Modern methods of treatment of cytomegalovirus infection. Cytomegalovirus Igg positive treatment Cytomegalovirus cmv antibodies igg positive

Cytomegaly

General information

Cytomegaly- an infectious disease of viral origin, transmitted sexually, transplacental, household, blood transfusion. Symptomatically proceeds in the form of persistent cold. There is weakness, malaise, headaches and joint pain, runny nose, enlargement and inflammation of the salivary glands, profuse salivation. Often asymptomatic. The severity of the course of the disease is due to the general state of immunity. In the generalized form, severe foci of inflammation occur throughout the body. Pregnant cytomegaly is dangerous: it can cause spontaneous miscarriage, congenital malformations, intrauterine fetal death, congenital cytomegaly.

Other names for cytomegaly found in medical sources are cytomegalovirus infection (CMV), inclusion cytomegaly, viral disease of the salivary glands, inclusion disease. The causative agent of cytomegalovirus infection, cytomegalovirus, belongs to the human herpesvirus family. Cells affected by cytomegalovirus multiply in size, so the name of the disease "cytomegaly" is translated as "giant cells".

Cytomegaly is a widespread infection, and many people who are carriers of cytomegalovirus are not even aware of it. The presence of antibodies to cytomegalovirus is detected in 10-15% of the population in adolescence and in 50% of adults. According to some sources, the carriage of cytomegalovirus is determined in 80% of women of the childbearing period. First of all, this refers to the asymptomatic and oligosymptomatic course of cytomegalovirus infection.

Not all people who carry cytomegalovirus are sick. Often, cytomegalovirus is in the body for many years and may never manifest itself and not harm a person. The manifestation of a latent infection occurs, as a rule, when the immune system is weakened. Threatening in its consequences, the danger of cytomegalovirus is in persons with reduced immunity (HIV-infected, who have undergone bone marrow transplantation or internal organs, taking immunosuppressants), with a congenital form of cytomegalovirus, in pregnant women.

Ways of transmission of cytomegalovirus

Cytomegaly is not a highly contagious infection. Usually, infection occurs through close, prolonged contact with carriers of cytomegalovirus. Cytomegalovirus is transmitted in the following ways:

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

The mechanism of development of cytomegaly

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 in HIV infection leads to 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 are replaced by IgG, which are found in the blood throughout the rest of life. With strong immunity, cytomegalovirus does not cause clinical manifestations, the course of infection is asymptomatic, hidden, although the presence of the virus is determined in many tissues and organs. By infecting cells, cytomegalovirus causes an increase in their size; under a microscope, the affected cells look like an “owl's eye”. Cytomegalovirus is determined in the body for life.

Even with an asymptomatic course of infection, the carrier of cytomegalovirus is potentially contagious to uninfected individuals. An exception is the intrauterine route of 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, while in the rest it is asymptomatic.

Forms 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 had primary cytomegalovirus. 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 a decrease and complete loss of vision.

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

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 (during household contact with an infected mother or breastfeeding), in most cases an asymptomatic course of cytomegalovirus infection develops. However, in preterm infants, cytomegalovirus can cause prolonged pneumonia, which is often accompanied by a concomitant bacterial infection. Often, when affected by cytomegalovirus in children, there is a slowdown in physical development, an increase in lymph nodes, hepatitis, and a rash.

Mononucleosis-like syndrome

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

• prolonged (up to 1 month or more) fever with high body temperature and chills;
• aching joints and muscles, headache;
• pronounced weakness, malaise, fatigue;
• sore throat;
• enlarged lymph nodes and salivary glands;
• skin rashes resembling rubella rash (usually occurs during treatment with ampicillin).

In some cases, a mononucleosis-like syndrome is accompanied by the development of hepatitis - jaundice and an increase in liver enzymes in the blood. Even less often (up to 6% of cases), pneumonia is a complication of mononucleosis-like syndrome. However, in individuals with normal immune reactivity, it proceeds without clinical manifestations, being detected only when X-rays of the lungs are performed.

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

Cytomegalovirus infection in immunocompromised individuals

Weakened immunity 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 responses, 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 in liver transplants, pneumonia in lung transplants, 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 the situation when a cytomegalovirus-infected donor material is transplanted to an uninfected recipient.

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

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

Diagnosis of cytomegaly

In order to diagnose cytomegalovirus infection, a laboratory determination of specific antibodies to cytomegalovirus, immunoglobulins M and G, is carried out in the blood. The presence of immunoglobulins M may indicate a primary infection with cytomegalovirus or a reactivation of a chronic cytomegalovirus infection. Determination of high titers of IgM in pregnant women may 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 immunoglobulins 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.

To determine the DNA of cytomegalovirus in blood cells and mucous membranes (in scrapings from the urethra and cervical canal, in sputum, saliva, etc.), the PCR diagnostic method (polymerase chain reaction) is used. Especially informative is the quantitative PCR, which gives an idea of ​​the activity of cytomegalovirus and the infectious process it causes. The diagnosis of cytomegalovirus infection is based on the isolation of cytomegalovirus in clinical material or with a fourfold increase in antibody titer. Treatment of cytomegalovirus infection in individuals at risk is carried out with the antiviral drug ganciclovir. In cases of severe cytomegalovirus, ganciclovir is administered intravenously, since the tablet forms of the drug have only a preventive effect against cytomegalovirus. Since ganciclovir has severe side effects (causes hematopoiesis suppression - anemia, neutropenia, thrombocytopenia, skin reactions, gastrointestinal disorders, fever and chills, etc.), its use is limited in pregnant women, children and people suffering from renal insufficiency (only for health reasons), it is not used in patients without impaired immunity.

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 electrolyte disturbances (a decrease in magnesium and potassium in the blood plasma), ulceration of the genital organs, impaired urination, nausea, and kidney damage. These adverse reactions require careful use and timely adjustment of the dose of the drug.

Prevention

The issue of prevention of cytomegalovirus infection is especially acute in individuals at risk. The most susceptible to infection with cytomegalovirus and the development of the disease are HIV-infected (especially AIDS patients), patients after organ transplantation and persons with immunodeficiency of a different origin.

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

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

Before starting treatment for cytomegalovirus, it is necessary to accurately diagnose the disease and determine whether treatment for CMVI is necessary in your case. Since it is not always required, you need to be aware of it. In addition, it is not easy to diagnose the presence of cytomegalovirus infection and CMV is easily confused with other diseases. Below we will talk about how to cure cytomegalovirus and how it is treated, as well as in what cases it is necessary.

Cytomegalovirus infection should be treated only when the disease is an undeniable danger to the human body. Such cases are clearly identified only by a specialist, after visiting a sick clinic to diagnose the disease. If the body has symptoms of a generalized cytomegalovirus infection, then it is extremely important to contact the clinic. The treatment regimen for cytomegalovirus can only be drawn up after a personal examination of the patient.

A person who has been ill with cytomegalovirus and has undergone an infectious disease without any serious consequences acquires a fairly strong immunity. In the vast majority of cases, cytomegalovirus infection, having struck the human body, does not cause any symptoms. The virus itself in the body takes a sleep mode, remaining in a person forever. And it manifests itself, causing relapses, accompanied by all sorts of complications, only with a strong weakening of the immune system.

In all cases, the treatment of cytomegalovirus infection pursues the goal - to significantly mitigate the negative impact of a viral infection on the human body. Most often, after infection, a person with a sufficiently strong immune system easily endures the primary outbreak of an infectious disease, so there is no need for a person with cytomegalovirus to go to the hospital. In such people, after a short manifestation, the set of symptoms that have been created ceases without a trace. As a result, the disease mostly goes unnoticed.

When is cytomegalovirus treatment really necessary?

The specific circumstances under which the attending physician determines the course of treatment of cytomegalovirus infection in adults or in children include such manifestations as:

• The presence of acquired or congenital immunodeficiency in a patient of any age.
• Generalized stage - the widespread spread of the virus is accompanied by a very painful inflammatory process throughout the body or in a certain organ against the background of the presence of other infections that weaken the basic protective functions of the human body.
• Complicated or exacerbated course of cytomegalovirus or preparation for treatment with allogeneic organ transplantation, pneumonia, encephalitis, oncological diseases - when using therapy that severely suppresses the immune system.
• During the first trimester of pregnancy, immunocompromised women may develop primary cytomegalovirus, which can potentially cause extremely severe damage to the fetus, and may also cause miscarriage.

The generalized stage or symptomatic exacerbation of a cytomegalovirus infection is often characterized by the fact that most patients, and even sometimes some doctors, confuse this viral disease due to its similarity with the symptoms of influenza-like diseases or SARS. As well as other infectious diseases. Often this leads to erroneous treatment and a high risk of developing severe complications.

With absolutely accurate differential diagnosis, the treatment for cytomegalovirus will be prescribed to the patient as adequate as possible. And the medicines are prescribed for the right purpose.

Drugs and vitamins for the treatment of cytomegalovirus infection

Let's look at how to treat cytomegalovirus with drugs. The main medications for cytomegalovirus infection and their treatment are divided into several small groups:

• Symptomatic remedies- provide relief, anesthetize, eliminate inflammation, constrict blood vessels (nasal drops, eye drops, painkillers, anti-inflammatory, folk remedies).
• Antiviral drugs- inhibit the activity of the infection (Ganciclovir, Panavir, Cidofovir, Foscarnet).
• Posyndromic drugs- restore damaged organs and tissues in case of complications (capsules, suppositories, tablets, injections, gels, ointments, drops).
• Immunomodulators- strengthen and stimulate the immune system (Leukinferon, Roferon A, Neovir, Genferon, Viferon).
• Immunoglobulins- bind and destroy viral particles (Neocytotect, Cytotect, Megalotect).
• Vitamin and mineral complex- to support the immune system.

In men, cytomegalovirus is treated with antiviral drugs - Foscarnet, Ganciclovir, Viferon. And immunoglobulins - Cytotect, Megalotect.

In women, cytomegalovirus is treated with antiviral drugs - Acyclovir, Viferon, Genferon, Cycloferon.

List of drugs

1. Foscarnet is an antiviral drug. Infectious cytomegalovirus is treated quite successfully with Foscarnet. It is used in severe cases of the disease and in complex forms of possible exacerbations that can be caused by other diseases. It is advisable to use this drug with a weakened immune system in a patient. When the drug enters the diseased cell, the elongation of the viral chain is disrupted, that is, the drug slows down, and then completely stops the active reproduction of the virus.
2. Ganciclovir is an antiviral drug. The drug is one of the most effective, rather difficult in practical use. The remedy is prescribed during the course of the disease - a cytomegalovirus infection, complicated by especially severe organ pathologies, rather extensive inflammations. It is also used to prevent viral infection, congenital CMV infection. Release form - tablets and crystalline powder from the group of polar hydrophilic solvents. For ophthalmic gel or injection, the drug is available as a lyophilisate. The use of Ganciclovir is advisable in the treatment of cytomegalovirus - a herpes infection.
3. Cytotect - immunoglobulin. For many patients, Cytotect seems to be one of the most optimal means for the treatment of cytomegaluvirus. The drug combines a fairly effective efficiency and an almost complete absence of general toxicity and relative contraindications. Prescribed for prophylaxis in patients with suppressed immune system drugs. Prevents mass manifestations of the disease after infection with CMVI. When applied, it can create: headaches; nausea and vomiting; chills and fever; joint pain and mild back pain; sometimes a decrease in blood pressure.
4. Neovir is an immunostimulant. Solution for injection, used as an immunostimulating drug for the treatment and prevention of cytomegalovirus infection in people with immunodeficiency.
5. Viferon is an immunomodulator. Candles with antiviral action. It is used for complications of infectious diseases, for primary inflammation, as well as for recurrence of cytomegalovirus infection of a localized form. The drug is applied rectally. When applied, it can cause an allergic reaction in the form of a skin rash.
6. Bischofite is an anti-inflammatory drug. Produced in the form of a balm (gel) in a tube or in a glass container in the form of a brine. It is applied topically as therapeutic mud or mineral water.

List of vitamins

1. C - Broad spectrum antioxidant. Stimulates the work of cells that eat bacteria and viruses in the blood. Increases the resistance of the human body to various infections through the resistance of cells to the penetration of infectious agents.
2. B9 - for the powerful maintenance of the production factory (bone marrow) of the human body's immune system.

The general rules for the treatment of cytomegalovirus include hospitalization of the patient in cases where it is absolutely necessary. Since during the treatment period the patient appears to be a very active source of viral infection for others, the patient must significantly limit any contact with people. Ensure maximum peace of mind. Provide the best necessary microclimate conditions. Observe strict rules of personal hygiene. Use a therapeutic and preventive diet.

With strict adherence to these rules and all the recommendations of the attending physician, you can rely on a fairly quick and most effective way to get rid of the infection and prevent complications and relapses.

Treatment with folk remedies

If a person heard that people were treated for cytomegalovirus by home medicine, then this is an erroneous idea that, thanks to traditional medicine, it is possible to cope with such a difficult task. Treatment of such an infection and all sorts of complications should not occur on its own without the supervision of a specialist. But it is quite advisable to support the immune system with folk remedies.

Cytomegalovirus is a virus belonging to the herpesvirus family. This virus has a high prevalence in the human population.

Ten to fifteen percent of adolescents and forty percent of adults have antibodies to cytomegalovirus in their blood.

The incubation period is quite long - up to two months. During this period, the disease is always asymptomatic. Then a pronounced manifest beginning. Which is provoked by stress, hypothermia or simply reduced immunity.

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

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

The contagiousness of the virus is low.

Ways of transmission: sexual, contact-household (through kisses and saliva), from mother to child, through blood products.

Infected people are usually asymptomatic. But sometimes, in those who suffer from poor immunity, the disease manifests itself as a mononucleosis-like syndrome.

It is characterized by an increase in body temperature, feelings of chills, fatigue and general malaise, and severe pain in the head. A mononucleosis-like syndrome has a happy ending - recovery.

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

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

What does cytomegalovirus IgG positive mean?

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

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

This organism has formed a lifelong stable immunity. Carriers are about 90% of people, so there is no norm for antibodies to this virus. There is also no concept of increased or decreased level.

Determination of antibodies to cytomegalovirus is only necessary to establish the correct diagnosis.

Cytomegalovirus infection is considered the presence of a virus in PCR analysis when examining material containing certain DNA.

From the tenth to the fourteenth day after infection, IgG antibodies to cytomegalovirus infection appear in the blood. Antibodies easily pass through the placenta. Therefore, newborns are not always infected, it can be maternal immunoglobulins.

The level of immunoglobulin in the blood is checked after three weeks to clarify the diagnosis and the severity of the process. The process is considered active if the level of immunoglobulins increases.

Cytomegalovirus in children

Cytomegalovirus infection is very similar to herpetic. And she also happens often.

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

There are children who suffer greatly from cytomegalovirus:

• exposed to intrauterine infection, since the placental barrier is not an obstacle to cytomegalovirus;
• newborns, with weak and unstable immunity;
• at any age, with a greatly weakened immune system, or, for example, in patients with AIDS.

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

For newborns, cytomegalovirus is infectious mononucleosis. The lymphatic system is affected - the lymph nodes increase, the palatine tonsils become inflamed, the liver and spleen increase, it becomes difficult to breathe.

In addition, congenital infection is characterized by:

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

Violation of nasal breathing threatens with such symptoms:

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

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

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

For these children, complications are possible:

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

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

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

Characterized by:

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

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

The earliest diagnosis of cytomegalovirus infection and timely treatment significantly reduce the risk of complications. It is best to start treatment within seven to nine days after infection. Then the cytomegalovirus infection will not leave a trace.

Cytomegalovirus in women

Cytomegalovirus infection in females occurs in a chronic form. Most often it is asymptomatic, but sometimes there are symptoms. A weak immune system contributes to the active manifestation of the disease.

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

In the acute form, the infection is characterized by damage to the cervical lymph nodes.

Then there is an increase in the submandibular, axillary and inguinal lymph nodes. As I said, such a clinical picture is similar to infectious mononucleosis. It is characterized by headache, general malaise, hepatomegaly, atypical blood mononuclear cells.

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

Nine out of ten women with AIDS have cytomegalovirus infection. They are characterized by bilateral pneumonia and encephalitis phenomena.

Encephalitis is characterized by dementia and memory loss.

Women with AIDS and cytomegalovirus suffer from polyradiculopathy. Such women are characterized by damage to the kidneys, liver, pancreas, eyes and organs of the MPS.

Cytomegalovirus during pregnancy

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

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

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

If the factors that weaken the immune system exacerbate the latent virus carrier, then this is a less dangerous situation.

There are already immunoglobulins (IgG) in the blood, the virus is weakened and not so active. The virus is dangerous by infecting the fetus in only two percent of cases. Early pregnancy is more dangerous in terms of infection. Pregnancy often ends in spontaneous miscarriage. Or the fetus develops abnormally.

Infection with cytomegalovirus infection later in pregnancy results in polyhydramnios or preterm labor (“congenital cytomegalovirus”). Unfortunately, it is impossible to completely destroy cytomegalovirus in the body. But you can make it inactive. Therefore, pregnant women and those planning to become pregnant should be especially attentive to their health. Cytomegalovirus is very dangerous for the fetus.

Cytomegalovirus IgM positive

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

IgM analysis is carried out to determine:

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

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

The number of cytomegalovirus is subject to control by immunoglobulin G, not allowing the picture of an acute illness to develop.

An IgM positive result with an IgG negative result indicates acute recent infection and lack of permanent immunity against CMV. An exacerbation of a chronic infection is characterized by indicators when IgG and IgM are present in the blood. The body is in a stage of serious deterioration of immunity.

There has already been infection in the past (IgG), but the body can not cope, and non-specific IgM appear.

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

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

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

In modern society, almost all women are infected with the infection.

Treatment of cytomegalovirus and treatment results

If a person has a healthy immune system, then he himself will cope with a cytomegalovirus infection. You can not carry out any therapeutic actions. Immunity will only be weakened if treated for a cytomegalovirus infection that does not manifest itself. Drug treatment is necessary only when the immune defense fails and the infection actively intensifies.

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

With a positive analysis for IgM, to translate an acute condition into a latent course of the disease. It must always be remembered that drugs for cytomegalovirus infection have many side effects. Therefore, only a knowledgeable specialist can prescribe them, self-medication should be avoided.

The active stage of infection is the presence of positive IgM. Other test results must also be taken into account. It is especially necessary to monitor the presence of antibodies in the body of pregnant women and immunodeficient people.

Cytomegalovirus (CMV, cytomegalovirus, CMV) is type 5 herpesvirus. To identify the stage of the course of an infectious disease and its chronicity, 2 research methods are used - PCR (polymerase chain reaction) and ELISA (enzymatic immunoassay). They are prescribed when symptoms appear and infection with a cytomegalovirus infection is suspected. If cytomegalovirus igg is positive in the results of a blood test, what does this mean and what danger does it pose to humans?

Antibodies IgM and IgG to cytomegalovirus - what is it

When examining infections, different immunoglobulins are used, they all play a role and perform their functions. Some fight viruses, others fight bacteria, others neutralize excessively formed immunoglobulins.

For the diagnosis of cytomegaly (cytomegalovirus infection), 2 classes of immunoglobulins are isolated from 5 existing ones (A, D, E, M, G):

1. Immunoglobulin class M (IgM). It is produced immediately upon penetration of a foreign agent. Normally, it contains approximately 10% of the total amount of immunoglobulins. Antibodies of this class are the largest; during pregnancy, they are present exclusively in the blood of the expectant mother, and they cannot get to the fetus.
2. Immunoglobulin class G (IgG). It is the main class, its content in the blood is 70-75%. It has 4 subclasses and each of them is endowed with special functions. For the most part, it is responsible for the secondary immune response. The start of production occurs a few days after immunoglobulin M. It remains in the body for a long time, thereby preventing the possibility of a recurrence of the infection. Neutralizes harmful toxic microorganisms. It has a small size, which contributes to the penetration to the fetus during pregnancy through the "children's place".

Cytomegalovirus igg positive - interpretation of results

The titers help to decipher the results of the analyzes, which may differ depending on the laboratory. The classification into “negative / positive” is carried out using indicators at the concentration of immunoglobulins G:

• over 1.1 honey / ml (international units in millimeters) - positive;
• below 0.9 honey / ml - negative.

Table: "Antibodies to cytomegalovirus"

ELISA determines the avidity of immunoglobulins to cytomegalovirus

Positive IgG antibodies indicate a past encounter of the body with a virus, a previous cytomegalovirus infection.

Komarovsky on positive IgG in children

At the birth of a child, blood is immediately taken for analysis in the maternity ward. Doctors will immediately determine the presence of a cytomegalovirus infection in a newborn.

If cytomegaly is acquired, then parents will not be able to distinguish the disease from a viral infection, since their symptoms are identical (fever, signs of respiratory diseases and intoxication). The disease itself lasts up to 7 weeks, and the incubation period - up to 9 weeks.

In this case, it all depends on the immunity of the child:

1. With a strong immune system, the body will fight back the virus and will not be able to continue its development, but at the same time, those very positive IgG antibodies will remain in the blood.
2. With a weakened immune system, other antibodies join in the analysis, and a disease with a sluggish handicap will give complications to the liver, spleen, kidneys and adrenal glands.

During this period, it is important for parents to monitor the baby's drinking regimen and do not forget to give vitamins.

High avidity of igg during pregnancy

During pregnancy, the avidity of class G immunoglobulin is of particular importance.

1. With low avidity of IgG, we are talking about primary infection.
2. IgG antibodies have high avidity (CMV IgG) - this indicates that the expectant mother has already had CMV earlier.

The table presents the possible variants of positive immunoglobulin G in combination with IgM during childbearing, their significance and consequences.

When planning a pregnancy, it is necessary to take tests for the detection of CMV in order to avoid unpleasant consequences during pregnancy. Normal indicators are considered IgG (-) and IgM (-).

Whether it is necessary to treat?

Treatment is necessary or not depends directly on the stage of the disease. The goal of therapy is to transfer the virus from the active stage to the inactive one.

In the chronic course of the disease, there is no need to prescribe medications. It is enough to maintain immunity with the help of vitamins, healthy food, giving up bad habits, walking in the fresh air and timely fight against other diseases.

If a positive class G immunoglobulin indicates a recurrent (exacerbation of infection in a chronic course) or an acute form of the disease, then it is important for the patient to undergo a course of treatment that includes:

• antiviral agents;
• immunoglobulins;
• immunomodulators.

In general, high avidity of immunoglobulin G is most dangerous for children infected in the womb, pregnant women and those with immunodeficiency. But as practice shows, for the most part it is enough to adhere to preventive measures for a successful fight against the pathogen. Exclusively with a decrease in the body's defenses, complex treatment with drugs is required.

What it is? Cytomegalovirus is a genus of viruses in the herpesvirus family. This virus is quite common, today cytomegalovirus antibodies can be found in about 10-15% of adolescents, and in 40% of adults. Below, we will give a full description of this disease, as well as consider the causes, symptoms and treatments for cytomegalovirus.

Causes and ways of infection with cytomegalovirus

Cytomegalovirus (from lat. Cytomegalovirus) is actually a relative of herpes vulgaris, because it belongs to the group of herpesviruses, which includes, in addition to herpes and cytomegalovirus, also two diseases such as infectious mononucleosis and.

The presence of cytomegalovirus is noted in blood, semen, urine, vaginal mucus, and also in tears, which determines the possibility of infection by it through close contact with these types of biological fluids.

How does infection occur? Cytomegalovirus infection can occur:

• when using contaminated items,
• by blood transfusion and even by airborne droplets,
• as well as during sexual contact,
• during childbirth and pregnancy.

The virus is also found in blood, saliva, cervical secretions, semen, and breast milk.

If a person has already become infected with cytomegalovirus, then he becomes its carrier for life.

Unfortunately, it is not possible to recognize the presence of cytomegalovirus immediately - this disease has an incubation period that can last up to 60 days. During this period, the disease may not manifest itself in any way, but after that, there will definitely be an unexpected and sharp outbreak, which in most cases can be provoked by stress, hypothermia or a general decrease in the immune system.

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.

People who have a normal immune system may be infected with cytomegalovirus and not know about it, as the immune system will keep the virus suppressed, therefore, the disease will be asymptomatic, without causing harm. In rare cases, in people with normal immunity, cytomegalovirus can cause a mononucleosis-like syndrome.

In people with weak or weakened immunity (HIV-infected, cancer patients, etc.), cytomegalovirus causes serious illness, damage occurs:

• eye,
• lungs
• brain and digestive system,
• which eventually leads to death.

Cytomegalovirus is the most dangerous in only two cases. These are people with weakened immune systems and children who were infected while the fetus was in the womb of a mother who contracted the virus during pregnancy.

Symptoms of cytomegalovirus in women

In women, the symptoms of cytomegalovirus will appear depending on the form of the disease. The disease begins with an incubation period of 20-60 days. At this time, the pathogen actively multiplies in the cells, and there are no signs of the disease.

If the woman's immunity is not weakened, then no symptoms of the disease will be observed. In some cases, a woman may be concerned about:

• flu-like symptoms
• a slight increase in temperature up to 37.1 ° C,
• weakness,
• slight discomfort.

Signs in men

Stopping on the symptoms of cytomegalovirus in men, the following manifestations can be distinguished:

• temperature increase;
• chills;
• headache;
• swelling of the mucous membranes and nose;
• enlarged lymph nodes;
• runny nose;
• skin rash;
• inflammatory diseases that occur in the joints.

As you can see, the listed manifestations are similar to the manifestations observed in acute respiratory infections and acute respiratory viral infections. Meanwhile, it is important to take into account that the symptoms of the disease occur only after 1-2 months from the moment of infection, that is, after the end of the incubation period.

Diagnostics

We found out what cytomegalovirus is, and now let's find out how the disease is diagnosed. To diagnose sexually transmitted infections (STIs), methods are used based on the detection of the virus that causes the disease in the body. However, this disease is different. After all, it can be detected with the help of a special study of blood, urine, saliva, smears, semen and scrapings, which are taken from the genital organs during the primary infection or during an exacerbation of the infection.

1. For the purpose of diagnosis, a laboratory determination of specific antibodies to cytomegalovirus, immunoglobulins M and G, is carried out in the blood. The presence of immunoglobulins M may indicate a primary infection with cytomegalovirus or a reactivation of a chronic cytomegalovirus infection. Determination of high titers of IgM in pregnant women may 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.
2. An increase in immunoglobulins 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.
3. To determine the DNA of cytomegalovirus in blood cells and mucous membranes (in the materials of scrapings from the urethra and cervical canal, in sputum, saliva, etc.), the method of PCR diagnostics (polymerase chain reaction) is used. Especially informative is the quantitative PCR, which gives an idea of ​​the activity of cytomegalovirus and the infectious process it causes.
4. The diagnosis of cytomegalovirus infection is based on the isolation of cytomegalovirus in clinical material or a fourfold increase in antibody titer.

It is worth noting that it is advisable to take tests for cytomegalovirus for women who are planning a pregnancy. It is also necessary to pass a similar analysis to those people who very often have a cold, since a cold can be a manifestation of this infection.

It is necessary to treat cytomegalovirus infection in a complex way, therapeutic therapy should include drugs that are directly aimed at combating the virus, at the same time, these drugs should increase the protective functions of the body and strengthen the immune system. At present, no such remedy has yet been invented that could completely cure cytomegalovirus, it remains in the body forever.

The main goal of the treatment of cytomegalovirus is the suppression of its activity.. People who are carriers of this virus need to adhere to a healthy lifestyle, eat well, and consume the amount of vitamins necessary for the body.

Due to the fact that in the vast majority of cases the body itself is able to cope with cytomegalovirus, the treatment of the infection associated with it is most often limited to easing the symptoms and reducing the suffering of the patient.

To reduce the temperature characteristic of almost all forms of cytomegalovirus infection, use the usual Paracetamol. Aspirin is not recommended due to possible side effects associated with the viral nature of the disease.

It is also very important for carriers of this disease to lead a normal and proper lifestyle that provides a person with the right amount of fresh air, a balanced diet, movement and all the factors that strengthen the immune system.

In addition, there are a large number of immunomodulatory drugs that are prescribed to strengthen the immune system. In general, treatment with immunomodulators can last several weeks, and only a doctor prescribes such treatment. It should be noted that such treatment is possible if the cytomegalovirus is latent, so these drugs are used for prevention, but not for treatment.

Prevention

It is worth noting that cytomegalovirus is the most dangerous during the initial infection, so it is necessary to take all precautions when contacting already infected people and about preventing this infection. And especially such caution is very important for pregnant women who are not carriers of cytomegalovirus. Therefore, pregnant women, in order to protect their health and the health of the baby, need to give up casual sex.

Prevention of cytomegalovirus for everyone else comes down to observing the basic rules of personal and sexual hygiene.

1. You should not enter into new intimate contacts without a condom: this advice from doctors is repeated more and more often and is more relevant than ever.
2. When communicating with casual acquaintances, one should not use the same washing utensils and utensils, it is necessary to keep oneself and one's home clean, wash one's hands thoroughly after contact with money and other objects held in the hands of other people.

In addition, it is very important to work on strengthening the immune system, since a healthy immune system, even if the cytomegalovirus accidentally enters the body, will not allow the development of an acute cytomegalovirus infection.