Cytomegalovirus g positive what does it mean. What do IgG and IgM mean for cytomegalovirus. Cytomegaly: danger and consequences

If the cytomegalovirus IgG test is positive, many people become concerned. They believe that this indicates a hidden serious illness that needs to be treated immediately. However, the presence of IgG antibodies in the blood is not a sign of developing pathology. The vast majority of people become infected with cytomegalovirus in childhood and do not even notice it. Therefore, a positive test result for antibodies (AT) to cytomegalovirus is a surprise for them.

What is cytomegalovirus infection?

The causative agent is herpes virus type 5 - cytomegalovirus (CMV). The name "herpes" is derived from the Latin word "herpes", which means "creeping". It reflects the nature of diseases caused by herpes viruses. CMV, like their other representatives, are weak antigens (the so-called microorganisms that bear the imprint of foreign genetic information).

Recognition and neutralization of antigens is the main function of the immune system. Weak are those that do not cause a pronounced immune response. Therefore, the primary often occurs unnoticed. The symptoms of the disease are mild and resemble the symptoms of a common cold.

Transmission and spread of infection:

1. In childhood, the infection is transmitted by airborne droplets.
2. Adults become infected mainly through sexual contact.
3. After the initial invasion, herpes viruses settle permanently in the body. It is impossible to get rid of them.
4. The infected person becomes a carrier of cytomegalovirus.

If a person’s immunity is strong, CMV hides and does not manifest itself in any way. If the body's defenses are weakened, microorganisms are activated. They can cause the development of serious diseases. In immunodeficiency states, various human organs and systems are affected. CMV causes pneumonia, enterocolitis, encephalitis and inflammatory processes in various parts of the reproductive system. With multiple lesions, death can occur.

Cytomegalovirus is especially dangerous for a developing fetus. If a woman is first infected during pregnancy, the pathogen is likely to cause serious developmental defects in her baby. If infection occurs in the 1st trimester of pregnancy, the virus often causes fetal death.

A recurrence of cytomegalovirus infection poses a significantly less threat to the embryo. In this case, the risk of developmental defects in the child does not exceed 1–4%. Antibodies present in a woman’s blood weaken pathogens and prevent them from attacking fetal tissue.

It is very difficult to determine the activity of cytomegalovirus infection only by external manifestations. Therefore, the presence of a pathological process in the body is detected using laboratory tests.

How the body reacts to the activation of viruses

In response to the invasion of viruses, they form in the body. They have the ability to combine with antigens according to the “key to lock” principle, linking them into an immune complex (antigen-antibody reaction). In this form, viruses become vulnerable to cells of the immune system, which cause their death.

At different stages of CMV activity, different antibodies are formed. They belong to different classes. Immediately after the penetration or activation of “dormant” pathogens, class M antibodies begin to appear. They are designated IgM, where Ig is an immunoglobulin. IgM antibodies are an indicator of humoral immunity that protects the intercellular space. They allow you to capture and remove viruses from the bloodstream.

The concentration of IgM is highest at the beginning of the acute infectious process. If the activity of the viruses has been successfully suppressed, the IgM antibodies disappear. Cytomegalovirus IgM is detected in the blood for 5–6 weeks after infection. In the chronic form of the pathology, the number of IgM antibodies decreases, but does not completely disappear. A small concentration of immunoglobulins can be detected in the blood for a long time until the process subsides.

After class M immunoglobulins, IgG antibodies are formed in the body. They help destroy pathogens. When the infection is completely defeated, immunoglobulin G remains in the bloodstream to prevent re-infection. During secondary infection, IgG antibodies quickly destroy pathogenic microorganisms, preventing the development of a pathological process.

In response to the invasion of a viral infection, class A immunoglobulins are also formed. They are found in various biological fluids (saliva, urine, bile, lacrimal, bronchial and gastrointestinal secretions) and protect the mucous membranes. IgA antibodies have a pronounced anti-adsorption effect. They prevent viruses from attaching to the surface of cells. IgA antibodies disappear from the bloodstream 2–8 weeks after the destruction of infectious agents.

The concentration of immunoglobulins of different classes makes it possible to determine the presence of an active process and evaluate its stage. An enzyme-linked immunosorbent assay (ELISA) is used to study the amount of antibodies.

Linked immunosorbent assay

The ELISA method is based on searching for the formed immune complex. The antigen-antibody reaction is detected using a special tag enzyme. After combining the antigen with the enzyme-labeled immune serum, a special substrate is added to the mixture. It is broken down by an enzyme and causes a color change in the reaction product. The intensity of the color is used to judge the number of bound antigen and antibody molecules. Features of ELISA diagnostics:

1. The results are assessed automatically using special equipment.
2. This minimizes the influence of the human factor and ensures error-free diagnosis.
3. ELISA is characterized by high sensitivity. It allows detection of antibodies even if their concentration in the sample is extremely low.

ELISA allows you to diagnose the disease in the first days of development. It makes it possible to detect infection before the first symptoms appear.

How to decipher ELISA results

The presence of antibodies to CMV IgM in the blood indicates the activity of cytomegalovirus infection. If the amount of IgG antibodies is insignificant (negative result), primary infection has occurred. The normal cmv IgG is 0.5 IU/ml. If fewer immunoglobulins are detected, the result is considered negative.

In cases where, simultaneously with a high concentration of IgM antibodies, a significant amount of IgG is detected, an exacerbation of the disease is observed, and the process actively develops. These results indicate that the primary infection occurred a long time ago.

If IgG appears positive in the absence of IgM and IgA antibodies, there is no need to worry. The infection happened a long time ago, and a stable immunity to cytomegalovirus has developed. Therefore, re-infection will not cause serious pathology.

When the analysis shows negative indicators of all antibodies, the body is not familiar with cytomegalovirus and has not developed protection against it. In this case, a pregnant woman needs to be especially careful. The infection is very dangerous for her fetus. According to statistics, primary infection occurs in 0.7–4% of all pregnant women. Important points:

• the simultaneous presence of two types of antibodies (IgM and IgA) is a sign of the height of the acute stage;
• the absence or presence of IgG helps to distinguish primary infection from relapse.

If IgA antibodies are detected, and class M immunoglobulins are absent, the process has become chronic. It may be accompanied by symptoms or occur hidden.

For a more accurate assessment of the dynamics of the pathological process, ELISA tests are performed 2 or more times every 1–2 weeks. If the amount of class M immunoglobulins decreases, the body successfully suppresses the viral infection. If the concentration of antibodies increases, the disease progresses.

It is also defined. Many people don't understand what this means. Avidity characterizes the strength of the binding of antibodies to antigens. The higher its percentage, the stronger the connection. At the initial stage of infection, weak bonds are formed. As the immune response develops, they become stronger. The high avidity of IgG antibodies allows one to completely exclude primary infection.

Features of evaluating ELISA results

When assessing test results, you need to pay attention to their quantitative significance. It is expressed in assessments: negative, weakly positive, positive or strongly positive.

Detection of antibodies to CMV classes M and G can be interpreted as a sign of recent primary infection (no more than 3 months ago). Their low indicators will indicate the attenuation of the process. However, some strains of CMV are capable of causing a specific immune response, in which class M immunoglobulins can circulate in the blood for up to 1–2 years or longer.

An increase in the titer (number) of IgG to cytomegalovirus several times indicates a relapse. Therefore, before pregnancy, it is necessary to do a blood test to determine the level of immunoglobulins G in the latent (dormant) state of the infectious process. This indicator is important, since when the process is reactivated, in approximately 10% of cases IgM antibodies are not released. The absence of class M immunoglobulins is due to the formation of a secondary immune response, characterized by overproduction of specific IgG antibodies.

If the number of immunoglobulins G has increased before conception, there is a high probability of exacerbation of cytomegalovirus infection during pregnancy. In this case, you need to consult an infectious disease doctor to reduce the risk of relapse.

According to statistics, recurrent infection (reactivation) occurs in 13% of pregnant women. Sometimes secondary infection with other strains of CMV is observed.

If IgG is positive in a newborn, it follows that the baby was infected during fetal development, during childbirth, or immediately after birth. The presence of IgG antibodies can be passed on to the child from the mother. The greatest risk to the health and life of the baby is intrauterine infection.

The active stage of cytomegalovirus infection will be indicated by a several-fold increase in the IgG titer in the results of 2 tests done at an interval of a month. If you start treating the disease during the first 3-4 months of a child’s life, the likelihood of developing serious pathologies will be significantly reduced.

Other methods for detecting CMV

In sick people with immunodeficiency, antibodies are not always detected. The absence of immunoglobulins is due to the weakness of the immune system, which is unable to form antibodies. Newborns, especially premature babies, are at risk.

For people with immunodeficiency conditions, cytomegalovirus infection is especially dangerous. To detect it in them, the polymerase chain reaction (PCR) method is used. It is based on the properties of special enzymes that detect the DNA of pathogens and repeatedly copy its fragments. Due to a significant increase in the concentration of DNA fragments, visual detection becomes possible. The method allows you to detect cytomegalovirus, even if only a few molecules of this infection are present in the collected material.

To determine the degree of activity of the pathological process, a quantitative PCR reaction is performed.

Cytomegalovirus can remain in an inactive state in various organs (in the cervix, on the mucous membrane of the throat, in the kidneys, salivary glands). If the analysis of a smear or scraping using the PCR method shows a positive result, it will not indicate the presence of an active process.

If it is detected in the blood, this means that the process is active or has recently stopped.

To make an accurate diagnosis, two methods are used simultaneously: ELISA and PCR.

A cytological examination of saliva and urine sediments may also be prescribed. The collected material is studied under a microscope to identify cells characteristic of cytomegalovirus infection.

During infection by the virus, they increase many times over. This reaction to infection gave another name to cytomegalovirus infection - cytomegaly. The altered cells look like an owl's eye. The enlarged core contains a round or oval inclusion with a strip-shaped light zone.

Warning signs

In order to detect cytomegalovirus infection in time, you need to pay attention to the presence of its characteristic symptoms.

The acute form of cytomegalovirus infection is accompanied by pain and sore throat in children and adults. The lymph nodes in the neck area become enlarged. A sick person becomes lethargic and drowsy, and loses ability to work. He develops a headache and cough. Body temperature may rise, and the liver and spleen may enlarge. Sometimes a rash appears on the skin in the form of small red spots.

Infants with a congenital form of cytomegaly have an enlarged liver and spleen. Hydrocephalus, hemolytic anemia, or pneumonia may be present. If cytomegalovirus hepatitis develops, the child develops jaundice. His urine becomes dark and his stool becomes discolored. Sometimes the only sign of cytomegalovirus infection in a newborn is petechiae. They are round dotted spots of a rich red-purple color. Their size ranges from a dot to a pea. Petechiae cannot be felt because they do not protrude above the surface of the skin.

Disorders of the acts of swallowing and sucking appear. They are born with low body weight. Strabismus and muscle hypotonia are often detected, followed by increased muscle tone.

If such signs are observed against the background of a positive test result for IgG antibodies, you should immediately consult a doctor.

Cytomegalovirus (abbreviated CMV or CMV) is a causative agent of an infectious disease belonging to the herpesvirus family. Once it enters the human body, it remains there forever. Antibodies produced by the immune system in response to the penetration of the virus are the main diagnostic sign for detecting infection.

Cytomegalovirus infection can occur either asymptomatically or with multiple lesions of internal organs and systems. In damaged tissues, normal cells turn into giant ones, which is why this disease got its name (cytomegaly: from the Greek cytos - “cell”, megalos - “big”).

In the active stage of infection, cytomegaloviruses cause significant changes in the immune system:

• dysfunction of macrophages that destroy bacteria and viruses;
• suppression of the production of interleukins that regulate the activity of immune cells;
• inhibition of the synthesis of interferon, which provides antiviral immunity.

Antibodies to cytomegalovirus, determined using laboratory methods, serve as the main markers of CMV. Their detection in blood serum allows diagnosing the disease in the early stages, as well as monitoring the course of the disease.

Types of antibodies to CMV and their features

When foreign bodies enter the body, a response occurs from the immune system. Special proteins are produced - antibodies, which contribute to the development of protective inflammatory reactions.

The following types of antibodies to CMV are distinguished, differing in structure and role in the formation of immunity:

• IgA, the main function of which is to protect the mucous membranes from infections. They are found in saliva, tear fluid, breast milk, and are also present on the mucous membranes of the gastrointestinal tract, respiratory tract and genitourinary tract. Antibodies of this type bind to microbes and prevent them from adhering to and penetrating the body through the epithelium. Immunoglobulins circulating in the blood provide local immunity. Their lifespan is only a few days, so periodic examination is necessary.
• IgG, making up the bulk of antibodies in human serum. They can be transmitted from a pregnant woman to the fetus through the placenta, ensuring the formation of its passive immunity.
• IgM, which are the largest type of antibodies. They occur during primary infection in response to the penetration of previously unknown foreign substances. Their main function is receptor function - transmitting a signal into the cell when a molecule of a certain chemical substance is attached to the antibody.

By the ratio of IgG and IgM, it is possible to determine at what stage the disease is - acute (primary infection), latent (latent) or active (reactivation of a “sleeping” infection in its carrier).

If infection occurs for the first time, then the amount of IgM, IgA and IgG antibodies increases rapidly during the first 2-3 weeks.

From the second month from the onset of infection, their level begins to decline. IgM and IgA can be detected in the body within 6-12 weeks. These types of antibodies are taken into account not only for the diagnosis of CMV, but also for the detection of other infections.

igg antibodies

IgG antibodies are produced by the body at a late stage, sometimes only 1 month after infection, but they persist throughout life, providing lifelong immunity. If there is a risk of re-infection with another strain of the virus, their production increases sharply.

Upon contact with the same culture of microorganisms, the formation of protective immunity occurs in a shorter period of time - up to 1-2 weeks. A feature of cytomegalovirus infection is that the pathogen can avoid the action of immune forces by creating other varieties of the virus. Therefore, infection with modified microbes proceeds as during primary contact.

However, the human body also produces group-specific immunoglobulins, which prevent their active reproduction. Antibodies to class G cytomegalovirus are more often detected among the urban population. This is due to the high concentration of people in small areas and weaker immunity than that of rural residents.

In families with a low standard of living, CMV infection among children is observed in 40-60% of cases even before they reach 5 years of age, and by adulthood, antibodies are detected in 80%.

Antibodies igm

IgM antibodies act as the first line of defense. Immediately after the introduction of microorganisms into the body, their concentration increases sharply, and its peak is observed in the interval from 1 to 4 weeks. Therefore, they serve as a marker of recent infection, or the acute stage of CMV infection. In blood serum they persist for up to 20 weeks, in rare cases - up to 3 months or more.

The latter phenomenon is observed in patients with impaired immunity. A decrease in IgM levels in subsequent months occurs even if no treatment is given. However, their absence is not a sufficient basis for a negative result, since the infection can occur in a chronic form. During reactivation they also appear, but in smaller quantities.

IgA

IgA antibodies are detected in the blood 1-2 weeks after infection. If treatment is carried out and it is effective, then their level decreases after 2-4 months. With repeated infection with CMV, their level also increases. A consistently high concentration of antibodies of this class is a sign of a chronic form of the disease.

In people with weakened immune systems, IgM is not formed even in the acute phase. For such patients, as well as for those who have undergone organ transplantation, a positive IgA test result helps to recognize the form of the disease.

Avidity of immunoglobulins

Avidity refers to the ability of antibodies to bind to viruses. In the initial period of the disease it is minimal, but gradually increases and reaches a maximum by 2-3 weeks. During the immune response, immunoglobulins evolve, the efficiency of their binding increases, due to which the “neutralization” of microorganisms occurs.

Laboratory diagnostics of this parameter are performed to estimate the time of infection. Thus, acute infection is characterized by the detection of IgM and IgG with low avidity. Over time they become highly avid. Low-avidity antibodies disappear from the blood after 1-5 months (in rare cases, longer), while high-avidity antibodies remain until the end of life.

Such a study is important when diagnosing pregnant women. This category of patients is characterized by frequent false-positive results. If high-avidity IgG antibodies are detected in the blood, this will exclude an acute primary infection that is dangerous for the fetus.

The degree of avidity depends on the concentration of viruses, as well as on individual differences in mutations at the molecular level. In older people, the evolution of antibodies occurs more slowly, so after 60 years of age, resistance to infections and the effect of vaccination decreases.

Norms for CMV levels in the blood

There is no numerical value for the “normal” level of antibodies in biological fluids.

The concept of counting IgG and other types of immunoglobulins has its own characteristics:

• Antibody concentration is determined by titration. Blood serum is gradually diluted with a special solvent (1:2, 1:6 and other concentrations that are multiples of two). The result is considered positive if the reaction to the presence of the test substance remains during titration. For cytomegalovirus infection, a positive result is detected at a dilution of 1:100 (threshold titer).
• Titers represent an individual reaction of the body, which depends on the general condition, lifestyle, activity of the immune system and metabolic processes, age, and the presence of other pathologies.
• Titers give an idea of ​​the total activity of antibodies of classes A, G, M.
• Each laboratory can use its own test systems to detect antibodies with a certain sensitivity, so they must produce a final interpretation of the results, which indicates reference (borderline) values ​​and units of measurement.

Avidity is assessed as follows (units of measurement – ​​%):

• <30% – low-avidity antibodies, primary infection that occurred about 3 months ago;
• 30-50% – it is not possible to accurately determine the result, the analysis must be repeated after 2 weeks;
• >50% – high-avidity antibodies, infection occurred a long time ago.

In adults

The results for all groups of patients are interpreted in the manner indicated in the table below.

Table:

Antibodies to cytomegalovirus can be at low levels for several years, and when reinfected with other strains, the amount of IgG increases rapidly. To obtain an accurate diagnostic picture, the level of IgG and IgM is determined simultaneously, and a repeat analysis is carried out after 2 weeks.

In children

Children during the neonatal period and breastfeeding may have IgG in their blood that they received in utero from their mother. Their level begins to gradually decline after a few months due to the lack of a constant source. IgM antibodies often give false-positive or false-negative results. In this regard, diagnosis at this age causes difficulties.

Taking into account the overall clinical picture, immunological tests are interpreted as follows:

Repeated testing allows you to determine the time of infection:

• after birth– increasing titer;
• intrauterine– constant level

During pregnancy

Diagnosis of CMV in pregnant women is carried out according to the same principle. If in the first trimester it is discovered that IgG is positive and IgM is negative, then it is necessary to take a PCR test to confirm the absence of reactivation of the infection. In this case, the fetus will receive maternal antibodies that will protect it from the disease.

The antenatal clinic doctor should issue directions for monitoring the IgG titer also in the second and third trimesters.

If a low avidity index is detected at a period of 12-16 weeks, then infection could have occurred before pregnancy, and the probability of infection of the fetus is almost 100%. At 20-23 weeks this risk decreases to 60%. Determining the time of infection during pregnancy is of great importance, since transmission of the virus to the fetus leads to the development of severe pathologies.

To whom and why is a test for antibodies to CMV prescribed?

The analysis is indicated for those individuals who are at risk of developing infection:

In healthy people with strong immunity, primary infection is often asymptomatic and without complications. But CMV in active form is dangerous in case of immunodeficiency and pregnancy, as it causes numerous complications. Therefore, doctors recommend undergoing examination before the planned conception of a child.

Methods for detecting the virus and deciphering research results

All research methods for determining CMV can be divided into 2 groups:

• Direct– cultural, cytological. Their principle is to grow a culture of viruses or study the characteristic changes that occur in cells and tissues under the influence of a microorganism.
• Indirect– serological (ELISA, fluorescent antibody method), molecular biological (PCR). They serve to detect the immune response to infection.

The standard in diagnosing this disease is to use at least 2 of the methods listed above.

Test for antibodies to cytomegalovirus (ELISA - enzyme-linked immunosorbent assay)

The ELISA method is the most common due to its simplicity, low cost, high accuracy and the possibility of automation, eliminating laboratory technician errors. The analysis can be completed in 2 hours. Antibodies of the IgG, IgA, IgM classes are detected in the blood.

Determination of immunoglobulins to cytomegalovirus is carried out as follows:

1. The patient’s blood serum, control positive, negative and “threshold” samples are placed in several wells. The titer of the latter is 1:100. The plate containing the wells is made of polystyrene. Purified CMV antigens are pre-precipitated on it. When reacting with antibodies, specific immune complexes are formed.
2. The plate with samples is placed in a thermostat, where it is kept for 30-60 minutes.
3. The wells are washed with a special solution and a conjugate is added to them - a substance with antibodies labeled with an enzyme, then again placed in a thermostat.
4. The wells are washed and an indicator solution is added to them and kept in a thermostat.
5. A stop reagent is added to stop the reaction.
6. The results of the analysis are recorded in a spectrophotometer - the optical density of the patient's serum is measured in two modes and compared with the values ​​for control and threshold samples. To determine the titer, a calibration graph is constructed.

If the test sample contains antibodies to CMV, then under the influence of the indicator its color (optical density) changes, which is recorded by a spectrophotometer. Disadvantages of ELISA include the risk of false-positive results due to cross-reactions with normal antibodies. The sensitivity of the method is 70-75%.

The avidity index is determined similarly. A solution is added to the patient's serum samples to remove low-avidity antibodies. The conjugate and organic dye are then injected, the absorbance is measured and compared with control wells.

Polymerase chain reaction (PCR) method for diagnosing cytomegalovirus

The essence of PCR is to detect fragments of DNA or RNA of the virus.

After preliminary cleaning of the sample, the results are recorded using one of 2 methods:

• Electrophoretic, in which viral DNA molecules move in an electric field, and a special dye causes them to fluoresce (glow) under the influence of ultraviolet rays.
• Hybridization. Artificially synthesized sections of DNA labeled with a dye bind to the viral DNA in the sample. Next, they are fixed.

The PCR method is more sensitive (95%) compared to ELISA. The duration of the study is 1 day. Not only blood serum, but also amniotic or cerebrospinal fluid, saliva, urine, and secretions from the cervical canal can be used as biological fluids for analysis.

Currently, this method is the most informative. If viral DNA is found in blood leukocytes, this is a sign of primary infection.

Isolation of cell culture (seeding) for the diagnosis of CMV

Despite the high sensitivity (80-100%), seeding of cell cultures is rarely performed, since the following limitations exist:

• The method is very labor intensive, the analysis time takes 5-10 days;
• the need for highly qualified medical personnel;
• the accuracy of the study strongly depends on the quality of the collection of biological material and the time between the analysis and culture;
• a large number of false negative results, especially when diagnostics are carried out later than 2 days.

Just as with PCR analysis, it is possible to determine the specific type of pathogen. The essence of the study is that samples taken from the patient are placed in a special nutrient medium in which microbes grow and are subsequently studied.

Cytology for the diagnosis of cytomegalovirus

Cytological examination is one of the primary types of diagnosis. Its essence lies in the study of cytomegal cells under a microscope, the presence of which indicates a typical change in CMV. Saliva and urine are usually taken for analysis. This method cannot serve as the only reliable method for diagnosing cytomegalovirus infection.

What to do if IgG to CMV is positive?

Antibodies to cytomegalovirus detected in blood and other biological fluids may indicate three possible conditions: primary or re-infection, recovery and carriage of the virus. The test results require a comprehensive assessment.

If IgG is positive, then to determine the acute phase, which is the most dangerous to health, you need to consult an infectious disease doctor and conduct additional ELISA tests for IgM, IgA, avidity or PCR analysis.

If IgG is detected in a child under 1 year of age, it is recommended that the mother also undergo this examination. If approximately identical antibody titers are detected, then it is highly likely that simple transfer of immunoglobulins occurred during pregnancy, and not infection.

It should be taken into account that small amounts of IgM can be detected for 2 or more years. Therefore, their presence in the blood does not always indicate recent infection. In addition, the accuracy of even the best test systems can produce both false positive and false negative results.

What does it mean if Anti-CMV IgG is detected?

If antibodies to CMV are re-detected and there are no other signs of acute infection, test results indicate that the person is a lifelong carrier of the virus. In itself, this condition is not dangerous. However, before planning pregnancy, as well as in case of immunodeficiency, it is necessary to periodically monitor the level of immunoglobulins.

In healthy people, this disease occurs silently, sometimes with flu-like symptoms. Recovery indicates that the body has successfully coped with the infection, and lifelong immunity has been developed.

To monitor the dynamics of the disease, tests are prescribed every 2 weeks. If the IgM level gradually decreases, the patient recovers, otherwise the disease progresses.

Is it necessary to treat cytomegalovirus?

It is impossible to completely get rid of cytomegalovirus. If a person is a carrier of this infection, but there are no symptoms, then treatment is not required. Prevention of CMV, which is aimed at strengthening the immune system, is of great importance. This allows you to keep the virus in a “dormant” state and avoid exacerbation.

The same tactics are used against pregnant women and children. In people with severe immunodeficiency, cytomegalovirus infection may develop complications such as pneumonia, inflammation of the colon and retina. To treat this category of people, strong antiviral drugs are prescribed.

How to treat cytomegalovirus

CMV therapy is carried out in stages:

Depending on which organs are affected by the virus, the doctor prescribes additional medications.

In severe cases, the following treatment methods are used:

• for detoxification of the body - droppers with saline solution, acesol, di- and trisol;
• to reduce swelling and inflammation in case of damage to the central nervous system - corticosteroid drugs (Prednisolone);
• in case of secondary bacterial infection, antibiotics (Ceftriaxone, Cefepime, Ciprofloxacin and others).

During pregnancy

Pregnant women with CMV are treated with one of the following agents listed in the table below:

Drugs

The basis of treatment for CMV is antiviral drugs:

The doctor may prescribe the following as immunomodulatory agents:

• Cycloferon;
• Amiksin;
• Lavomax;
• Galavit;
• Tiloron and other drugs.

Immunomodulators used in the remission phase can also be used during relapse. After the end of the acute phase of the disease, restorative and physiotherapeutic treatment is also indicated; it is necessary to eliminate chronic inflammatory and infectious foci.

Folk remedies

In folk medicine, there are several recipes for the treatment of CMV infection:

• Grind fresh wormwood herb and squeeze the juice out of it. Heat 1 liter of dry wine over a fire to approximately 70° C (at this point a whitish haze will begin to rise), add 7 tbsp. l. honey, mix. Pour 3 tbsp. l. wormwood juice, turn off the heat, stir. Take 1 glass of “wormwood wine” every other day.
• Wormwood, tansy flowers, crushed elecampane roots are mixed in equal proportions. 1 tsp. pour 0.5 liters of boiling water into the mixture. This amount is drunk in equal portions 3 times a day half an hour before meals. The duration of treatment with the collection is 2 weeks.
• Crushed alder, aspen and willow bark are mixed in equal proportions. 1 tbsp. l. collection, brew 0.5 liters of boiling water and take it in the same way as in the previous recipe.

Prognosis and complications

Cytomegalovirus infection most often occurs benignly, and its symptoms are confused with ARVI, since patients experience the same symptoms - fever, headaches and muscle pain, general weakness, chills.

In severe cases, infection can lead to the following complications:

This infection is most dangerous in the early stages of pregnancy, as fetal death and miscarriage often occur.

The surviving child may have the following congenital abnormalities:

• reduction in brain size or dropsy;
• malformations of the heart, lungs and other organs;
• liver damage – hepatitis, cirrhosis, bile duct obstruction;
• hemolytic disease of newborns - hemorrhagic rash, hemorrhages in the mucous membranes, stool and vomiting with blood, bleeding from the umbilical wound;
• strabismus;
• muscle disorders - cramps, hypertonicity, asymmetry of the facial muscles and others.

Subsequently, mental retardation may become apparent. IgG antibodies detected in the blood are not a sign that there is an active CMV infection in the body. A person may already have lifelong immunity to cytomegalovirus. It is most difficult to determine the diagnostic picture in newborns. The disease in its passive form does not require treatment.

Article format: Lozinsky Oleg

Video about antibodies to cytomegalovirus

Cytomegalovirus Igg and Igm. ELISA and PCR for cytomegalovirus:

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(the CMV virus multiplies most actively in them).
• 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 for the first time during pregnancy 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% 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 (CMV) is a type 5 herpes virus. CMV infection is present in the majority of the world's population. For a long time, cytomegalovirus, like other herpes viruses, can exist in a latent form. It only appears when the immune system is weakened. This may be due to a previous illness or the person’s membership in a risk group, which includes:

• HIV-infected;
• pregnant women (intrauterine infection of the fetus is especially dangerous);
• leukemia patients;
• have undergone organ transplantation.

Methods of contracting CMV infection

Cytomegalovirus is transmitted:

• through household contact (by contact with contaminated saliva: through dishes or by kissing);
• sexually (through contact with infected semen or vaginal secretions);
• by intrauterine infection (transplacental route) or during childbirth;
• through breast milk.

Clinical manifestations of cytomegalovirus

The period of exacerbation of the disease lasts from 2 to 6 weeks and is expressed in general weakness, muscle pain, chills, headaches, and a restructuring of the immune system occurs in the body.

CMV infection can also manifest itself;

• as an acute respiratory viral infection (ARVI);
• as a chronic nonspecific inflammation of the genital organs and organs of the urinary system;
• in a generalized form (characterized by damage to internal organs, accompanied by bronchitis and pneumonia, which are difficult to respond to antibiotics; inflammation of the joints, enlargement of the salivary glands).

Moreover, cytomegalovirus can cause pregnancy disorders, pathologies of the fetus and infant. CMV infection is one of the main causes of miscarriages.

Cytomegalovirus: IgM negative IgG positive

Diagnosis of cytomegalovirus is carried out mainly by PCR or ELISA. Enzyme immunoassay is based on determining the presence of antibodies in the blood - determining the immune system's response to infection. A positive IgG result indicates that the primary infection with CMV was more than three weeks ago (it is observed in 90% of people). It is desirable that a woman who is planning a pregnancy in the near future has a similar result. However, an increase in the IgG norm by 4 times or more means the onset of a period of activation of cytomegalovirus and requires specialist intervention.

Usually the concentration of immunoglobulin IgM is determined. The result of IgM (-), IgG (+) represents the most favorable situation for pregnancy, when immunity has been developed and there is no risk of primary infection. Cytomegalovirus is amenable to preventive measures and does not pose a danger to the fetus.

A child has been diagnosed with cytomegalovirus: what should parents do? The scientific name of this disease is human herpes type five. Infection of children from animals is absolutely excluded, that is, a child can only become infected from an infected person.

Cytomegalovirus in children: forum for reasons

Very often, mothers of children who are infected with cytomegalovirus form various online forums dedicated to this topic. There they indicate what led their child to develop cytomegalovirus, how the infection occurred, at what stage the disease is now and how it is combated.

Most often, a child suffers from a congenital form of cytomegalovirus. Infection occurs if a woman is sick before conception or if infection occurs during pregnancy. Infection usually occurs due to infection passing through the maternal placenta to the fetus. It is important to understand that if infection occurs early in pregnancy, the pregnancy may end in miscarriage.

If the infection occurs late in life, the child will suffer from various developmental pathologies. This will affect the child in one way or another in later life.

How is cytomegalovirus detected in a child’s body?

There are various diagnostic methods for this.

1. Carrying out polymerase chain reaction. In this case, a positive cytomegalovirus in a child indicates that the child is infected. This method is very sensitive and accurate, but is often not used due to its high cost.
2. Serological ELISA method. An enzyme immunoassay is designed to detect antibodies in the body that are formed in response to viral exposure. We need to talk about this method in more detail.

Antibodies to cytomegalovirus in a child

There are several types of antibodies that can be produced by a child’s body as a response to the invasion of cytomegalovirus. The first bodies are called IgM. They do not form a memory of the immune system, that is, after they disappear, the body ceases to protect itself from infection. The second type of antibody is called IgG. These antibodies can protect a person throughout life because they arise after the infection has been suppressed.

Antibodies to cytomegalovirus IgG were detected in a child during diagnosis: what could this indicate? A positive cytomegalovirus IgG in a child indicates that the body has acquired a fairly strong immunity against cytomegalovirus, which will persist in the human body throughout life. However, this will only be true if antibodies of the second type were not detected. Cytomegalovirus IgG in a child and a positive result of such an analysis indicate a normal state and that the child may not be treated.

If the test for this type of antibody in a child is positive, but the presence of antibodies of the second type is also registered, this indicates that the body is not reliably protected from infection and appropriate therapy is necessary ().

If IgG antibodies are not diagnosed in a child’s body, this indicates that the child is not infected with cytomegalovirus. At the same time, there is a fairly high probability that a person will become infected upon contact with an infected person.

Analysis for cytomegalovirus in a child under one year of age should be carried out strictly according to indications. Cytomegalovirus g in children and the test results must be deciphered by a doctor. If the doctor says that the child is infected, do not panic. It is urgent to consult a doctor and make a further decision.

Dr. Komarovsky about cytomegalovirus in children

Cytomegalovirus in children (Komarovsky): video - what can you say about this doctor’s opinion regarding childhood cytomegalovirus?

The doctor says that if the virus is transmitted to a child in utero, then at birth the child may experience such serious developmental pathologies as visual and hearing impairment, as well as severe pathology of the nervous system.

If a child acquires this infection during his life, it does not pose such a global danger for him.

Symptoms of cytomegalovirus in children

If this is a child under seven years old and he encounters cytomegalovirus for the first time in his life, then, provided he is in good health, he can recede in two to three weeks. After this, the child’s further health will not suffer in any way. In this case, cytomegalovirus manifests itself with the following symptoms:

1. Skin rash;
2. Swelling of the nasopharynx and larynx;
3. Increased body temperature;
4. Signs similar to sore throat;
5. Muscle pain;
6. Migraine;
7. Vomiting and nausea.

If we are talking about the incidence of cytomegalovirus in adolescents, it should be noted that this infection rarely occurs in them and, as a rule, this occurs at a time when the body’s defenses are noticeably reduced. Symptoms usually disappear after two weeks from the time of infection and the person becomes harmless to others. How are the symptoms presented in this case?

1. Aches in bones and joints;
2. Increased fatigue;
3. Increased body temperature;
4. Headache.

Treatment of cytomegalovirus in children

Treatment for a child should be prescribed by a doctor only on the basis of laboratory diagnostics. You must first confirm the disease through tests, and then find out which antibacterial agent will be most effective in this case. If the virus is detected, but does not make itself felt when the body becomes ill, there is no need to treat such an infection.

In this case, the only necessary measure will be to increase immunity. If the infection manifests itself in a special clinical form and can lead to severe complications, it is necessary to prescribe antiviral drugs. In addition to these medications, the doctor also prescribes immunomodulators, but this is done taking into account the individual characteristics of the child’s body.

If the doctor chooses the right tactics, the child’s immune system will be able to cope with the infection that has entered the body.