occurs transplacentally and during childbirth. CMV infection is characterized by a variety of 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. 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 infection in pregnant women, examination during pregnancy.

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. 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 pneumonitis, 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:

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.

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

Indications for use

Preparing 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 origin.
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).

Interpretation of results

Interpretation of research results contains information for the attending physician and is not a diagnosis. The information in this section should not be used for self-diagnosis or self-treatment. The doctor makes an accurate diagnosis using both the results of this examination and the necessary information from other sources: medical history, results of other examinations, etc.

Units of measurement units of measurement in the INVITRO laboratory: U/ml. Reference values: 0 - 6 U/ml. 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 to 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.

A positive test result for IgG to cytomegalovirus means that the person is immune to this virus and is a carrier of it.

Moreover, this does not at all mean that the cytomegalovirus infection is in the active stage or any guaranteed dangers for a person - it all depends on his own physical condition and the strength of the immune system. The most pressing question of the presence or absence of immunity to cytomegalovirus is for pregnant women - it is on the developing fetus that the virus can have a very serious impact.

Let's look at the meaning of the analysis results in more detail...

IgG analysis for cytomegalovirus: the essence of the study

An IgG test for cytomegalovirus means looking for specific antibodies to the virus in various samples from the human body.

For reference: Ig is an abbreviation for the word “immunoglobulin” (in Latin). Immunoglobulin is a protective protein produced by the immune system to destroy the virus. For each new virus that enters the body, the immune system produces its own specific immunoglobulins, and in an adult, the variety of these substances becomes simply enormous. For simplicity, immunoglobulins are also called antibodies.

The letter G is a designation for one of the classes of immunoglobulins. In addition to IgG, humans also have immunoglobulins of classes A, M, D and E.

Obviously, if the body has not yet encountered the virus, then it has not yet produced the corresponding antibodies to it. And if there are antibodies to the virus in the body, and the test for them is positive, then, consequently, the virus has already entered the body at some point. Antibodies of the same class against different viruses are quite different from each other, so an IgG test gives a fairly accurate result.

An important feature of the cytomegalovirus itself is that once it infects the body, it remains in it forever. No medicine or therapy will help you get rid of it completely. But since the immune system develops a strong defense against it, the virus remains to exist in the body in an invisible and practically harmless form, persisting in the cells of the salivary glands, some blood cells and internal organs. Most carriers of the virus are not even aware of its existence in their bodies.

You also need to understand the differences between the two classes of immunoglobulins - G and M - from each other.

IgM are fast immunoglobulins. They are large in size and are produced by the body for the fastest possible response to the penetration of the virus. However, IgM does not form immunological memory, and therefore, with their death after 4-5 months (this is the lifespan of the average immunoglobulin molecule), the protection against the virus with their help disappears.

IgG are antibodies that, once produced, are cloned by the body and maintain immunity against a specific virus throughout life. They are much smaller than the previous ones, but are produced later on the basis of IgM, usually after the infection has been suppressed.

We can conclude: if cytomegalovirus-specific IgM is present in the blood, this means that the body became infected with this virus relatively recently and, perhaps, an exacerbation of the infection is currently occurring. Other details of the analysis can help clarify more subtle details.

Decoding of some additional data in the analysis results

In addition to just a positive IgG test, the test results may contain other data. The attending physician should understand and interpret them, but just to understand the situation it is useful to know the meanings of some of them:

Anti- Cytomegalovirus IgM+, Anti- Cytomegalovirus IgG-: cytomegalovirus-specific IgM is present in the body. The disease occurs in an acute stage; most likely, the infection was recent;
Anti- Cytomegalovirus IgM-, Anti- Cytomegalovirus IgG+: inactive stage of the disease. The infection occurred a long time ago, the body has developed a strong immunity, and viral particles that enter the body again are quickly eliminated;
Anti-Cytomegalovirus IgM-, Anti-Cytomegalovirus IgG-: There is no immunity to CMV infection. The organism had never encountered it before;
Anti- Cytomegalovirus IgM+, Anti- Cytomegalovirus IgG+: reactivation of the virus, exacerbation of infection;
Antibody avidity index below 50%: primary infection of the body;
Antibody avidity index above 60%: immunity to the virus, carriage or chronic form of infection;
Avidity index 50-60%: uncertain situation, the study must be repeated after a few weeks;
Avidity index 0 or negative: the body is not infected with cytomegalovirus.

It should be understood that the different situations described here may have different consequences for each patient. Accordingly, they require individual interpretation and approach to treatment.

A positive test for CMV infection in a person with normal immunity: you can just relax

In immunocompetent people who do not have diseases of the immune system, positive tests for antibodies to cytomegalovirus should not cause any alarm. Whatever the stage of the disease, with strong immunity it usually proceeds asymptomatically and unnoticed, only sometimes expressing itself in the form of a mononucleosis-like syndrome with fever, sore throat and malaise.

It is only important to understand that if tests indicate an active and acute phase of the infection, even without external symptoms, then from a purely ethical point of view, the patient needs to independently reduce social activity for a period of a week or two: be less in public, limit visits to relatives, not communicate with small children and especially with pregnant women (!). At this moment, the patient is an active spreader of the virus and is capable of infecting a person for whom CMV infection can be truly dangerous.

Presence of IgG in immunocompromised patients

Perhaps the most dangerous virus is cytomegalovirus for people with various forms of immunodeficiency: congenital, acquired, artificial. Their positive IgG test result may be a harbinger of complications of the infection such as:

hepatitis and jaundice;
cytomegalovirus pneumonia, which is the cause of death in more than 90% of AIDS patients in developed countries of the world;
diseases of the digestive tract (inflammation, exacerbation of peptic ulcers, enteritis);
encephalitis, accompanied by severe headaches, drowsiness and, in advanced conditions, paralysis;
retinitis is an inflammation of the retina of the eye, leading to blindness in a fifth of patients with immunodeficiencies.

The presence of IgG to cytomegalovirus in these patients indicates a chronic course of the disease and the likelihood of an exacerbation with a generalized course of infection at any time.

Positive test results in pregnant women

In pregnant women, the results of an analysis for antibodies to cytomegalovirus can determine how likely the fetus is to be affected by the virus. Accordingly, it is based on the test results that the attending physician makes a decision on the use of certain therapeutic measures.

A positive test for IgM to cytomegalovirus in pregnant women indicates either a primary infection or a relapse of the disease. In any case, this is a rather unfavorable development of the situation.

If this situation is observed in the first 12 weeks of pregnancy, it is necessary to take urgent measures to combat the virus, since with primary infection of the mother there is a high risk of teratogenic effects of the virus on the fetus. With a relapse, the likelihood of fetal damage decreases, but still persists.

With later infection, it is possible for the child to develop a congenital cytomegalovirus infection or become infected at the time of birth. Accordingly, specific pregnancy management tactics will be developed in the future.

The doctor can determine whether the doctor is dealing with a primary infection or a relapse in this case by the presence of specific IgG. If the mother has them, it means that she has immunity to the virus, and the exacerbation of the infection is caused by a temporary weakening of the immune system. If there is no IgG for cytomegalovirus, this indicates that the mother became infected with the virus for the first time during pregnancy, and the fetus will most likely be affected by it, as well as the mother’s entire body.

To take specific therapeutic measures, it is necessary to study the patient’s medical history, taking into account many additional criteria and features of the situation. However, the mere presence of IgM already indicates that there is a risk to the fetus.

The presence of IgG in newborns: what does it mean?

The presence of IgG to cytomegalovirus in a newborn indicates that the baby was infected with the infection either before birth, or at the time of birth, or immediately after it.

Neonatal CMV infection is clearly indicated by a fourfold increase in IgG titer in two tests at a monthly interval. In addition, if the presence of specific IgG in the blood of a newborn is observed already in the first three days of life, they usually speak of a congenital cytomegalovirus infection.

CMV infection in children can be asymptomatic, or can be expressed by quite serious symptoms and have complications such as inflammation of the liver, chorioretinitis and subsequent strabismus and blindness, pneumonia, jaundice and the appearance of petechiae on the skin. Therefore, if cytomegalovirus is suspected in a newborn, the doctor must carefully monitor his condition and development, remaining ready to use the necessary means to prevent complications.

What to do if you test positive for antibodies to CMV infection

If you test positive for cytomegalovirus, you should first consult your doctor.

In most cases, the infection itself does not lead to any consequences, and therefore, in the absence of obvious health problems, it makes sense not to carry out treatment at all and entrust the fight against the virus to the body itself.

The drugs used to treat CMV infection have serious side effects, and therefore their use is prescribed only in cases of urgent need, usually in patients with immunodeficiencies. In these situations use:

Ganciclovir, which blocks the multiplication of the virus, but at the same time causes digestive and hematopoietic disorders;
Panavir in the form of injections, not recommended for use during pregnancy;
Foscarnet, which can cause kidney problems;
Immunoglobulins obtained from immunocompetent donors;
Interferons.

All these drugs should be used only on the recommendation of a doctor. In most cases, they are prescribed only to patients with immunodeficiencies or those who are prescribed chemotherapy or organ transplants that involve artificial suppression of the immune system. Only sometimes they treat pregnant women or infants.

In any case, it should be remembered that if previously there were no warnings about the danger of cytomegalovirus for the patient, then everything is fine with the immune system. And a positive test for cytomegalovirus in this case will only inform about the fact of the presence of already formed immunity. All that remains is to maintain this immunity.

Video about the danger of cytomegalovirus infection for pregnant women

Cytomegalovirus belongs to the herpes virus family, namely. A blood test for the virus will help detect it.

Cytomegalovirus affects different types of cells:

salivary glands;
kidney;
liver;
placenta;
eyes and ears.

But, although the list is impressive, in most cases cytomegalovirus is not dangerous to human health!

What is the danger of cytomegalovirus?

hearing loss;
impairment or even loss of vision;
mental retardation;
the occurrence of seizures.

Such consequences can occur both during the primary infection and during activation. You just need to remember the likelihood of such serious consequences occurring.

In an infant who became infected during pregnancy, the following external manifestations of cytomegalovirus infection are possible:

intracerebral calcifications;
ventriculomegaly (enlarged lateral ventricles of the brain);
the liver and spleen are enlarged;
excess fluid occurs in the peritoneum and chest cavity;
microcephaly (small head);
petechiae (small hemorrhages on the skin);
jaundice.

What is analysis on igg?

If the igg is positive, this is evidence that the patient has developed immunity to the virus, but at the same time the person is its carrier.

This does not mean that cytomegalovirus is active or that the patient is in danger. The primary role will be played by the patient’s physical condition and immunity.

A positive test is most important for a pregnant woman, since the baby’s body is still developing and does not produce antibodies to cytomegalovirus.

During the cytomegalovirus igg study, samples are taken from the patient's body to find specific antibodies to the cytomegalovirus igg. Igg is an abbreviation for the Latin word “immunoglobulin”.

This is a type of protective protein produced by the immune system to fight the virus.

The immune system begins to produce special antibodies for each new virus that appears in the body.

As a result, upon reaching , a person may already possess a whole “bouquet” of such substances. The letter G denotes a certain class of immunoglobulins, marked in humans with the letters A, D, E, G, M.

Thus, a body that has not yet encountered the virus is unable to produce antiviral antibodies. This is why the presence of antibodies in a person indicates that the body has previously been exposed to the virus.

Please note: antibodies of the same type, which are designed to fight different viruses, have significant differences. This is why the results of cytomegalovirus tests on igg are quite accurate.

How is the analysis deciphered?

An important feature of cytomegalovirus is that after the initial damage to the body, it remains in it forever. No treatment will help get rid of its presence.

The virus functions practically without harm in the internal organs, blood and salivary glands, and its carriers do not even suspect that they are carriers of the virus.

What are the differences between immunoglobulins M and G?

Igm combines fast “large” antibodies produced by the body in order to respond to the virus as soon as possible.

Igm do not provide immunological memory, dying off within six months, and the protection that they are supposed to provide is eliminated.

igg refers to antibodies that the body clones from the moment they appear. This is done with the aim of maintaining protection against a particular virus throughout a person's life.

These cytomegalovirus antibodies are smaller in size and have a later production time. Typically, they are produced from igm antibodies after the infection has been suppressed.

That is why, having detected cytomegalovirus igm in the blood, which reacts to , it can be argued that the person became infected with the virus relatively recently and at the moment there may be an exacerbation of infection.

To obtain more complete information, it is necessary to study additional research indicators.

Antibodies to cytomegalovirus igg

What additional tests can be done?

It may consist not only of information about cytomegalovirus, but also carry other necessary data. Specialists interpret the data and prescribe treatment.

To better understand the values, it is worth familiarizing yourself with the laboratory test indicators:

Іgg– , igm+: specific igm antibodies were found in the body. With a high degree of probability, the infection occurred recently, and now there is an exacerbation of the disease;
igg+, igm– means: the disease is inactive, although the infection occurred a long time ago. Since immunity has already developed, virus particles that re-enter the body are quickly destroyed;
igg– , igm– – evidence of a lack of immunity to cytomegalovirus, since this virus has not yet been recognized by the body;
igg+, igm+ – evidence of reactivation of cytomegalovirus and exacerbation of infection.

Another important indicator is called immunomodulins:

below 50% is evidence of primary infection;
50 – 60% – the result is uncertain. The analysis should be repeated after 3 - 4 weeks;
over 60% – there is immunity to the virus, although the person is a carrier or the disease has become chronic;
0 or negative result – the body is not infected.

If a person does not have immune system diseases, a positive one should not be a cause for concern.

At any stage of the disease, good immunity is a guarantee of an imperceptible and asymptomatic course of the disease.

Only occasionally does cytomegalovirus manifest itself with the following symptoms:

general malaise.

It is important to remember that intense and aggravated infection, even in the absence of external signs, is recommended to reduce your activity for several weeks:

appear less often in public places;
communicate as little as possible with children and pregnant women.

At this stage, the virus is actively spreading, capable of infecting another person and requiring serious treatment for cytomegalovirus.

?

The greatest danger to the fetus exists when the virus enters the female body during pregnancy. The danger increases if a woman becomes infected for the first time and is between 4 and 22 weeks pregnant.

If we are talking about reactivation of cytomegalovirus during pregnancy, the risk of infection for the fetus is minimal, but during pregnancy, cytomegalovirus infection can lead to the following consequences:

birth of a mentally retarded child;
The baby develops seizures, hearing or vision loss.

But one should not panic: the tragic consequences of cytomegalovirus are registered in 9% of cases with primary cytomegalovirus infection and 0.1% with re-infection.

Thus, the vast majority of women with such an infection give birth to healthy children!

Situations typical for pregnant women:

If, even before pregnancy, a blood test showed antibodies to cytomegalovirus), then such a woman will never have a primary infection during pregnancy, since it has already occurred in the past - this is evidenced by antibodies in the blood.
A blood test for antibodies was taken for the first time during pregnancy and antibodies to the virus were detected. In such cases, reactivation of the infection may occur during pregnancy, and the probability of serious damage to the fetus is 0.1%.
The blood test was taken before pregnancy. The woman did not have antibodies to cytomegalovirus (igg-, CMV igm-).

Based on other medical publications, it can be argued: unfortunately, in domestic medicine, everything bad that happens to a child is usually attributed to cytomegalovirus infection.

Therefore, repeat tests for CMV IgG and CMV IgM are prescribed, as well as a PCR test for CMV mucus from the cervix.

If there is evidence of constant levels of CMV igg and the absence of CMV igm in the cervix, we can safely deny that possible pregnancy complications are caused by cytomegalovirus.

Treatment of cytomegalovirus infection

It should be emphasized: none of the available treatment methods completely eliminates the virus.

If cytomegalovirus is asymptomatic, women with normal immunity do not need treatment.

Therefore, even if cytomegalovirus or antibodies to it were detected in a patient with good immunity, there are no indications for treatment.

Efficiency of use, polyoxidonium, etc. is not a panacea.

It can be argued: immunotherapy for cytomegalovirus infection, as a rule, is driven not so much by medical as by commercial considerations.

Treatment of cytomegalovirus in people with weakened immune systems is reduced to the use of (ganciclovir, foscarnet, cidofovir).

Cytomegalovirus penetrates the child’s cells immediately, remaining there for life, existing in an inactive state.

Children aged 2 – 6 months are infected with virtually no symptoms or any serious health problems.

But if a child becomes infected in the first months of life, infection can provoke a real tragedy.

We are talking about congenital infection, when the child became infected in the mother’s stomach during childbirth.

Which children are more dangerous from the virus?

children who have not yet been born become infected during the period of intrauterine development;
with a weakened immune system;
children of all ages with weakened or absent immunity.

Congenital infection with cytomegalovirus carries the risk of affecting the child with serious damage to the nerves, digestive system, blood vessels and musculoskeletal system.

There is a possibility of irreversible damage to the organs of hearing and vision.

Diagnosed using laboratory analysis. Enzyme immunoassay is widely used in the Russian Federation today.

Preventive measures

Using condoms reduces the risk of acquiring infection during sexual intercourse.

Those with a congenital infection should avoid casual intimate relationships during pregnancy.