Cytomegalovirus infection: symptoms, diagnosis, treatment. Symptoms and types of cytomegalovirus infection

Date: 25.03.2019

Every day, a person comes into contact with a huge number of microorganisms and viruses that can cause changes in the functions of the body's systems, leading to diseases of various severity and duration, as well as the adverse consequences of these diseases.

If for the treatment of bacterial and fungal infectious diseases highly effective antibacterial and antimycotic drugs have been created, then the treatment of patients with viral lesions presents significant difficulties in connection with the peculiarities of the biology of viruses, the nature of the interaction of viral particles and the host organism, the state immune system the latter and many other factors.

Viruses - serious problem humanity

A distinctive feature of viruses is that they cannot reproduce on their own, but they are able to effectively reproduce in sensitive cells of a macroorganism, where they implement their genetic program to create offspring.

The main stages of the interaction of viruses with the cell: adsorption (this is a trigger mechanism manifested by the interaction of specific receptors of the virus and the host cell), penetration (fusion of the supercapsid with the cell membrane), release (isolation of nucleicapsid nucleic acids and activation of viral nucleic acid), synthesis of nucleic acids and viral proteins (subordination of host cell systems and their work on the reproduction of the virus), assembly of virions and the release of new viral particles from cells into the intercellular space, blood or lymph.

The host's antiviral defense is a very complex and multicomponent mechanism. In the primary interaction with viruses, infectious agents are opposed by nonspecific defense mechanisms of the body, which include the epithelium of the skin, mucous membranes. After the virus enters the cell, interferons and other cytokines produced by infected cells play the main role in providing local immunity. The importance to contain viral infection after infection, they also have lymphocytes, macrophages, which provide phagocytosis and destruction of viruses. Antibodies formed during viral infections act directly on viruses or on cells infected with them.

Almost all viruses stimulate the production of interferons. Their education is one of the earliest defense reactions organism for the introduction of viruses. Interferons inhibit the intracellular stages of viral reproduction in infected cells, provide immunity to viruses surrounding healthy cells, and prevent the dissemination of viruses in the body.

The use of immunotropic drugs, interferon and its inducers is becoming a necessary part of the conventional treatment of various infectious diseases.

Cytomegalovirus infection - what is it and where does it come from?

Cytomegalovirus infection is a widespread infection. In the 1st year of life, antibodies in cytomegalovirus infection are found in 20% of children, in children attending kindergartens, the prevalence of infection is 25-80%, in the adult population, antibodies to cytomegalovirus are found in 85-90% of the population.

The relevance of the study of cytomegalovirus infection is due to the fact that cytomegalovirus can cause adverse effects after infection in newborns and children of the 1st year of life, whose mothers have had an infection during pregnancy.

The source of infection can be a virus carrier, an acute patient (in case of primary infection) or a patient during an exacerbation of the infection. The main transmissions of infection are airborne, sexual, contact, oral, parenteral, enteral and vertical routes, while the transmission of viruses is carried out through all biological fluids and excretions of the body (saliva, urine, blood, etc.). If the virus enters the human body after primary infection, it can remain in the body for life. The infection can be asymptomatic (virus carrier) due to the fact that the virus is protected by lymphocytes from the action of specific antibodies and interferon.

In the literature, the latent course of infection caused by cytomegalovirus is referred to as "cytomegalovirus infection", and the clinically expressed course with organ damage is referred to as "cytomegalovirus disease". The development of cytomegalovirus disease is characterized by leukocyte infiltration various bodies

Symptoms of CMVI, the prevalence of the disease and possible consequences

Severe symptoms of the disease may appear during primary infection or activation latent infection against the background of a decrease in the body's immunity. This can be observed in children, pregnant women, adults with reduced immunity resulting from exposure to adverse environmental factors, with immunodeficiency, taking cytostatics and immunosuppressants, after transplantation or chemotherapy in cancer patients, and in other cases of immunosuppression (conditions in which immunity decreases) ...

The clinical picture of cytomegalovirus infection is nonspecific and largely depends on the route of infection, the state of the immune system. Most typical symptoms cytomegalovirus disease - a temperature above 38 ° C, leukopenia (a decrease in the number of leukocytes), thrombocytopenia (a decrease in the number of platelets), an increase in the activity of liver enzymes. With cytomegalovirus disease, lesions may develop different departments gastrointestinal tract, occur characteristic of colds inflammatory processes nasopharynx and oropharynx. The most severe form of the disease is cytomegalovirus pneumonia, characterized by the development of severe respiratory failure and antibiotic resistance.

The period of primary infection lasts about 2-3 weeks, in the absence of an immune response, it turns into a generalized form; with insufficient immune response acute illness can pass into a localized form, and if sufficient, a cure occurs. Carriage of viruses is observed in 90-95% of the adult population (cytomegalovirus positivity), while the carrier is not dangerous to others, but with a decrease in immunity, the carrier can go into active form... The generalized form can occur in persons with severe immunodeficiency and manifest as inflammation of the parotid and submandibular salivary glands, liver tissue, adrenal glands, spleen, joints and other organs. The manifestations of the localized form in women may be cervicitis, endometritis, salpingo-oophoritis, inflammation of the submandibular and parotid salivary glands, cervical lymph nodes, in men there may be asymptomatic carriage or sluggish urethritis.

Cytomegalovirus infection - danger for pregnant women

Cytomegalovirus infection and antibodies to viruses are found in 50-85% of pregnant women, while primary infection occurs in 1-12% of pregnant women, which poses a danger to pregnancy and the fetus.

Primary cytomegalovirus infection can cause complications such as non-developing or premature pregnancy, fetal-placental insufficiency, fetal growth retardation syndrome, polyhydramnios, premature placental abruption, etc. the fetus depends on the gestational age at which the primary infection or reactivation of the infection occurred.

If a woman's primary infection occurred in the first half of pregnancy, then 8-10% of children born to these mothers may experience clinical manifestations in the form of hepatosplenomegaly, hepatitis, thrombocytopenia, petechial rash, microcephaly, retinitis, hyperbilirubinemia, hypotrophy, delay syndrome fetal development, pneumonia and other manifestations.

Infection in the second half of pregnancy can lead to chronic congenital cytomegalovirus infection, in severe cases - to dysfunction of the central nervous system, liver, impaired vision and hearing. Intranatal (during childbirth) and early postnatal infection (immediately after birth), which occurs when feeding seropositive mothers, proceeds, as a rule, without clinical manifestations and is more common than transplacental.

It is for these reasons that all pregnant women, without exception, are recommended to be tested not only for CMVI, but also for other intrauterine infections.

Diagnostics of the cytomegalovirus infection

Difficulties in diagnosing cytomegalovirus infection are associated with the lack of seasonal cyclicity of the incidence, with the fact that it is erased incubation period, there are no characteristic clinical manifestations of the disease, latent forms of the course of the infectious process are often found.

The main diagnostic method for cytomegalovirus infection is serological with the detection of specific antibodies to the antigens of the virus. To identify the features of the course of infection, it is recommended to determine the avidity of immunoglobulins M and G and antibodies to the nadranny protein. Molecular biological methods (DNA hybridization, ligase chain reaction, PCR) make it possible to detect early stages, latent and persistent infection, quantitative parameters of viremia. The cytological method is used for express diagnostics of cytomegalovirus infection on the surface of the chorion, fetal membranes.

Treatment of cytomegalovirus infection

Treatment is prescribed and monitored by a physician due to the toxicity of many drugs traditionally used in the treatment of CMVI, especially in pregnant and lactating women.

This article will focus on cytomegalovirus infection. About what methods of treatment are used for this disease. And also about the causes, symptoms, diagnosis of this disease.

What is cytomegalovirus?

Cytomegalovirus Is one of a kind of viruses that belongs to the herpesvirus family. It is stored for life in the human body. Such a virus is not highly contagious. The likelihood of infection is high if very long time had close communication with a person who has this virus.

The virus does not carry significant labor to the body, if the human immune system is in order. The dangerous period is pregnancy.

In autumn, during stress, with a lack of vitamin, a person's immunity weakens, so it is so important to strengthen it. The drug is completely natural and allows for a short time recover from colds.

It has expectorant and bactericidal properties. Enhances protective functions immunity, perfect as a prophylactic agent. Recommend.

Cytomegalovirus infection

Virus infection can occur in the following ways:

Airborne droplets;
Contact and household;
Sexual;
From mother to fetus;
Infection of the baby during childbirth;
Infection through breast milk;
Possible infection through blood transfusion;
Organ transplant

With all this, a patient with a diagnosis of cytomegaly is considered the main source of infection.

Take care of your health! Strengthen your immune system!

Immunity is a natural reaction that protects our body from bacteria, viruses, etc. To increase tone, it is better to use natural adaptogens.

It is very important to maintain and strengthen the body, not only with the absence of stress, proper sleep, nutrition and vitamins, but also with the help of natural herbal remedies.

It has the following properties:

Kills viruses and eliminates secondary signs of influenza and SARS in 2 days
24 hours of immunity protection infectious period and during epidemics
Kills putrefactive bacteria in the digestive tract
The preparation contains 18 herbs and 6 vitamins, extracts and concentrates of plants
Removes toxins from the body, shortening the rehabilitation period after illness

Propagation paths

There are many ways cytomegalovirus spreads:

Through saliva, with a kiss;
Through semen, during sexual intercourse without a fuse;
Through the placenta, during pregnancy;
Through organs, when transplanted from a patient with the virus;
Through blood, during transfusion;
Through mother's breast milk, into postpartum period, during feeding;
Through dirty hands, other people's toothbrushes and other household items.

Knowing all the ways the virus spreads, a person can completely protect himself. It is necessary to follow the rules of personal hygiene, family members are required to donate blood for cytomegalovirus

Stories from our readers!
"After pneumonia, I drink to maintain immunity. Especially in the autumn-winter periods, during epidemics of flu and colds.

Drops are completely natural and not only from herbs, but also propolis and badger fat, which have long been known as good folk remedies... It performs its main function perfectly, I advise. "

Factors in the development of infection

The main factors for the development of infection include:

Source of infection. That is, a person who already has cytomegalovirus. With very close and long communication with this person, there is a risk of infection.
Transfer mechanisms. That is, through which paths infection is possible. These include sexual intercourse, kissing, donation, organ transplants, mother-to-child and more.
The degree of susceptibility of the human body to viruses. That is, how much a person is protected by immunity. If a person has a sufficiently strong and persistent immunity, infection can be avoided.

The main cause of bronchitis accompanied by phlegm is a viral infection. The disease occurs due to damage by bacteria, and in some cases - when the body is exposed to allergens.

Now you can safely purchase excellent natural preparations that alleviate the symptoms of the disease, and can completely get rid of the disease in up to several weeks.

Symptoms of cytomegalovirus in women

The clinical manifestation of the virus mainly depends on the state of the patient's immunity. In the event that a person's immune system is normal, cytomegalovirus can persist in the body without manifesting itself at all and without causing harm to a person.

But there is one problem which is expressed in the fact that the virus can be transmitted to a healthy person. In most cases, the infection is asymptomatic. However, there are still exceptions.

In such cases, the following symptoms are observed:

The body temperature rises;
Chills appear;
Fatigue, fatigue;
General intoxication of the body;
Strong headache.

If the human immune system is weak for any reason, then the cytomegalovirus particles increase their activity and clinical picture becomes pronounced.

Symptoms of cytomegalovirus infection resembles a clinic for acute respiratory infections. The main difference between them is the duration. Cytomegalovirus infection lasts about 4-6 weeks.

The symptoms are as follows:

Increased body temperature;
Nasal congestion;
Enlarged liver and spleen as well as cervical The lymph nodes;
Headaches, muscle pains appear;
The patient has chills;
The appearance of a rash is possible.

The acute form of the virus proceeds a little differently. First, there is an incubation period of 20 to 60 days. During the incubation period, an infected person poses a great threat to healthy people... This condition can persist for up to 2-3 years.

CMV can be manifested by genitourinary system:

In women, due to the virus, it is possible that various erosion(cervix, vagina, ovaries). A bluish discharge from the genitals may appear. The appearance of pain in the lower abdomen is possible. If at this time the woman is pregnant, then there is a risk of infection of the fetus.

This condition can only be observed with weak immunity.

What is CMV infection associated with in immunocompromised women?

When the immune system is weakened, the infection process is very active.

There are two options for the manifestation of the disease:

Mononucleosis-like type. Lymph nodes increase, first cervical, then mandibular, then axillary, inguinal. The increase is accompanied by soreness.
After that, symptoms of general intoxication of the body appear. When diagnosed, an increase in the liver is observed. When laboratory research there is an increase in leukocytes in the blood, and the appearance of atypical mononuclear cells is also observed.
Generalized type. This type of disease is very rare. Its course has a very severe form.
Many organs are affected: liver, kidneys, reproductive system, retina of eyes, salivary glands, lungs. This is the main clinic for the generalized form of the disease.

Symptoms of cytomegalovirus in women with AIDS

Most women diagnosed with AIDS suffer from cytomegalovirus infection... The disease manifests itself as pneumonia or encephalitis.

Clinic cytomegalovirus pneumonia looks like that:

Bilateral inflammation is observed lung tissue(often fatal);
The disease has a long course;
There are bouts of coughing and shortness of breath.

With cytomegalovirus encephalitis, the clinic is as follows:

Dementia;
Deterioration of intelligence;
Memory and attention deteriorate.

Since AIDS has a clear immunodeficiency there is damage from the liver, kidneys, spinal cord, the reproductive system. The most important damage is from the organs of vision. Every fifth woman diagnosed with AIDS loses her eyesight, while others have vision problems.

Symptoms in women during pregnancy

During pregnancy, the clinic of a cytomegalovirus infection of the usual course also resembles ARVI:

Symptoms of general intoxication;
Fever
Chills;
Runny nose, etc.

However, with a severe course of the disease, the appearance is observed:

Inflammation of the lungs;
Hepatitis A;
Myocarditis;
Ulcers of the stomach and intestines.

If cytomegalovirus appeared before pregnancy, then it does not cause much harm to the woman and child.

But if the virus appeared during pregnancy, it poses a serious threat to the fetus:

The threat of termination of pregnancy;
Premature birth;
Severe malformations of the brain, eyes and other organs;
Intrauterine fetal death.

Symptoms of complications and consequences of cytomegalovirus

In a severe course of cytomegalovirus infection, various complications and consequences are possible:

Kidney damage.
With kidney damage, the following symptoms are observed:

Fever
Soreness when urinating;
Intermittent urination;
Pain from the kidneys and more.

Liver damage.
Symptoms:

There is an increase in the liver;
Nausea, vomiting;
Stool disorder, etc.

Damage to the organs of vision:

Vision problems;
Blindness.

Violations from the outside central system;
Emergence allergic rash.

The consequences of the virus are maximally dangerous for pregnant women and their children. Through the placenta, the virus enters the fetus and this threatens the death of the fetus. But if the infection occurred before pregnancy, it will not pose any risk to the fetus, since the mother has already developed protective antibodies.

Cytomegalovirus can for a long time to be in the human body, while not manifesting in any way

However, with reduced immunity, the virus immediately makes itself felt with the following consequences:

Sore throat;
Stool disorder (diarrhea, bloody stools, colon inflammation);
Disruption of the liver;
Purulent formations;
Pneumonia;
Disruption of the work of internal organs.

Compulsory treatment is necessary, since if treatment is not carried out on time, this will lead to a worsening of the patient's condition and, in the most severe case, even death.

Rare forms of CMV

There are two of the most rare forms of cytomegalovirus infection:

Generalized form of CMV. This form is rare. It is observed in persons with clearly compromised immunity due to HIV infection, radiation, immunodeficiency, and radiation sickness.
With this form, a person has damage to the kidneys, lungs, liver, intestines, retina, and brain. A rash may appear, an increase in the salivary, parotid glands is observed.
The most common manifestations of this form:

hepatitis;
pneumonia;
retinitis.

Localized form. This form is extremely rare.
It localized affects the genitourinary system:

in females it is acute, endometritis, erosion are observed;
there are erosive and ulcerative genitals.

Complications

Cytomegalovirus infection, like other diseases, has a number of complications:

The defeat of a number of organs(liver, kidney, spleen, eyes, etc.);
Fetal infection. There is a possibility of miscarriage, a threat premature birth, as well as disruption of the fetal organs;
With the longest and most severe form the disease can be fatal.

Diagnosis of cytomegalovirus

Diagnostics is aimed at identifying the virus due to which the disease is caused.

It includes the following studies:

Detection of antibodies to CMV;
DNA diagnostics;
Sowing.

When conducting correct diagnosis antibodies to the disease can be detected and the appropriate treatment can be selected

Determination of the duration of infection

To determine the age of infection, it is necessary to pass an antibody test. It is necessary to determine the avidity of antibodies.

That is, what is the strength between antibody and antigen. If the avidity of antibodies is close to 30-60%, this means the infection is fresh, the infection has occurred recently.

If 60% - the infection has already been transferred. That is, thanks to this analysis, it is possible to sufficiently determine the time and stage of the patient's infection.

Which doctors should you contact if you have cytomegalovirus infection?

Many are wondering which doctor to turn to. In the case of cytomegalovirus infection, it all depends on the course of the disease.

If CMV is in a pregnant woman, a gynecologist will take care of the treatment. In other cases, an immunologist, an infectious disease specialist, as well as other specialized specialists will help.

CMV treatment

After carrying out the correct diagnosis, it is required to start treatment. Treatment is carried out in two ways.

Medication

Treatment with medications does not strongly affect cytomegalovirus. It is necessary to combine drugs. It is necessary to use antiviral drugs: viferon, interferon, etc. And you can also use medicated tampons.

At this time, antibiotics are more often used, which have antiviral and immunostimulating effects. Complete cure can occur only if treatment is started on time.

Folk remedies

TO folk methods herbal medicine belongs, and there are also several recipes:

You need to mix a tablespoon of St. John's wort, chamomile, immortelle and birch buds. Pour boiled water on top and leave for 45 minutes. Consume a tablespoon twice a day for a month.
Pour 500 ml of boiled water over one salt spoon of echinacea. Insist for 10 hours. Take 150 ml 30 minutes before meals. Consume 2-4 weeks.
It is necessary to take a series of thyme, yarrow, birch buds in the same quantity. Grind. 2 tablespoons of the collection will require half a liter of boiling water. Pour and leave for 24 hours. Take a glass 3-4 times a day.

Prevention

Prevention is a very important element. In this case, it is especially important for pregnant women. In this regard, pregnant women need to refrain from all contact with sick people, and also avoid casual sexual intercourse.

In other cases, prevention consists in observing the norms of personal hygiene. Needed physical activity, as well as healthy image life.

The most important thing is that a person must take care of himself.

Cytomegalovirus, in Lately, has become a common disease. In many patients, the disease is not associated with visible disorders, but can be transmitted from one infected person to another sexually (through contact with the uterine lining or sperm).

Cytomegalovirus is an infection from the herpes family. The virus is not dangerous for healthy people. In general, the disease worsens with a decrease in immunity. The transition of the "dormant" stage to the active one may be associated with the formation malignant neoplasms, severe hypothermia, chronic stress, medication.

The virus damages the genital mucosa, sometimes leading to an inflammatory reaction with proliferation, exudation, and microcirculation disorders.

The disease can manifest itself with a weakening of the body, as well as with normal immunity. Symptoms of genital cytomegalovirus include: headaches and muscle pains, weakness, chills, high fever body, inflammation of the genitourinary system, erosion of the cervix, ovaries and vagina, skin rash.

Also, the disease can be associated with pain during urination, the appearance of a whitish-blue discharge.

Cytomegalovirus is necessarily determined in scrapings taken from the genitals, blood and oral mucosa. Additionally, a study is carried out for diseases transmitted through sexual contact using the PCR method. When clinical manifestations can be held additional examinations damaged organ (heart, lungs, liver, etc.).

After establishing an accurate diagnosis, the doctor prescribes treatment for the disease according to a scheme that includes drugs that increase immunity in the treatment of genital cytomegalovirus, preparations of immunoglobulins and interferon.

Treatment of a viral infection has general nature where it is necessary to strengthen the immune system for the body's resistance to the development of the disease, even when infected. Antibiotic therapy is also carried out against concomitant diseases, which allows the cytomegalovirus to become inactive.

When the infection intensifies, you cannot self-treat. You definitely need to contact a specialist to prescribe the correct treatment.

Preventive measures include the use of a condom during intercourse. To reduce the risk of congenital infection, and during pregnancy, you need to abandon casual relationships.

Photo: Cytomegalovirus in the lungs under a microscope

Cytomegalovirus is so widespread among humans that this infection can hardly be attributed to sex. Although it is transmitted precisely with close physical contact through body fluids - saliva, tears, mucus, sperm, blood. The herpesvirus family is numbered 5, the name is often shortened to CMV or CMV.

For healthy people it is completely safe - if there are manifestations, they are similar to a cold, they go away on their own without treatment and without consequences. Antibodies remain in the blood, which will now protect the body from re-infection throughout its life.

In people with poor immunity, the disease is difficult. In them, CMV is capable of causing irreversible damage to the nervous, respiratory, genitourinary and other systems. At risk are unborn or premature babies, pregnant women who have not previously encountered cytomegalovirus, patients HIV and AIDS and those undergoing immunosuppressive therapy.

Ways of transmission of cytomegalovirus

In external environment cytomegalovirus is quite stable - it can survive for hours, and even days. You can catch it with any repeated close contact with a person whose infection is in an active phase. Kisses, common towels, dishes, hygiene products are contagious.

Babies are infected from mothers through breast milk, older children - from parents in the household way and from other children during games. Adults - during sex and everyday life. Rarely - with blood transfusion, organ transplantation.
The incubation period ranges from several days to several weeks.

The course of the disease in people with normal immunity

The target of the virus is primarily the epithelial cells lining the mucous membranes. Also lives in glandular tissue, multiplying in salivary glands, prostate and pancreas. May affect nervous tissue.

The course of the disease is highly dependent on the initial state of immunity. If health is excellent, symptoms of cytomegalovirus may be completely absent. But more often the primary infection is similar to the common cold: sore throat, malaise, weakness, cough, muscle and joint pain, fever up to 38-39 degrees. The disease lasts 2-3 weeks and goes away on its own, after which the pathogen goes into a dormant state, being under the control of the immune system.

It is impossible to completely get rid of CMV. In a dormant state, he is out of reach of protective forces. But in case of reactivation of the virus or new contact with it from the outside, the body will be ready for defense immediately. The antibodies remaining in the blood serum after the first time will now cope with it so effectively that the person will not notice anything, and the fact of the disease can be established only by the test results.

Bad news for those at risk: during the reactivation period, such a person, without knowing it, is still contagious. In Russia, 60% of the population over 6 years old are carriers, and all of them are potentially dangerous to those who cannot face cytomegalovirus. Among older people, the carrier rate reaches 91%.

Cytomegalovirus in people with immunodeficiency

In all pregnant women, the body deliberately weakens the immune system - this is how it protects against the fact that the fetus can be mistaken for a foreign object. Primary infection during gestation is especially dangerous for the baby, but the mother may also have health consequences.

In some conditions, a weakening of the immune system is prescribed by doctors: autoimmune diseases, conditions after organ transplantation, chemotherapy treatment for oncological pathology.

And the infected HIV AIDS) know that they have to be afraid of any foreign microbes.

For all these people, cytomegalovirus infection is especially dangerous. Complications can be serious:

inflammation of the liver tissue (hepatitis), including fulminant, which entails a failure of organ function with rapidly progressive liver failure;
inflammation of the retina, which, if untreated, leads to blindness;
inflammation of the lining of the colon (viral colitis);
inflammation of the lungs (pneumonia);
inflammation of the lining of the esophagus (viral esophagitis);
inflammation of the white and gray matter of the brain (encephalitis) or spinal cord (myelitis), inflammation of the meninges (viral meningitis), inflammation of nerve fibers (polyneuropathy), neuritis of the auditory nerve, etc.

Without treatment, these conditions can pose a threat to life and health, become the cause irreversible processes... Antiviral drugs are used as a preventive measure in such cases. Treatment of cytomegalovirus is carried out with valganciclovir, ganciclovir, or cidofovir. It is imperative to constantly monitor the titer (amount) of antibodies and viral load. They also conduct a course of immunostimulating therapy, prescribe vitamins, immunomodulators (interferon is most often used). Even during pregnancy, the potential risk from prescribing drugs is lower than the risk associated with intrauterine infection of the baby.

Most women experience CMV for the first time before conception. If this fact is known reliably, you can not be particularly afraid of it. In the case of reactivation of the infection during gestation, the risk of its transmission from mother to child is 1%, the risk of pathologies in the fetus is 0.1%. Yes, the numbers are nonzero, but against the background of other dangers, these probabilities are not serious.

If you are planning a child, or just thinking about it, or even just one of the women of childbearing age with a constant sex life- check in advance if you have antibodies to cytomegalovirus. To do this, it is enough to pass a single analysis for latent infections. Save the result.

The most unfavorable is the primary infection of a woman during pregnancy. Then the virus is transmitted to the baby in 40% of cases, and the risk of pathologies is 9%.

On average, one child in 150 newborns is born with a congenital form of cytomegalovirus infection. 80% of these children do not have pronounced symptoms of cytomegalovirus. But the absence of symptoms does not protect against long-term consequences.

The outcome depends on the period at which the infection occurred. In the first trimester, cytomegalovirus is one of the frequent reasons frozen or undeveloped pregnancy. The reason is fetal abnormalities incompatible with life. The body itself prevents the birth of a seriously ill child. If this defense mechanism fails, possibly the birth of a child with developmental abnormalities, the severity of which can vary widely. The most serious pathologies are the absence of the brain (anencephaly), microcephaly (an abnormally small head), etc.

Congenital cytomegalovirus in children is also the cause of jaundice, skin rashes, viral pneumonia, and seizures. Possible weight loss at birth, delay intrauterine development, convulsive syndrome, blindness, deafness, mental retardation... With absence serious diseases health problems can show up at a later age. Children who have had a congenital CMV infection are more likely to have problems with coordination, learning, and lag behind their peers.

Diagnosis of cytomegalovirus

The basis for the diagnosis of cytomegalovirus is linked immunosorbent assay(IFA). The method is based on the detection of specific antibodies in the blood, which are produced by the body in response to the invasion of the pathogen. The more aggressive the disease progresses, the higher the antibody titer.

In the acute phase, an increase in antibody titer occurs due to class M immunoglobulins. The presence of anti-CMV-IgM in the blood serum indicates that the virus is in the active phase. They remain in the body from 1 to 3 months after the cure.

In chronic infection, the titer of antibodies to cytomegalovirus class G - anti-CMV-IgG increases.

Doctors recommend testing immediately if symptoms of ARVI occur in women in a position. In the presence of a high titer of immunoglobulins M, prophylactic treatment is carried out with the help of antiviral drugs. This strategy allows you to prevent severe complications at the fetus.

Above, we described why it is so important to establish whether the primary infection occurred during pregnancy or before it. Not everyone takes an analysis for latent infections in advance. Bearing lasts 9 months, while immunoglobulins of class M are present in the blood for a short time. In such cases, an ELISA test for IgG avidity to cytomegalovirus is performed. The method allows to clarify the timing of infection and the activity of the virus. Its principle is based on the indicators of the "strength" of antibodies. The longer the microbe is present in the body, the more the immune system has the ability to resist the disease. Over time, antibodies improve their ability to bind the pathogen. Conversely, new, still "green" antibodies are not very effective in fighting the virus.

Avidity is displayed as the percentage of highly avidity antibodies to CMV. The higher the%, the longer the penetration of the microbe took place. High avidity (more than 85-90%) eliminates primary infection over the past 3 months.

A more accurate but more expensive method for diagnosing CMV using PCR (polymerase chain reaction, PCR) is also used. Suitable for research are saliva, secreted from the genitals, lavage from the bronchi, cerebrospinal fluid, blood serum. Cervical mucus is taken from pregnant women. The method is based on the determination of the pathogen's genetic information in samples. The sequence of genes in each bacterium or virus is unique, like the pattern of the retina. In the presence of genetic information characteristic of the pathogen, the method allows you to determine the fact of infection ( qualitative analysis), approximate quantity the pathogen in the body and the degree of its activity / replication (viral load, quantitative analysis).

Prevention of cytomegalovirus

Prevention is relevant only to people with immunodeficiencies and pregnant women without class G antibodies. They will have to:

Observe hygiene especially carefully. For example, washing your hands not as usual, but very carefully, closing the tap through a napkin and grabbing the handle in in public places gloved.
Avoid contact with children. They are infectious in the first place.
Refuse intimacy and even kissing if the partner is immune to CMV. At any moment, he may have a reactivation of the virus, and then he will become infectious.

Cytomegalovirus infection (cytomegalovirus) - diagnosis, treatment

Cytomegalovirus was first discovered in 1956 in a study of newborns who died from a common infection. In its structure, cytomegalovirus is similar to the herpes simplex virus and chickenpox. Under its action, normal cells of the human body turn into gigantic ones.

Transmission routes

The source of infection is a person, the location of the virus is saliva, blood, breast milk, semen, and discharge from the cervix and vagina. Infection can occur: by contact by using contaminated objects, by blood transfusion and organ transplant from an infected donor, by airborne droplets, by sexual contact, intrauterinely during pregnancy and during childbirth.

Manifestations of infection

Cytomegalovirus can be in the human body for a long time in the form of a latent infection and manifests itself, as a rule, against the background of some other disease that sharply reduces immunity. The cytomegalovirus "dormant" in the body is activated against the background of influenza, acute respiratory infections, stress, pregnancy, chronic diseases... The vast majority of people get sick with cytomegalovirus infection like a common cold. Many do not even know that they are infected, and do not know that they pose a danger to others through various contacts. Against the background of a sharp decrease in immunity, the central nervous system (encephalitis), kidneys (nephritis), lungs (pneumonia), heart (myocarditis), spleen, liver, intestines are affected.

In women, the virus can cause cervicitis, cervical erosion, ovarian inflammation, fallopian tubes... These diseases proceed without pronounced manifestations, chronically, occasionally disturbed by pain in the genital area.

The course of cytomegalovirus infection during pregnancy

The insidiousness of cytomegalovirus infection lies in its asymptomatic course in most pregnant women. The virus has a high ability to penetrate from woman to fetus and ranks first among infections for intrauterine infection of the fetus. The infection rate in women of childbearing age is currently about 80%. For this reason, cytomegalovirus infection is included in the group of diseases (along with toxoplasmosis, rubella and herpes), for the presence of which it is better for a woman to be examined before conception.

There are three ways the virus is transmitted to the fetus:

1. During conception, infection with a virus from semen is possible.
2. The virus can penetrate from the mucous membrane of the uterus or from the cervical canal through the fetal membranes and infect amniotic fluid and then the fruit.
3. The virus can enter the fetus through the placenta.

The penetration of cytomegalovirus into the fetus can lead to:

* Development of intrauterine asymptomatic infection without consequences for the health of the child.
* Development of a severe infection with intrauterine fetal death (miscarriage, spontaneous abortion, birth control).
* The birth of a child with congenital cytomegalovirus infection, which immediately manifests itself as malformations.
* The birth of a child with congenital cytomegalovirus infection, which does not appear immediately, but at 2-5 years of age (blindness, deafness, mental retardation, speech inhibition, psychomotor disorders).

If a congenital infection is detected in a newborn with the help of laboratory methods, this does not necessarily mean that he is developing a disease. On the other hand, this does not exclude the possibility of developing late manifestations of the disease. Therefore, such children should be under dispensary supervision for the purpose of timely initiation of treatment with late development of symptoms of the disease.

The risk of transmission of cytomegalovirus depends primarily on its concentration in the mother's blood. With a primary infection, the risk of transmitting the virus to the child is higher than with an exacerbation of the old one.

Therefore, a married couple planning a child should be examined before pregnancy, and not during it. Remove the virus from the body modern medicine cannot, but it is possible to maintain antiviral immunity at the proper level. To do this, it is necessary to determine the antiviral immunity - antibodies to the herpes virus and cytomegaly. If there are no deviations from the norm in the indicators (otherwise a doctor's consultation is needed), it is possible to maintain immunity in a decent condition with the help of good nutrition, reasonable physical activity, good night etc., that is, through a healthy lifestyle

Diagnostics

The presence of cytomegalovirus can only be detected when special study saliva, urine, blood, semen, smears and scrapings taken from the genitals, especially during the initial infection or exacerbation of the disease. In the intervals between exacerbations, a blood test can detect antibodies to cytomegalovirus.

Laboratory diagnosis of congenital cytomegalovirus infection carried out by detecting antibodies in the umbilical cord blood and the virus itself in urine, saliva, blood in the first days of a child's life.

Treatment

Specific antiviral drugs, such as virazole, acyclovir, have no effect, so treatment is aimed at enhancing immunity. They use drugs Decaris, T-activin, Reaferon, etc. It is possible to use the immune gamma-globulin "Cytotex" made in Germany.

During pregnancy, timely detection of an exacerbation of the disease and proper treatment are necessary. In severe cases, termination of pregnancy is recommended. In this case, they are based on clinical indications, data of virological research and ultrasound of the fetus and placenta.