Cytomegalovirus lgg positive lgm. Cytomegalovirus lgg positive: what does it mean, diagnosis, results. Decoding of some additional data in the analysis results

The list of pathological conditions and diseases that a person suffers throughout his life largely depends on the way of life. After pathogenic microorganisms enter the body, the immune system is activated and begins to take measures to combat them.

In the case when the protective properties are reduced, the body is not able to fight pathogenic microflora. As a result, the development and progression of the disease occurs, and the mass reproduction of microorganisms: bacteria, viruses, fungi.

One of the most commonly diagnosed pathogenic microorganisms is the herpes virus. It is represented by several strains. No person is immune from the penetration of pathogens of various diseases into the body. This pathology can affect both men, women and children. The worst thing is that there is still no method of therapy that can destroy the virus and cure the pathology.

It deserves special attention. Quite often, after undergoing an examination, people ask the question: “Cytomegalovirus IgG is positive: what does this mean?” The infection can affect any system and organ. Active reproduction of the virus is fraught with critical consequences.

CMV: what is it

Before understanding the issue of a positive result for cytomegalovirus IgG, as well as what this means, you should learn in more detail about the pathogenic infection itself. CMV was first identified in 1956. Scientists and doctors have not fully studied it to this day. But despite this, there is the possibility of timely diagnosis of pathology, and, consequently, timely therapy, and prevention of the development of complications.

According to statistics, a third of the world's population is carriers of the herpes virus. The spread of the pathogen is weak, and in order to become infected, you must be with the infected person for an extended period. Infection can occur through sexual contact, during childbirth and through saliva.

It is quite difficult to immediately identify and diagnose the disease. And this is due to the presence of an incubation period. The patient or carrier of the infection can live with the disease, feel normal and not even suspect the presence of CMV.

The pathology is insidious, as it can masquerade as other, less dangerous diseases, especially colds.

In the initial stages, the disease is accompanied by the following manifestations:

• hyperthermia;
• chronic fatigue, weakness;
• enlarged lymph nodes;
• chills;
• frequent headaches;
• sleep disorder;
• dyspeptic disorders;
• joint pain;
• decreased appetite.

Timely detection of the disease is very important, since the lack of appropriate therapy is fraught with serious complications, in particular the development of encephalitis, pneumonia, and arthritis. With weakened immunity, eye damage and malfunctions in the kidneys and urinary system, as well as the gastrointestinal tract, may occur.

If alarming symptoms appear, you should undergo an examination. A positive test result for cytomegalovirus IgG means that the infected person has protection against CMV and is its carrier.

It is not at all necessary that a person is sick and that he is extremely dangerous to others. Everything will depend on the protective properties of his body. CMV is dangerous during pregnancy.

The essence of analysis

The essence of the IgG test is to look for antibodies to CMV. To do this, they take different samples (blood, saliva). To make it clearer, Ig is an immunoglobulin. This substance is a protective protein that is produced by the body to destroy pathogenic microorganisms. The immune system produces a specific antibody to any new pathogenic organism. The G in the abbreviation IgG stands for one of the classes of antibodies. In addition to IgG, there are also groups A, M, E and D.

If a person is healthy, then specific Igs have not yet been produced. The danger is that, having entered the body once, the infection will remain in it forever. It is impossible to destroy it. But since the immune system produces protection against it, the virus exists in the body harmlessly. It is important to know that in addition to IgG there is also IgM. These are two completely different groups of antibodies.

The second are fast antibodies. They are large and are produced for a quick response to the herpes virus entering the body. But they do not have immunological memory. This means that after their death, after about four to five months, the protection against CMV subsides.

As for IgG, these antibodies tend to clone and maintain protection against a specific pathogenic microorganism throughout life. They are small in size, but are produced later than IgM, usually after suppression of the infectious process.

And it turns out that if IgM antibodies are detected, then the infection occurred recently and most likely the infectious process is in the active phase.

How are analyzes deciphered?

In addition to IgG+, the results often contain other data.

A specialist will help you decipher them, but in order to understand the situation, it is useful to familiarize yourself with some meanings:

1. 0 or “-” - there is no CMV in the body.
2. If the avidity index is 50-60%, then the situation is considered uncertain. The study is repeated after one to two weeks.
3. Above 60% - there is immunity, the person is a carrier.
4. Below 50%, the person is infected.
5. Anti- CMV IgM+, Anti- CMV IgG+ - the infection has reactivated.
6. Anti-CMV IgM-, Anti-CMV IgG- - protection against the virus has not been developed, since there has never been penetration of the virus before.
7. Anti-CMV IgM-, Anti-CMV IgG+ - the pathology occurs in an inactive stage. The infection happened a long time ago, the immune system has developed a strong defense.
8. Anti- CMV IgM+, Anti- CMV IgG- - acute stage of pathology, the person became infected recently. Fast Igs to CMV are available.

Result “+” in a person with strong immunity

If there are no health problems, a “+” result should not cause panic or anxiety. Regardless of the degree of the disease, with persistent protective properties, its course is asymptomatic. Occasionally, sore throat and fever may occur.

But it should be understood that if tests indicate activation of the virus, but the pathology is asymptomatic, the patient should temporarily reduce social activity (limiting communication with family, excluding conversations and contacts with pregnant women and children). During the active phase, a sick person is an active spreader of cytomegalovirus infection and can infect a person whose body CMV will cause significant damage.

CMV IgG positive: in immunodeficiency, pregnancy and infants

A CMV “+” result is dangerous for everyone. However, a positive CMV IgG result is most dangerous for a patient with immunodeficiency: congenital or acquired. Such a result signals the development of serious complications.

• Retinitis- development of the inflammatory process in the retina. This pathology can lead to blindness.
• Hepatitis and jaundice.
• Encephalitis. This pathology is characterized by severe headaches, sleep disturbances, and paralysis.
• Gastrointestinal ailments- inflammatory processes, exacerbation of ulcers, enteritis.
• Pneumonia. This complication, according to statistics, is the cause of death in more than 90% of people suffering from AIDS.

CMV IgG positive in such patients signals the course of the pathology in a chronic form and a high probability of exacerbations.

Positive result during pregnancy

An IgG+ result is no less dangerous for pregnant women. CMV IgG positive signals infection or an exacerbation of the pathology. If IgG to cytomegalovirus is detected in the early stages, urgent measures must be taken. Primary infection with the virus carries a high risk of the fetus developing serious abnormalities. With relapses, the risk of harmful effects on the fetus is significantly reduced.

Infection in the second and third trimester is fraught with the occurrence of congenital CMV infection in the child or its infection during passage through the birth canal. The doctor judges whether the infection is primary or an exacerbation by the presence of specific group G antibodies. Their detection signals that there is protection, and the exacerbation is due to a decrease in the body’s protective properties.

If IgG is absent, this indicates infection during pregnancy. This suggests that the infection can cause enormous damage not only to the mother, but also to the fetus.

Result “+” in a newborn

A fourfold increase in IgG titer during two studies with an interval of thirty days indicates congenital CMV infection. The course of the pathology in infants can be either asymptomatic or characterized by pronounced manifestations. The disease may also be associated with a high risk of complications. Pathology in a small child is fraught with the appearance of blindness, the development of pneumonia, and malfunction of the liver.

What to do if you have an IgG+ result

The first thing to do if you have a positive CMV IgG is to seek help from a qualified specialist. CMVI itself often does not provoke critical consequences. If there are no obvious signs of the disease, there is no point in carrying out treatment. The fight against infection should be left to the immune system.

For severe symptoms, the following medications are most often prescribed:

• Interferons.
• Immunoglobulins.
• Foscarnet (taking the drug is fraught with disruptions in the functioning of the urinary system and kidneys).
• Panavira.
• Ganciclovir. Helps block the proliferation of pathogenic microorganisms, but at the same time provokes the appearance of disruptions in the gastrointestinal tract and hematopoietic disorders.

You should not take any medications without your doctor's knowledge. Self-medication can lead to unpredictable consequences. It is important to understand one thing - if everything is in order with the immune system, the “+” result only informs about the presence of a formed defense in the body. The only thing you need to do is support your immune system.

Cytomegalovirus is a herpetic type infection, diagnosed in a child or adult by a blood test for igg, igm antibodies. Carriers of this infection are 90% of the world's population. It manifests itself with a significant decrease in immunity and is dangerous for intrauterine development. What are the symptoms of cytomegaly, and when is drug treatment necessary?

What is cytomegalovirus infection

Cytomegalovirus infection is a herpetic type virus. It is called hepres type 6 or CMV. The disease caused by this virus is called cytomegaly. With it, infected cells lose the ability to divide and greatly increase in size. Inflammation develops around the infected cells.

The disease can be localized in any organ - the sinuses (rhinitis), bronchi (bronchitis), bladder (cystitis), vagina or urethra (vaginitis or urethritis). However, the CMV virus more often chooses the genitourinary system, although its presence is found in any fluid media of the body ( saliva, vaginal discharge, blood, sweat).

Conditions of infection and chronic carriage

Like other herpes infections, cytomegalovirus is a chronic virus. It enters the body once (usually in childhood) and is stored there for the rest of one’s life. The form of storage of the virus is called carriage, while the virus is in a latent, dormant form (stored in the ganglia of the spinal cord). Most people do not realize they carry CMV until their immune system fails. The dormant virus then multiplies and produces visible symptoms.

Unusual situations lead to a significant decrease in immunity in healthy people: organ transplant operations (accompanied by taking medications that purposefully reduce immunity - this prevents rejection of a transplanted foreign organ), radiation and chemotherapy (in the treatment of oncology), long-term use of hormonal drugs (contraceptives), alcohol.

Interesting fact: The presence of cytomegalovirus infection is diagnosed in 92% of examined people. Carriage is a chronic form of the virus.

How the virus is transmitted

Just 10 years ago, cytomegalovirus infections were considered sexually transmitted. CMV was called " kissing disease", believing that the disease is transmitted through kisses. Modern research has proven that cytomegalovirus is transmitted in various household situations- using shared utensils, towels, and shaking hands (if there are cracks, abrasions, or cuts on the skin of the hands).

The same medical studies have found that children are most often infected with cytomegalovirus. Their immunity is at the stage of formation, so viruses penetrate the child’s body, cause illness or form a carrier state.

Herpetic infections in children manifest visible symptoms only with low immunity ( for frequent illnesses, vitamin deficiency, serious immune problems). With normal immunity, exposure to the CMV virus is asymptomatic. The child becomes infected, but no symptoms (fever, inflammation, runny nose, rash) follow. The immune system copes with foreign invasion without raising the temperature (forms antibodies and remembers the program for their production).

Cytomegalovirus: manifestations and symptoms

External manifestations of CMV are difficult to distinguish from ordinary acute respiratory infections. The temperature rises, a runny nose appears, and the throat hurts. Lymph nodes may become enlarged. The complex of these symptoms is called mononucleosis syndrome. It accompanies many infectious diseases.

CMV can be distinguished from a respiratory infection by the protracted duration of the disease. If a common cold goes away in 5-7 days, then cytomegaly lasts longer - up to 1.5 months.

There are special signs of cytomegalovirus infection (they rarely accompany ordinary respiratory infections):

• Inflammation of the salivary glands(in them the CMV virus multiplies most actively).
• In adults - inflammation of the genital organs(for this reason, CMV has long been considered a sexually transmitted infection) - inflammation of the testicles and urethra in men, uterus or ovaries in women.

Interesting to know: Cytomegalovirus in men often occurs without visible symptoms if the virus is localized in the genitourinary system.

CMV has a long incubation period. When infected with herpes infection type 6 ( cytomegalovirus) signs of the disease appear 40-60 days after the virus enters.

Cytomegaly in infants

The danger of cytomegaly for children is determined by the state of their immunity and the presence of breastfeeding. Immediately after birth, the child is protected from various infections by the mother’s antibodies (they entered his blood during intrauterine development, and continue to do so during breastfeeding). Therefore, in the first six months or a year (the time of predominantly breastfeeding), the baby is protected by the mother’s antibodies. Cytomegalovirus in children under one year of age does not cause any symptoms due to the presence of maternal antibodies.

Infection of a child becomes possible by reducing the number of breastfeedings and incoming antibodies. The source of infection becomes the closest relatives (when kissing, bathing, general care - let us remind you that the majority of the adult population is infected with the virus). The reaction to primary infection can be strong or invisible (depending on the state of immunity). Thus, by the second or third year of life, many children develop their own antibodies to the disease.

Is cytomegalovirus dangerous in an infant?

With normal immunity - no. With a weak and insufficient immune response - yes. It can cause long-term extensive inflammation.

Dr. Komarovsky also speaks about the connection between CMV symptoms and immunity: “ Cytomegalovirus in children does not pose a threat if the immune system is normal. Exceptions from the general group are children with special diagnoses - AIDS, chemotherapy, tumors».

If a child was born weakened, if his immunity is impaired by taking antibiotics or other potent drugs, infection with cytomegalovirus causes an acute infectious disease - cytomegaly(symptoms of which are similar to long-term acute respiratory infections).

Cytomegaly in pregnant women

Pregnancy is accompanied by a decrease in maternal immunity. This is a normal reaction of the female body, which prevents the rejection of the embryo as a foreign organism. Row physical and chemical processes and hormonal changes are aimed at reducing the immune response and limiting the action of immune forces. Therefore, it is during pregnancy that dormant viruses can be activated and cause relapses of infectious diseases. So, if cytomegalovirus did not manifest itself in any way before pregnancy, then during pregnancy it can increase the temperature and form inflammation.

Cytomegalovirus in a pregnant woman can be the result of a primary infection or a secondary relapse. Primary infection poses the greatest danger to the developing fetus.(the body does not have time to give a worthy response and the CMV virus penetrates the placenta to the child).

Recurrences of infection during pregnancy are not dangerous in 98% of cases.

Cytomegaly: danger and consequences

Like any herpetic infections, the CMV virus is dangerous for a pregnant woman (or rather, for the child in her womb) only during primary infection. Primary infection forms various malformations, deformities or defects of the brain, and pathologies of the central nervous system.

If infection with the CMV virus or another herpes-type pathogen occurred long before pregnancy (in childhood or adolescence), then this situation is not terrible for the child in the womb, and is even useful. During primary infection, the body produces a certain amount of antibodies, which are stored in the blood. In addition, a program of protective reaction to this virus is developed. Therefore, the relapse of the virus is brought under control much faster. For a pregnant woman, the best option is to become infected with CMV in childhood and develop certain mechanisms to fight the infection.

The most dangerous situation for a child is a woman’s sterile body before conception. You can get infections anywhere (more than 90% of the planet's population are carriers of herpes viruses). At the same time, infection during pregnancy causes a number of disturbances in the development of the fetus, and infection in childhood passes without serious consequences.

Cytomegaly and uterine development

The CMV virus poses the greatest danger to a child in the womb. How does cytomegalovirus affect the fetus?

Infection of the fetus is possible during initial exposure to the virus during pregnancy. If infection occurs before 12 weeks, a miscarriage occurs in 15% of cases.

If infection occurs after 12 weeks, a miscarriage does not occur, but the child develops symptoms of the disease (this happens in 75% of cases). 25% of children whose mothers become infected with the virus during pregnancy for the first time are born completely healthy.

Cytomegalovirus in a child: symptoms

What symptoms can be used to suspect congenital cytomegaly in a child:

• Retarded physical development.
• Severe jaundice.
• Enlarged internal organs.
• Foci of inflammation (congenital pneumonia, hepatitis).

The most dangerous manifestations of cytomegaly in newborns are damage to the nervous system, hydrocephalus, mental retardation, loss of vision and hearing.

Analyzes and decoding

The virus is found in any body fluid - blood, saliva, mucus, urine in children and adults. Therefore, an analysis to determine CMV infection can be taken from blood, saliva, semen, as well as in the form of a smear from the vagina and pharynx. In the samples taken, they look for cells affected by the virus (they are large in size, they are called “huge cells”).

Another diagnostic method examines the blood for the presence of antibodies to the virus. If there are specific immunoglobulins that are formed as a result of the fight against the virus, it means there has been an infection and there is a virus in the body. The type of immunoglobulins and their quantity can indicate whether this is a primary infection or a relapse of an infection that was previously ingested.

This blood test is called enzyme immunoassay (abbreviated as ELISA). In addition to this analysis, there is a PCR test for cytomegalovirus. It allows you to reliably determine the presence of infection. For PCR analysis, a vaginal smear or amniotic fluid sample is taken. If the result shows the presence of infection, the process is acute. If PCR does not detect the virus in mucus or other secretions, there is no infection (or relapse of infection) now.

Analysis for cytomegalovirus: Igg or igm?

The human body produces two groups of antibodies:

• primary (they are designated M or igm);
• secondary (they are called G or igg).

Primary antibodies to cytomegalovirus M are formed when CMV first enters the human body. The process of their formation is not related to the severity of symptoms. Infection may be asymptomatic, but igm antibodies will be present in the blood. In addition to the primary infection, type G antibodies are formed during relapses when the infection got out of control and the virus began to actively multiply. Secondary antibodies are produced to control the dormant virus stored in the ganglia of the spinal cord.

Another indicator of the stage of infection formation is avidity. It diagnoses the maturity of antibodies and the primacy of infection. Low maturity (low avidity - up to 30%) corresponds to primary infection. If the analysis for cytomegalovirus shows high avidity ( more than 60%), then this is a sign of chronic carriage, the latent stage of the disease. Average indicators ( from 30 to 60%) - correspond to a relapse of infection, activation of a previously dormant virus.

Note: deciphering a blood test for cytomegalovirus takes into account the number of antibodies and their type. These data make it possible to draw conclusions about the primary or secondary nature of the infection, as well as about the level of the body’s own immune response.

Blood for cytomegalovirus: interpretation of results

The main test to determine the presence of CMV infection is a blood antibody test (ELISA). Almost all women are tested for cytomegalovirus during pregnancy. The results of the analysis look like a list of types of antibodies and their quantities:

• Cytomegalovirus igg igm - “-” (negative)- this means that there has never been contact with the infection.
• "Igg+, igm-"- this result is obtained in most women when they are examined when planning pregnancy. Since CMV carriage is almost universal, the presence of group G antibodies indicates familiarity with the virus and its presence in the body in a dormant form. “Igg+, igm-” - normal indicators, which allow you not to worry about possible infection with a virus while carrying a baby.
• “Igg-, igm+” - presence of acute primary disease(igg is absent, which means that the body has encountered an infection for the first time).
• “Igg+, igm+” - presence of acute relapse(against the background of igm there are igg, which indicates an earlier acquaintance with the disease). Cytomegalovirus G and M are signs of relapse of the disease and the presence of decreased immunity.

The worst result for a pregnant woman is cytomegalovirus igm positive. During pregnancy, the presence of group M antibodies indicates an acute process, primary infection or relapse of infection with the manifestation of symptoms (inflammation, runny nose, fever, enlarged lymph nodes). It’s even worse if, against the background of igm+, the cytomenalovirus igg has a “-”. This means that this infection entered the body for the first time. This is the most depressing diagnosis for an expectant mother. Although the probability of complications in the fetus is only 75%.

Interpretation of ELISA analysis in children

Cytomegalovirus igg in children is usually detected in the first year of life, especially in breastfed babies. This does not mean that the child became infected with CMV from the mother. This means that, along with milk, maternal immune bodies enter his body, which protect against acute manifestations of infection. Cytomegalovirus igg in a breastfed child is the norm, not a pathology.

Is it necessary to treat cytomegalovirus?

Healthy immunity itself controls the amount of CMV and its activity. If there are no signs of illness, treatment for cytomegalovirus is not necessary. Therapeutic measures are necessary when an immune failure occurs and the virus becomes active.

Chronic cytomegalovirus during pregnancy is characterized by the presence of type G antibodies. This is a chronic carriage and is present in 96% of pregnant women. If cytomegalovirus igg is detected, treatment is not necessary. Treatment is necessary in the acute stage of the disease when visible symptoms appear. It is important to understand that a complete cure for the CMV virus is impossible. Therapeutic measures are aimed at limiting the activity of the virus, transferring it to a dormant form.

The titer of group G antibodies decreases over time. For example, cytomegalovirus igg 250 is detected if the infection occurred in the last few months. A low titer means that the primary infection occurred quite a long time ago.

Important: a high titer of the immunoglobulin g test for cytomegalovirus indicates a relatively recent infection with the disease.

From the point of view of the pharmaceutical industry, it is necessary to treat everyone who has antibodies to CMV (of any type and titer). After all, this is primarily profit. From the point of view of a woman and her child in the womb, treating a dormant infection in the presence of igg antibodies is not beneficial, and possibly harmful. Drugs to support immunity contain interferon, which is not recommended for use during pregnancy without special indications. Antiviral drugs are also toxic.

How to treat cytomegalovirus during pregnancy

Treatment of cytomegalovirus occurs in two directions:

• Means for general immunity boosting (immunostimulants, modulators) - drugs with interferon (Viferon, Genferon).
• Specific antiviral drugs (their action is directed specifically against herpes virus type 6 - CMV) - foscarnet, ganciclovir.
• Vitamins (injections of B vitamins) and vitamin-mineral complexes are also indicated.

How to treat cytomegalovirus in children? The same drugs are used (immune stimulants and antivirals), but in reduced dosages.

How to treat cytomegalovirus with folk remedies

To treat any viruses, traditional medicine uses natural antimicrobial agents:

• garlic, onion;
• propolis (alcohol and oil tinctures);
• silver water;
• hot spices
• herbal treatment - garlic greens, raspberry leaves, wormwood, echinacea and violet flowers, ginseng rhizomes, rhodiola.

Cytomegalovirus is herpes type 5. In medicine it is referred to as CMV, CMV, cytomegalovirus.

Doctors diagnose the disease using polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA). The patient receives a referral if symptoms of CMV are present.

If the blood test response to cytomegalovirus IgG is positive, a person must know what this means, because The virus constantly lives in the body and carries the risk of exacerbation in a generalized form.

The meaning of an IgG test for cytomegalovirus

CMV is transmitted by airborne droplets, contact and household contact. Unprotected sex and kissing also lead to infection with cytomegalovirus, since the infection is concentrated in the semen of men, and in women it is contained in discharge from the vagina and cervix. In addition, the virus is found in saliva and urine. Positive cytomegalovirus IgG occurs in almost all adults.

The essence of an IgG test for cytomegalovirus is to search for specific antibodies in various biomaterials of a person who is suspected of having an infection. IgG is a shortened version of the Latin word immunoglobulin. It is a protective protein that is produced by the immune system to destroy the virus. With the entry of each new virus into the body, the immune system produces specific immunoglobulins, or antibodies. As a person grows older, there are more of them.

The letter G identifies the immunoglobulin class. In addition to IgG, antibodies of other classes are found:

If the body has never encountered a particular virus, there will be no antibodies to it at the moment. If immunoglobulins are present in the blood and the test shows a positive result, it means that the virus has entered the body. It is impossible to completely get rid of CMV, however, it may not bother its owner for a long time as long as his immunity remains strong. In latent form, viral agents live in the cells of the salivary glands, blood and internal organs.

IgG can be described this way. These are antibodies against a specific virus that are cloned by the body from the moment of their initial appearance. The production of IgG antibodies occurs after the infection has been suppressed. You also need to know about the existence of fast immunoglobulins - IgM. These are large cells that react with maximum speed to the penetration of the virus. But this group of antibodies does not form immunological memory. After 4 to 5 months, IgM becomes useless.

The detection of specific IgM in the blood indicates recent infection with the virus. At the current time, most likely, the disease is acute. To fully understand the situation, the specialist must pay attention to other blood test indicators.

The relationship between cytomegalovirus and immunity with a positive test

If a patient with a strong immune system learns from a doctor that his cytomegalovirus hominis IgG is elevated, there is no need to worry. An immune system that works smoothly keeps the virus under control and the infection goes unnoticed. Occasionally a person notices causeless malaise, sore throat and increased body temperature. This is how mononucleosis syndrome manifests itself.

But even without pronounced signs of illness, a person should spend less time in society and refuse close contact with relatives, children and pregnant women. The active phase of the infection, which is manifested by an increase in IgG levels, makes a person a spreader of the virus. It can infect weakened others, and for them CMV will be a dangerous pathogenic agent.

People with various forms of immunodeficiency are susceptible to cytomegalovirus and any pathogenic flora. Their positive cytomegalovirus hominis IgG is an early sign of such serious diseases as:

• Encephalitis is brain damage.
• Hepatitis is a liver pathology.
• Retinitis is an inflammation of the retina of the eye, leading to blindness.
• Gastrointestinal diseases - new or chronic recurrent.
• Cytomegalovirus pneumonia - a combination with AIDS is fraught with death. According to medical statistics, death occurs in 90% of cases.

In patients with severe immunodeficiency, positive IgG signals a chronic course of the disease. Exacerbation occurs at any time and gives unpredictable complications.

CMV Igg positive in pregnancy and newborns

In pregnant women, the purpose of analysis for cytomegalovirus is to determine the degree of risk of viral damage to the fetus. The test results help the doctor develop an effective treatment regimen. A positive IgM test has an adverse effect on pregnancy. It signals a primary lesion or relapse of chronic CMV.

The virus poses an increased danger in the first trimester during the initial infection of the expectant mother. Without treatment, herpes type 5 causes fetal malformations. With relapses of the disease, the likelihood of a teratogenic effect of the virus on the fetus decreases, but the danger of mutations still exists.

Infection with cytomegalovirus in the second or third trimester of pregnancy is fraught with the development of a congenital form of the disease in the child. Infection can also occur at the time of birth.

If a blood test shows a positive result for cytomegalovirus IgG during pregnancy, what such a response means, the doctor should explain to the expectant mother. The presence of specific antibodies indicates the presence of immunity to the virus. But the fact of exacerbation of infection is associated with a temporary weakening of the immune system.

In the absence of IgG to cytomegalovirus, the analysis indicates that the female body first encountered the virus after conception. There is a high risk of damage to the fetus and maternal body.

A positive IgG in a newborn child confirms that the baby was infected either during fetal development, or during passage through the birth canal of an infected mother, or immediately after birth.

An increase in IgG titer by 4 times during a double blood test with an interval of 1 month confirms the suspicion of a neonatal infection. If, in the first 3 days after birth, specific IgG to cytomegalovirus is detected in the child’s blood, the analysis indicates a congenital disease.

In childhood, cytomegalovirus infection can be either asymptomatic or with severe symptoms. The complications the virus causes are quite serious - blindness, strabismus, jaundice, chorioretinitis, pneumonia, etc.

What to do if cytomegalovirus hominis igg is elevated

If there are no obvious health problems and a strong immune system, you can do nothing. It is enough to consult a doctor and allow the body to fight the virus on its own. Doctors prescribe medications intended to suppress viral activity in extreme cases and only to those patients who have been diagnosed with immunodeficiencies of varying complexity, or have a history of chemotherapy or organ transplantation.

Strictly under the supervision of a doctor, patients with cytomegalovirus undergo treatment using the following means:

Cytomegalovirus is a virus widespread throughout the world among adults and children, belonging to the group of herpes viruses. Since this virus was discovered relatively recently, in 1956, it is considered not yet sufficiently studied, and is still the subject of active debate in the scientific world.

Cytomegalovirus is quite common; antibodies to this virus are found in 10-15% of adolescents and young adults. In people aged 35 years or more, it is found in 50% of cases. Cytomegalovirus is found in biological tissues - semen, saliva, urine, tears. When the virus enters the body, it does not disappear, but continues to live with its host.

What it is?

Cytomegalovirus (another name is CMV infection) is an infectious disease that belongs to the herpesvirus family. This virus affects humans both in utero and in other ways. Thus, cytomegalovirus can be transmitted sexually or through airborne alimentary routes.

How is the virus transmitted?

The transmission routes for cytomegalovirus are varied, since the virus can be found in blood, saliva, milk, urine, feces, seminal fluid, and cervical secretions. Possible airborne transmission, transmission through blood transfusion, sexual intercourse, and possible transplacental intrauterine infection. An important place is occupied by infection during childbirth and when breastfeeding a sick mother.

There are often cases when the carrier of the virus does not even suspect it, especially in situations where symptoms hardly appear. Therefore, you should not consider every carrier of cytomegalovirus to be sick, since existing in the body, it may never manifest itself once in its entire life.

However, hypothermia and a subsequent decrease in immunity become factors that provoke cytomegalovirus. Symptoms of the disease also appear due to stress.

Cytomegalovirus igg antibodies detected - what does this mean?

IgM are antibodies that the immune system begins to produce 4-7 weeks after a person is first infected with cytomegalovirus. Antibodies of this type are also produced every time the cytomegalovirus remaining in the human body after a previous infection begins to actively multiply again.

Accordingly, if you have been found to have a positive (increased) titer of IgM antibodies against cytomegalovirus, this means:

• That you have been infected with cytomegalovirus recently (not earlier than within the last year);
• That you were infected with cytomegalovirus for a long time, but recently this infection began to multiply again in your body.

A positive titer of IgM antibodies can persist in a person's blood for at least 4-12 months after infection. Over time, IgM antibodies disappear from the blood of a person infected with cytomegalovirus.

Development of the disease

The incubation period is 20-60 days, the acute course is 2-6 weeks after the incubation period. Staying in a latent state in the body both after infection and during periods of attenuation - for an unlimited time.

Even after completing a course of treatment, the virus lives in the body for life, maintaining the risk of relapse, so doctors cannot guarantee the safety of pregnancy and full gestation even if a stable and long-term remission occurs.

Symptoms of cytomegalovirus

Many people who carry cytomegalovirus do not show any symptoms. Signs of cytomegalovirus may appear as a result of disturbances in the functioning of the immune system.

Sometimes in people with normal immunity this virus causes the so-called mononucleosis-like syndrome. It occurs 20-60 days after infection and lasts 2-6 weeks. It manifests itself as high fever, chills, fatigue, malaise and headache. Subsequently, under the influence of the virus, a restructuring of the body’s immune system occurs, preparing to repel the attack. However, in case of lack of strength, the acute phase passes into a calmer form, when vascular-autonomic disorders often appear, and damage to internal organs also occurs.

In this case, three manifestations of the disease are possible:

1. Generalized form- CMV damage to internal organs (inflammation of the liver tissue, adrenal glands, kidneys, spleen, pancreas). These organ lesions can cause, which further worsens the condition and puts increased pressure on the immune system. In this case, treatment with antibiotics turns out to be less effective than with the usual course of bronchitis and/or pneumonia. At the same time, damage to the intestinal walls, blood vessels of the eyeball, brain and nervous system can be observed in the peripheral blood. Externally it appears, in addition to enlarged salivary glands, a skin rash.
2. - in this case it is weakness, general malaise, headaches, runny nose, enlargement and inflammation of the salivary glands, fatigue, slightly elevated body temperature, whitish coating on the tongue and gums; Sometimes it is possible to have inflamed tonsils.
3. Damage to the genitourinary system- manifests itself in the form of periodic and nonspecific inflammation. At the same time, as in the case of bronchitis and pneumonia, inflammations are difficult to treat with antibiotics traditional for this local disease.

Particular attention should be paid to CMV infection in the fetus (intrauterine cytomegalovirus infection), in newborns and young children. An important factor is the gestational period of infection, as well as the fact whether the pregnant woman was infected for the first time or the infection was reactivated - in the second case, the likelihood of infection of the fetus and the development of severe complications is significantly lower.

Also, if a pregnant woman is infected, fetal pathology is possible when the fetus becomes infected with CMV entering the blood from outside, which leads to miscarriage (one of the most common causes). It is also possible to activate the latent form of the virus, which infects the fetus through the mother’s blood. Infection leads either to the death of the child in the womb/after birth, or to damage to the nervous system and brain, which manifests itself in various psychological and physical diseases.

Cytomegalovirus infection during pregnancy

When a woman becomes infected during pregnancy, in most cases she develops an acute form of the disease. Possible damage to the lungs, liver, and brain.

The patient notes complaints about:

• fatigue, headache, general weakness;
• enlargement and pain when touching the salivary glands;
• mucous discharge from the nose;
• whitish discharge from the genital tract;
• abdominal pain (caused by increased uterine tone).

If the fetus is infected during pregnancy (but not during childbirth), congenital cytomegalovirus infection may develop in the child. The latter leads to severe diseases and damage to the central nervous system (mental retardation, hearing loss). In 20-30% of cases the child dies. Congenital cytomegalovirus infection is observed almost exclusively in children whose mothers become infected with cytomegalovirus for the first time during pregnancy.

Treatment of cytomegalovirus during pregnancy includes antiviral therapy based on intravenous injection of acyclovir; the use of drugs to correct immunity (cytotect, intravenous immunoglobulin), as well as carrying out control tests after completing a course of therapy.

Cytomegalovirus in children

Congenital cytomegalovirus infection is usually diagnosed in a child in the first month and has the following possible manifestations:

• cramp, trembling of limbs;
• drowsiness;
• visual impairment;
• problems with mental development.

Manifestation is also possible in adulthood, when the child is 3-5 years old, and usually looks like an acute respiratory infection (fever, sore throat, runny nose).

Diagnostics

Cytomegalovirus is diagnosed using the following methods:

• detection of the presence of the virus in biological fluids of the body;
• PCR (polymerase chain reaction);
• cell culture seeding;
• detection of specific antibodies in blood serum.

Cytomegaly is an infectious disease of viral origin, transmitted sexually, transplacentally, domestically, or by blood transfusion. Symptomatically occurs in the form of a persistent cold. There is weakness, malaise, headaches and joint pain, runny nose, enlargement and inflammation of the salivary glands, and excessive salivation. It is often asymptomatic. Cytomegaly in pregnant women is dangerous: it can cause spontaneous miscarriage, congenital malformations, intrauterine fetal death, and congenital cytomegaly. Diagnosis is carried out by laboratory methods (ELISA, PCR). Treatment includes antiviral and symptomatic therapy.

ICD-10

B25 Cytomegalovirus disease

General information

Other names for cytomegaly found in medical sources are cytomegalovirus infection (CMV), inclusion cytomegaly, viral disease of the salivary glands, and inclusion disease. Cytomegaly is a widespread infection, and many people who are carriers of cytomegalovirus do not even know it. The presence of antibodies to cytomegalovirus is detected in 10-15% of the population during adolescence and in 50% of adults. According to some sources, carriage of cytomegalovirus is detected in 80% of women of the childbearing period. First of all, this applies to the asymptomatic and low-symptomatic course of cytomegalovirus infection.

Causes

The causative agent of cytomegalovirus infection, cytomegalovirus, belongs to the human herpesvirus family. Cells affected by cytomegalovirus increase in size many times over, so the name of the disease “cytomegaly” is translated as “giant cells.” Cytomegaly is not a highly contagious infection. Typically, infection occurs through close, prolonged contact with cytomegalovirus carriers. Cytomegalovirus is transmitted in the following ways:

• airborne: when sneezing, coughing, talking, kissing, etc.;
• sexually: during sexual contact through sperm, vaginal and cervical mucus;
• blood transfusion: with blood transfusion, leukocyte mass, sometimes with organ and tissue transplantation;
• transplacental: during pregnancy from mother to fetus.

Often, cytomegalovirus remains in the body for many years and may never manifest itself or cause harm to a person. The manifestation of a latent infection usually occurs when the immune system is weakened. Cytomegalovirus poses a threatening danger in its consequences in people with reduced immunity (HIV-infected people who have undergone bone marrow or internal organ transplantation, taking immunosuppressants), with a congenital form of cytomegaly, and in pregnant women.

Pathogenesis

Once in the blood, cytomegalovirus causes a pronounced immune reaction, manifested in the production of protective protein antibodies - immunoglobulins M and G (IgM and IgG) and an antiviral cellular reaction - the formation of CD 4 and CD 8 lymphocytes. Inhibition of cellular immunity during HIV infection leads to the active development cytomegalovirus and the infection it causes.

The formation of immunoglobulins M, indicating a primary infection, occurs 1-2 months after infection with cytomegalovirus. After 4-5 months, IgM is replaced by IgG, which is found in the blood throughout the rest of life. With strong immunity, cytomegalovirus does not cause clinical manifestations, the course of the infection is asymptomatic and hidden, although the presence of the virus is detected in many tissues and organs. By infecting cells, cytomegalovirus causes an increase in their size; under a microscope, the affected cells look like the “eye of an owl”. Cytomegalovirus is detected in the body for life.

Even with an asymptomatic infection, a cytomegalovirus carrier is potentially infectious to uninfected individuals. The exception is the intrauterine transmission of cytomegalovirus from a pregnant woman to the fetus, which occurs mainly during the active course of the process, and only in 5% of cases causes congenital cytomegaly, in the rest it is asymptomatic.

Symptoms of cytomegaly

Congenital cytomegaly

In 95% of cases, intrauterine infection of the fetus with cytomegalovirus does not cause the development of the disease, but is asymptomatic. Congenital cytomegalovirus infection develops in newborns whose mothers have suffered primary cytomegaly. Congenital cytomegaly can manifest itself in newborns in various forms:

• petechial rash - small skin hemorrhages - occurs in 60-80% of newborns;
• prematurity and intrauterine growth retardation - occurs in 30% of newborns;
• Chorioretinitis is an acute inflammatory process in the retina of the eye, often causing decreased and complete loss of vision.

Mortality from intrauterine infection with cytomegalovirus reaches 20-30%. Of the surviving children, most have mental retardation or hearing and vision disabilities.

Acquired cytomegaly in newborns

When infected with cytomegalovirus during childbirth (during the passage of the fetus through the birth canal) or in the postpartum period (through household contact with an infected mother or breastfeeding), in most cases an asymptomatic course of cytomegalovirus infection develops. However, in premature infants, cytomegalovirus can cause prolonged pneumonia, which is often accompanied by a concomitant bacterial infection. Often, when children are affected by cytomegalovirus, there is a slowdown in physical development, enlarged lymph nodes, hepatitis, and a rash.

Mononucleosis-like syndrome

In persons who have emerged from the neonatal period and have normal immunity, cytomegalovirus can cause the development of mononucleosis-like syndrome. The clinical course of mononuclease-like syndrome does not differ from infectious mononucleosis, caused by another type of herpes virus - the Ebstein-Barr virus. The course of mononucleosis-like syndrome resembles a persistent cold infection. It is noted:

• long-term (up to 1 month or more) fever with high body temperature and chills;
• aches in joints and muscles, headache;
• severe weakness, malaise, fatigue;
• sore throat;
• enlargement of lymph nodes and salivary glands;
• skin rashes resembling rubella rash (usually occurs during treatment with ampicillin).

In some cases, mononucleosis-like syndrome is accompanied by the development of hepatitis - jaundice and an increase in liver enzymes in the blood. Even less commonly (up to 6% of cases), pneumonia is a complication of mononucleosis-like syndrome. However, in individuals with normal immune reactivity, it occurs without clinical manifestations, being detected only by chest x-ray.

The duration of mononucleosis-like syndrome ranges from 9 to 60 days. Then, complete recovery usually occurs, although residual effects in the form of malaise, weakness, and enlarged lymph nodes may persist for several months. In rare cases, activation of cytomegalovirus causes recurrence of infection with fever, sweating, hot flashes and malaise.

Cytomegalovirus infection in immunocompromised individuals

Weakening of the immune system is observed in persons suffering from congenital and acquired immunodeficiency syndrome (AIDS), as well as in patients who have undergone transplantation of internal organs and tissues: heart, lung, kidney, liver, bone marrow. After organ transplantation, patients are forced to constantly take immunosuppressants, leading to a pronounced suppression of immune reactions, which causes the activity of cytomegalovirus in the body.

In patients who have undergone organ transplantation, cytomegalovirus causes damage to donor tissues and organs (hepatitis during liver transplantation, pneumonia during lung transplantation, etc.). After bone marrow transplantation, in 15-20% of patients, cytomegalovirus can lead to the development of pneumonia with high mortality (84-88%). The greatest danger is when donor material infected with cytomegalovirus is transplanted into an uninfected recipient.

Cytomegalovirus affects almost all HIV-infected people. At the onset of the disease, malaise, joint and muscle pain, fever, and night sweats are noted. In the future, these symptoms may be accompanied by damage to the lungs (pneumonia), liver (hepatitis), brain (encephalitis), retina (retinitis), ulcerative lesions and gastrointestinal bleeding.

In men, cytomegalovirus can affect the testicles and prostate; in women, the cervix, inner layer of the uterus, vagina, and ovaries. Complications of cytomegalovirus infection in HIV-infected people may include internal bleeding from affected organs and loss of vision. Multiple organ damage by cytomegalovirus can lead to organ dysfunction and death of the patient.

Diagnostics

To diagnose cytomegalovirus infection, a laboratory examination is performed. The diagnosis of cytomegalovirus infection is based on the isolation of cytomegalovirus in clinical material or a fourfold increase in antibody titer.

• ELISA diagnostics. Includes determination in the blood of specific antibodies to cytomegalovirus - immunoglobulins M and G. The presence of immunoglobulins M may indicate a primary infection with cytomegalovirus or reactivation of chronic CMV infection. Determination of high IgM titers in pregnant women can threaten infection of the fetus. An increase in IgM is detected in the blood 4-7 weeks after infection with cytomegalovirus and is observed for 16-20 weeks. An increase in immunoglobulin G develops during the period of attenuation of the activity of cytomegalovirus infection. Their presence in the blood indicates the presence of cytomegalovirus in the body, but does not reflect the activity of the infectious process.
• PCR diagnostics. To determine cytomegalovirus DNA in blood cells and mucous membranes (in scraping materials from the urethra and cervical canal, in sputum, saliva, etc.), the PCR diagnostic method (polymerase chain reaction) is used. Particularly informative is quantitative PCR, which gives an idea of ​​the activity of cytomegalovirus and the infectious process it causes.

Depending on which organ is affected by cytomegalovirus infection, the patient needs to consult a gynecologist, andrologist, gastroenterologist or other specialists. Additionally, according to indications, ultrasound of the abdominal organs, colposcopy, gastroscopy, MRI of the brain and other examinations are performed.

Treatment of cytomegalovirus infection

Uncomplicated forms of mononuclease-like syndrome do not require specific therapy. Typically, measures identical to the treatment of a common cold are carried out. To relieve symptoms of intoxication caused by cytomegalovirus, it is recommended to drink enough fluids.

Treatment of cytomegalovirus infection in individuals at risk is carried out with the antiviral drug ganciclovir. In cases of severe cytomegaly, ganciclovir is administered intravenously, since tablet forms of the drug have only a preventive effect against cytomegalovirus. Since ganciclovir has significant side effects (causes suppression of hematopoiesis - anemia, neutropenia, thrombocytopenia, skin reactions, gastrointestinal disorders, fever and chills, etc.), its use is limited in pregnant women, children and people suffering from renal failure (only for health reasons), it is not used in patients without immunocompromise.

For the treatment of cytomegalovirus in HIV-infected people, the most effective drug is foscarnet, which also has a number of side effects. Foscarnet can cause disturbances in electrolyte metabolism (decreased plasma magnesium and potassium), genital ulceration, urination problems, nausea, and kidney damage. These adverse reactions require careful use and timely adjustment of the drug dose.

Forecast

Cytomegalovirus is especially dangerous during pregnancy, as it can cause miscarriage, stillbirth, or cause severe congenital deformities in the child. Therefore, cytomegalovirus, along with herpes, toxoplasmosis and rubella, is one of those infections for which women should be screened prophylactically, even at the stage of pregnancy planning.

Prevention

The issue of preventing cytomegalovirus infection is especially acute for people at risk. The most susceptible to infection with cytomegalovirus and the development of the disease are HIV-infected people (especially AIDS patients), patients after organ transplantation and people with immunodeficiency of other origins.

Nonspecific methods of prevention (for example, personal hygiene) are ineffective against cytomegalovirus, since infection with it is possible even by airborne droplets. Specific prevention of cytomegalovirus infection is carried out with ganciclovir, acyclovir, foscarnet among patients at risk. Also, to exclude the possibility of cytomegalovirus infection of recipients during organ and tissue transplantation, careful selection of donors and monitoring of donor material for the presence of cytomegalovirus infection is necessary.