Whether a person is a carrier of cytomegalovirus can only be determined with certainty based on the results of laboratory tests.
A disease, if we can talk about a condition when a person is practically healthy and at the same time infected with a rather dangerous virus, most often occurs asymptomatically, without causing any inconvenience to the person.
Unfortunately, the virus does not always behave correctly - for those who for some reason have problems with immune defense, it prepares additional troubles, this time “on its own behalf.”
If a person is preparing for a major operation or a woman is expecting a child, such a “time bomb” can be very dangerous for them.
We wrote about what cytomegalovirus infection or simply cytomegalovirus is in this article. You can learn about the symptoms and treatment methods for cytomegalovirus.
Laboratory studies provide an answer not only to the question of the presence of the virus in the body, but also to its activity. This helps the doctor to objectively assess the situation, predict its possible development and, if necessary, begin treatment for CMV infection.
That's who tests for the presence of cytomegalovirus it is necessary to do:
- pregnant women;
- HIV-infected;
- people who have undergone transplant surgery;
- cancer patients.
All representatives of these categories have weakened immunity. If the virus becomes active, it will worsen the condition of patients, and in a pregnant woman it will jeopardize not only her own health, but also the future of the baby.
Diagnosis of cytomegalovirus
The main thing in diagnosing CMV infection is laboratory tests: a blood test is done, the virus is looked for in the urine, in a smear, in a scraping. Referrals for tests are usually given by a urologist and gynecologist.
Patients are warned: a man who is going to donate urine should not go to the toilet for several hours beforehand; a woman can donate blood for analysis on any days except “critical” days.
Diagnosis of cytomegalovirus is carried out using a number of methods, including immunological, virological and others.
Immunological
This method is called ELISA, which means - enzyme immunoassay. Samples taken for research are examined under a microscope. With its help, traces of cytomegalovirus (if any) are detected visually.
To accurately characterize the virus in enzyme immunoassays, an indicator such as the “positivity rate” is used.
The method is considered quite effective for determining which immunoglobulin is detected in samples and how active it is.
Molecular Biology
The purpose of studying the samples is to search for the causative agent of the virus. As part of the study, so-called PCR diagnostics are carried out (the term stands for “polymerase chain reaction”).
The DNA contained inside the virus is studied in samples taken for analysis. In this way, the researcher obtains PCR of saliva, blood, urine, and sputum.
Experts consider molecular biological techniques to be the most accurate. Their results can be obtained several days after samples are taken for analysis, even if the virus is not active at that moment.
The disadvantage of PCR is the inability to determine whether the infection is primary or a relapse in the acute stage.
By the way, PCR diagnostics of cancer patients (or rather, cancer DNA analysis) revealed connections with the Epstein-Barr virus (human herpes virus type 4). We wrote about what it is and how the Epstein-Barr virus is transmitted in the article.
Laboratory monitoring of the dynamics of ongoing processes will help doctors select the most effective treatment for this dangerous disease.
Cytological
This method is good if the analysis result needs to be obtained very quickly. He does not give explanations about any nuances, but only states: yes, there is a virus, or no, the body is not infected.
There are situations when such information is enough for the doctor to help the patient. As a study material take saliva and urine.
Samples are examined under a microscope to detect “giant cells” characteristic of CMV infection.
Virological
Detecting a virus using this technique is a rather lengthy process. The biomaterial taken for analysis is placed in a special environment in which microorganisms develop more actively than in natural conditions, after which they are identified - whether they are the desired virus or not.
Positive igg antibodies detected - what does this mean?
Antibodies that may or may not be detected in laboratory tests are immunoglobulins, a special type of protein. They are usually designated by the Latin letters Ig.
The abbreviation igg refers to antibodies that are regularly renewed (cloned) in the body, starting from the moment they appear (they are also called anti cmv igg).
This provides protection against a particular virus throughout a person's life, provided that it is not weakened by any external or internal circumstances.
A positive igg means that the person is a carrier of cytomegalovirus and he himself has normal immunity to this disease, a negative result indicates that there is no CMV infection in the patient’s body.
Types of immunoglobulins (IgA, IgM, IgG, IgD, IgE)
Immunoglobulins are represented by five classes. For CMVI, class g and class m are especially important. There are also classes a, e, d. They are distinguished by their structure, mass, and method of binding to antigens.
Based on their presence in the human body, the researcher can draw conclusions about what stage of development the disease is in, what its dynamics are and possible risks. The more complete the picture, the easier it is to choose the right treatment option.
After the body is infected (after 1-2 weeks), protection against the virus begins to form. IgM appears first, they perform their function for 8-20 weeks.
Once again they can appear during reactivation, after the virus has been in the body for a long time. True, in this case there are significantly fewer of them than during the primary infection.
IgG follows IgM, that is, they appear only 1 month after infection with the virus occurs, but they remain in the body throughout its life and help the human immune system quickly cope with the virus as soon as it begins to “raise its head.”
Having discovered a particular class of immunoglobulin in the samples being studied, a specialist can draw conclusions about whether the infection is primary, how long ago the infection entered the body and whether the defense built against it is reliable.
Laboratory examination reveals the presence of a process such as “antigen-antibody” in the studied samples. Its essence is that, in contrast to the virus (experts call it “antigen”) protection is formed in the form of immunoglobulin (“antibody”).
A kind of connection is formed in which ig tries to defeat the virus and deprive it of activity.
In the course of research, it is important to establish how strong this ligament is, what, as experts say, is the “avidity index” (avidity in Latin means “appropriation”).
This helps to get answers to important questions:
- when did the infection occur?
- whether the concentration of the virus in the body is high.
The researcher detects both high-avidity and low-avidity antibodies. Zero avidity index means that the body is not infected with CMV.
If it is below 50 percent This means that primary infection with the virus has occurred.
The rate is from 50 to 60 percent indicates the uncertainty of the result, which means that after 3-4 weeks the study needs to be repeated.
The number 60 indicates that the disease is chronic, but the body copes with it thanks to the developed immunity.
Normal blood levels
How to identify an infection and understand how dangerous it is for the body? With the help of analyses. The virus can be detected in the patient's urine, saliva, and blood.
The more data a doctor has, the easier it is for him to select appropriate therapy.
General values
In blood test such an indicator as “titles” is important(this is the designation for the highest serum dilution at which a positive reaction to the presence of immunoglobulin is noted).
If the indicator is less than 0.5 lgM, it means that the patient’s body is not infected with cytomegalovirus. Elevated titers (from 0.5 lgM or more) confirm the presence of the virus in the patient’s blood.
In children
Deciphering a blood test for antibodies in each age category gives its own results. In children, the IgM norm is 0.7 - 1.5 (for comparison: in men - from 0.5 to 2.5, in women - from 0.7 to 2.9).
The IgG norm in young patients is from 7.0 to 13.0 (for comparison: in adults – from 7.0 to 16.0).
There are methods that, based on the results of a blood test, help to draw conclusions that the child:
- absolutely healthy, not infected;
- received the virus while in the womb;
- the virus is activated, the risk to the baby’s health is high;
- the body is infected, the risk to health is minimal.
Laboratory blood tests for expectant mothers are mandatory(by the way, not only about CMV infection).
They help determine the infection of the woman herself and her fetus. The first 12 weeks are especially important in this regard.
If the test results cause concern to the doctor, he selects the safest but most effective treatment method for the woman.
In people with immunodeficiency
Determining the presence of positive IgG in the tests of a patient with immunodeficiency requires the doctor to take emergency measures, otherwise the patient may develop pneumonia, hepatitis, various inflammations of the digestive and nervous system, and eye diseases in addition to the underlying disease.
The presence or absence of two classes of Ig (IgM and IgG) in the body helps the specialist draw a picture of the processes occurring with great accuracy:
What to do?
Opponents and supporters of treatment for CMV infection, when the infection is in a “preserved” state, have their own reasons and arguments.
However, all experts agree on one thing: There are categories of people for whom treatment should be mandatory. This:
- patients diagnosed with HIV;
- patients who have undergone organ transplantation;
- patients receiving chemotherapy sessions.
Pregnant women are sometimes included in this list, but each case is considered individually.
Patients are wondering if antibodies are detected with cytomegalovirus igg, what does this mean? Nowadays, there are a number of diseases that do not manifest themselves in any way, and their presence in the body is detected only using laboratory methods, sometimes completely by accident. One such infection is cytomegalovirus. What does it mean if cytomegalovirus iG antibodies are detected?
What are antibodies to cytomegalovirus?
Testing for IgG antibodies to cytomegalovirus allows one to detect the presence of this infection.
Cytomegalovirus (abbreviated CMV) is a member of the herpesvirus family that causes cytomegaly in humans. Cytomegaly is a viral disease that is transmitted from person to person. It is characterized by the fact that the virus attaches to healthy cells of human tissues, changes their internal structure, and as a result, huge cells, the so-called cytomegales, are formed in the tissues.
This virus has the peculiarity of living in the human body for many years and not showing itself in any way. When the immune balance in the body is disrupted, the virus is activated, and the disease begins to progress very quickly. As a rule, cytomegalovirus is localized in the salivary glands, since its structure is close to this type of tissue.
in the human body are excreted independently. According to official data, antibodies to this virus are found in adolescent children in 10–15% of cases, and in adults in 40%.
Cytomegalovirus is spread:
- by airborne droplets, for example, through saliva;
- transplacental, i.e. from mother to fetus through the placenta, as well as during the passage of the child through the birth canal;
- nutritional, i.e. through the mouth when eating or drinking, as well as through dirty hands;
- sexually - in contact, for example, with the mucous membrane of the vagina, contact of mucous membranes with sperm;
- during blood transfusion;
- during lactation through mother's milk.
The incubation period of CMV lasts from 20 to 60 days, the acute period of the disease passes within 2–6 weeks. In the acute phase of the disease, a person experiences the following manifestations:
After the acute stage of the disease has passed, the immune system is activated and antibodies are produced. If the immune system is weak due to previous diseases and poor lifestyle, the disease enters the chronic stage and affects the tissues, and often the internal organs of a person.
For example, CMV provokes the development of wet macular degeneration, i.e., a disease of the eye cells responsible for transmitting nerve impulses from the organ of vision to the brain.
The disease manifests itself as:
- ARVI, in some cases pneumonia;
- generalized form, namely, damage to internal organs, for example, inflammation of the liver, pancreas and other glands, as well as tissues of the intestinal walls;
- problems with the organs of the genitourinary system, manifested in the form of recurrent inflammation.
You need to be especially concerned if a pregnant woman becomes infected with cytomegalovirus. In this case, fetal pathology develops when viruses in the mother’s blood are transmitted to him through the placenta. Pregnancy ends in miscarriage, or the child’s brain is damaged, as a result of which he suffers from diseases of both a physical and mental nature.
It is necessary to pay great attention to the diagnosis of the disease in utero form. It is especially important to establish how the pregnant woman became infected. If the body has already suffered from a disease before conception, and re-infection occurs during pregnancy, this fact means a higher chance of having a healthy baby. Cytomegalovirus provokes diseases that have a high risk of severe complications for life.
How is the disease diagnosed? The methods used in diagnosing CMV are as follows:
- immunofluorescence method, which allows to detect the virus in biological fluids of the body;
- chemiluminescence immunoassay (CHLA) method, based on an immunoassay;
- polymerase chain reaction (PCR) is a molecular biology method that allows you to detect viral DNA in human biological fluids;
- cell culture seeding;
- enzyme-linked immunosorbent assay (ELISA), which determines whether there are antibodies to CMV in the blood.
What does it mean if Anti-CMV IgG is detected?
The listed types of tests are aimed at identifying specific antibodies called immunoglobulins. This in turn makes it possible to determine at what stage of development the disease is. The most effective and frequently used of them are ELISA and CLLA tests.
There are 2 classes of immunoglobulins that appear in CMV. The analysis reveals their quantitative indicator, which goes beyond the reference values, i.e., exceeds the norm.
Immunoglobulins M, which quickly respond to viral infections. These antibodies have the international abbreviation ANTI-CMV IgM, which stands for antibodies generated against class M cytomegalovirus.
These antibodies do not form immune memory and are destroyed in the body within six months.
With an increased amount of cytomegalovirus IgM, the acute stage of the disease is diagnosed.
Immunoglobulins G, which are formed throughout life and are activated after the infection is suppressed. ANTI-CMV IgG is the abbreviated name for these antibodies, according to the international classification, which means class G antibodies. IgG antibodies to cytomegalovirus indicate that the virus is developing in the body. Laboratory tests can determine the approximate time of infection. This is indicated by an indicator called titer. For example, a titer of cytomegalovirus igg 250 indicates that the infection has entered the body over several months. The lower the indicator, the longer the duration of infection.
When assessing the likelihood of infection, an analysis of the ratio of antibodies of the IgG class and the IgM class is used. The interpretation of the relationship is:
It is especially important to conduct these studies in women of reproductive age. If a positive result for cytomegalovirus IgG is obtained with a negative IgM before conception, this means that during pregnancy there will be no primary infection (the most dangerous for the fetus).
If IgM is positive, pregnancy should be postponed and consult with your doctor. And if the result for cytomegalovirus IgG and IgM is negative, then there is no virus in the body, and there is a possibility of primary infection.
What should I do if I test positive for IgG antibodies?
Treatment for CMV is usually aimed at strengthening the immune system in order to bring the cytomegalovirus into a latent form that can be controlled by the human immune system.
Therapy is also based on taking antiviral drugs with antiherpes action. Concomitant diseases that develop along with CMV are treated with antibiotics.
To prevent CMV, a special vaccine has been developed, aimed primarily at protecting pregnant women. According to studies, the vaccine currently has an effectiveness rate of approximately 50%.
The results revealing a positive cytomegalovirus iGG should not be taken as a death sentence. The CMV virus is present in the body of the vast majority of people. Timely analysis, prevention and adequate treatment can minimize the risks of the disease provoked by this infection.
One of the most common viral diseases today is cytomegalovirus. About 90% of the population is infected with it. It belongs to the herpesvirus family. This disease is mostly latent, but under certain conditions it can be fatal.
Typically, a person becomes infected with cytomegalovirus before the age of 12. The disease is hidden and he does not even realize that he has it. However, with a significant decrease in immunity, it can become more active and affect various organs and cause severe complications, including death.
The danger exists for people who have suffered. A person with immunodeficiency or HIV falls into the risk group.
But cytomegalovirus is especially dangerous during pregnancy. During pregnancy, immunity decreases, so the disease may become more active. But the most dangerous thing is primary infection.
In this case, there is a high probability of infection of the fetus, which can lead to its pathologies and even death. The severity of the consequences depends on the period at which it happened.
A child can become infected during childbirth and breastfeeding. However, if it is full-term, then this usually does not lead to any consequences. A large percentage of children become infected with cytomegalovirus in the first six months of life.
Today it is mainly diagnosed by PCR. In the first case, the presence, that is, the reaction of the body’s immune system to an infection, is determined. If a person is positive for cytomegalovirus IgG, then more than 3 weeks have passed since the initial infection. If the IgG titer exceeds the norm by more than 4 times, this may indicate activation of the virus.
This, as well as primary infection, is indicated by an increased amount. The concentration of these two immunoglobulins is usually checked. Then the results can be interpreted as follows:
- IgG (+), IgM (-) - the virus is dormant;
- IgG (+), IgM (+) - activation of the virus, or recent infection;
- IgG (-), IgM (+) - recent infection (less than 3 weeks);
- IgG (-), IgM (-) - no infection.
Cytomegalovirus IgG norm (in IU/ml):
- more than 1.1 - positive;
- less than 0.9 - negative.
The PCR method allows you to detect the virus in saliva, semen, urine, vaginal and cervical discharge. Its appearance in these fluids indicates primary infection or activation of the virus. PCR is a very highly sensitive method; it allows you to detect even one DNA in a preparation.
Cytomegalovirus belongs to the group of TORCH infections. It also includes herpes, toxoplasmosis, rubella, and recently chlamydia has been added to it. What they have in common is that they are very dangerous for the fetus. They can lead to serious pathologies and even death.
Therefore, all women wishing to become pregnant are recommended to take a TORCH test. If cytomegalovirus IgG is positive before conception with negative IgM, this is good, since it excludes primary infection during pregnancy.
If IgM is positive, then pregnancy should be postponed until the titer normalizes. In this case, you need to consult a doctor, perhaps he will prescribe treatment.
Women who are negative for cytomegalovirus IgG and IgM need to be extremely careful not to become infected. They should wash their hands well, not have contact with children (especially not kiss them); if the husband is infected, then avoid kissing him.
Cytomegalovirus is transmitted through sexual contact, airborne transmission and household contact. Infection occurs through contact with liquids (urine, saliva, semen, secretions) that contain it.
Cytomegalovirus IgG is positive in 90% of the population. Therefore, when an adult receives such a result, this is the norm rather than the exception.
The largest number of people become infected at the age of 5-6 years. After infection, children can shed the virus for a long time, so it is better for pregnant women without immunity to it not to contact them.
Thus, cytomegalovirus IgG is positive in almost all adults. It is desirable for women who want to conceive a baby in the near future to have this result. The probability of developing serious pathologies in the fetus if the mother is infected during pregnancy is 9%, and if the virus is activated - only 0.1%.
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.
The symptoms are very similar to acute respiratory infections or acute respiratory viral infections. The body temperature rises, the head hurts severely, and general discomfort occurs. An untreated virus can result in inflammation of the lungs and joints, brain damage or other dangerous diseases. The infection remains in the body throughout a person’s life.
The year the virus was discovered is 1956. It is still being actively studied, its action and manifestations. Every year brings new knowledge.
The contagiousness of the virus is low.
Routes of transmission: sexual, household contact (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 increased body temperature, feelings of chills, fatigue and general malaise, and severe pain in the head. Mononucleosis-like syndrome has a happy ending - recovery.
There is a particular danger for two categories of people - those with weak immunity and infants infected in utero from a sick mother.
An increase in the titer of antibodies in the blood to cytomegalovirus by four times or even more indicates activation of cytomegalovirus.
What does cytomegalovirus IgG positive mean?
If the analysis for the determination of IgG antibodies to cytomegalovirus infection is positive, what conclusion is drawn?
The human immune system successfully coped with cytomegalovirus infection about a month ago, or even more.
This organism has developed a lifelong, stable immunity. About 90% of people are carriers, so there is no norm of 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 to be the presence of a virus in a PCR analysis, when material containing certain DNA is examined.
From the tenth to 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 may be the mother's 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 herpes infection. And it happens often too.
Even if the infection occurred in early childhood, but a person has good strong 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:
- those 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 severely weakened immune system, or, for example, in patients with AIDS.
Infection is most often diagnosed using ELISA (enzyme-linked immunosorbent assay). This method can determine not only the presence of cytomegalovirus infection in the child’s body. But it’s also possible to say for sure whether it is congenital or acquired.
For newborns, cytomegalovirus is infectious mononucleosis. The lymphatic system is affected - the lymph nodes become enlarged, the tonsils become inflamed, the liver and spleen become enlarged, and it becomes difficult to breathe.
In addition, congenital infection is characterized by:
- prematurity;
- squint;
- jaundice of newborns;
- disorders of swallowing and sucking reflexes.
Poor nasal breathing can cause the following symptoms:
- loss of appetite and weight loss;
- sleep disorders;
- crying and worrying.
Congenital infection of a child most often occurs in utero. But sometimes through the mother's birth canal or breast milk during feeding.
Most often, a very dangerous asymptomatic course of cytomegalovirus infection is observed. Even two months after being born into this world.
For such children, complications are possible:
- 20% of children with asymptomatic, actively occurring cytomegalovirus after months are characterized by the presence of severe convulsions, abnormal movements of the limbs, changes in the bones (for example, in the skull), and insufficient body weight;
- after five years, 50% have speech impairment, intellect suffers, the cardiovascular system is affected and vision is severely affected.
If a child becomes 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, it is asymptomatic or reminiscent of classic childhood ARVI.
Characterized by:
- lethargy and drowsiness;
- cervical lymphadenitis;
- pain in the musculoskeletal system (muscles and joints);
- chills and low-grade fever.
This lasts two weeks – two months. Ends with 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 this is asymptomatic, but sometimes symptoms are present. A weak immune system contributes to the active manifestation of the disease.
Unfortunately, cytomegalovirus infection affects women at any age. Provoking factors are cancer, HIV infection or AIDS, and gastrointestinal pathologies. Another similar effect is observed from taking antitumor drugs and antidepressants.
In its 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 already said, this clinical picture is similar to infectious mononucleosis. It is characterized by headache, general poor health, hepatomegaly, and atypical mononuclear cells in the blood.
Immunodeficiency (for example, HIV infection) causes a severe, generalized form of cytomegalovirus infection. Internal organs, blood vessels, nerves and salivary glands are affected. Cytomegalovirus hepatitis, pneumonia, retinitis and sialadenitis occur.
Nine out of ten women with AIDS have cytomegalovirus infection. They are characterized by bilateral pneumonia and encephalitis.
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 MPS organs.
Cytomegalovirus during pregnancy
An infection that comes from a person who has an acute form of the disease is the worst option for pregnant women.
There are still no antibodies in the pregnant woman's blood.
The active virus of an infecting person passes through all barriers without difficulty and has a detrimental effect on the child. According to statistics, this happens in half of infections.
If factors that weaken the immune system aggravate latent virus carriage, 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 leads to polyhydramnios or premature birth (“congenital cytomegaly”). 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 careful about their health. Cytomegalovirus is very dangerous for the fetus.
Cytomegalovirus IgM positive
IgM is the first protective barrier against all kinds of viruses. They do not have a specification, but they are produced urgently, as a response to the penetration of cytomegalovirus infection into the body.
An IgM test is carried out to determine:
- primary infection by the virus (maximum antibody titer);
- stages of aggravated cytomegalovirus (the number of the virus is growing and the number of IgM is growing);
- reinfection (a new strain of cytomegalovirus has caused infection).
Later, from IgM, specific antibodies, IgG, are formed. If the strength of the immune system does not decrease, then IgG will fight cytomegalovirus all their lives. The IgG antibody titer is highly specific. From it you can determine the specification of the virus. Despite the fact that an IgM test shows the presence of any virus in the material being tested.
The number of cytomegalovirus is subject to control by immunoglobulin G, preventing the development of a picture of an acute disease.
If the results are “IgM positive” and “IgG negative”, this indicates an acute recent infection and the absence 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 cannot cope, and nonspecific IgM appears.
The presence of positive IgG and negative IgM is the best test result for a pregnant woman. She has specific immunity, which means the child will not get sick.
If the situation is the opposite, with positive IgM and negative IgG, then this is also not scary. This indicates a secondary infection that is being fought in the body, which means there should be no complications.
It’s worse if there are no antibodies at all, of both classes. This indicates 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 can cope with cytomegalovirus infection on his own. You may 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 treatment if they have specific IgG antibodies in their blood.
With a positive test for IgM, to transfer the acute condition into a latent course of the disease. You must always remember that medications 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. It is necessary to take into account other test results. It is especially necessary to monitor the presence of antibodies in the body for pregnant and immunodeficient people.
Antibodies to cytomegalovirus IgG, CMV IgG quantitative- allows you to determine the presence of IgG antibodies to cytomegalovirus (CMV or CMV), which indicates a current or recent infection.
The duration of the incubation period ranges from 15 days to 3 months. With this infection, non-sterile immunity occurs (that is, complete elimination of the virus is not observed). Immunity to cytomegalovirus infection (CMVI) is unstable and slow. Reinfection with an exogenous virus or reactivation of a latent infection is possible. Due to long-term persistence in the body, the virus affects all parts of the patient’s immune system. When a person comes into contact with CMV, his immune system exhibits a protective response by producing IgM and IgG antibodies against CMV.
IgG antibodies to cytomegalovirus are specific immunoglobulins that are produced in the human body during the period of pronounced clinical manifestations of cytomegalovirus infection and indicate current or recent infection.
Cytomegalovirus infection is a widespread viral infection of the body, which belongs to the so-called opportunistic infections, which usually occur latently. Clinical manifestations are observed against the background of physiological immunodeficiency states (children in the first 3–5 years of life, pregnant women - more often in the 2nd and 3rd trimester), as well as in persons with congenital or acquired immunodeficiencies (HIV infection, use of immunosuppressants, oncohematological diseases, radiation, diabetes etc.).
Cytomegalovirus- is part of the herpes virus family. Like other representatives of this group, it can persist in a person throughout his life. The risk group includes children 5–6 years old, adults 16–30 years old, as well as people who practice anal sex. Children are susceptible to airborne transmission from parents and other children with latent forms of infection. For adults, sexual transmission is more common. The virus is found in semen and other body fluids. Vertical transmission of infection (from mother to fetus) occurs transplacentally and during childbirth.
In healthy people with normal immunity, the primary infection occurs without complications (and is often asymptomatic). In rare cases, a picture of infectious mononucleosis develops (about 10% of all cases of infectious mononucleosis), clinically indistinguishable from mononucleosis caused by the Epstein-Barr virus. Replication of the virus occurs in the tissues of the reticuloendothelial system, epithelium of the urogenital tract, liver, mucous membrane of the respiratory tract and digestive tract. When immunity is reduced after organ transplantation, immunosuppressive therapy, HIV infection, as well as in newborns, CMV poses a serious threat, since the disease can affect any organ. The development of hepatitis, pneumonia, esophagitis, gastritis, colitis, retinitis, diffuse encephalopathy, fever, leukopenia is possible. The disease can be fatal.
Cytomegalovirus in immunodeficiency states
Cytomegalovirus is dangerous in cases of immunodeficiency and during pregnancy is potentially dangerous for the development of the fetus. Therefore, 5-6 months before a planned pregnancy, it is necessary to undergo a TORCH examination in order to assess the state of immunity in relation to these viruses, if necessary, carry out treatment, or provide prevention and control.
When a pregnant woman is initially infected with cytomegalovirus (in 35–50% of cases) or the infection is reactivated during pregnancy (in 8–10% of cases), an intrauterine infection develops. Confirming or excluding the fact of recent infection is especially important when examining pregnant women, since it is with primary infection during pregnancy that the risk of vertical transmission of infection and the development of fetal pathology is high.
If an intrauterine infection develops before 10 weeks, there is a risk of developmental defects and possible spontaneous termination of pregnancy. When infected at 11–28 weeks, intrauterine growth retardation and hypo- or dysplasia of internal organs occur. If infection occurs at a later date, the lesion may be generalized, affecting a specific organ (for example, fetal hepatitis) or appear after birth (hypertensive-hydrocephalic syndrome, hearing impairment, interstitial pneumonia, etc.). Manifestations of infection also depend on maternal immunity, virulence and localization of the virus.
To date, a vaccine against cytomegalovirus has not been developed. Drug therapy allows you to increase the period of remission and influence the recurrence of infection, but does not eliminate the virus from the body.
It is impossible to completely cure this disease: cytomegalovirus cannot be removed from the body. But if you promptly, at the slightest suspicion of infection with this virus, consult a doctor and carry out the necessary tests, then you can keep the infection in a “dormant” state for many years. This will ensure a normal pregnancy and the birth of a healthy child.
Laboratory diagnosis of cytomegalovirus infection is of particular importance in the following categories of subjects:
Women preparing for pregnancy
1. Latent course of the disease
2. Difficulty in differential diagnosis of primary infection and recurrent infection during examination during pregnancy
3. Severe consequences of intrauterine infection in newborns
Pregnant women
1. Severe consequences of intrauterine infection in newborns
2. Immunodeficiency states (generalized forms)
Consecutive repeated determination of the level of IgG antibodies in newborns makes it possible to distinguish congenital infection (constant level) from neonatal infection (increasing titers). If the titer of IgG antibodies does not increase during repeated (after two weeks) analysis, then there is no reason for alarm; if the titer of IgG increases, the issue of abortion should be considered.
CMV and TORCH
CMV infection is part of the group of TORCH infections (the name is formed by the initial letters in the Latin names - Toxoplasma, Rubella, Cytomegalovirus, Herpes), which are considered potentially dangerous for the development of a child. Ideally, a woman should consult a doctor and undergo laboratory testing for TORCH infection 2–3 months before the planned pregnancy, since in this case it will be possible to take appropriate therapeutic or preventive measures, and also, if necessary, compare the results of studies before pregnancy in the future with the results of examinations during pregnancy.
Indications:
- preparation for pregnancy;
- signs of intrauterine infection, feto-placental insufficiency;
- state of immunosuppression due to HIV infection, neoplastic diseases, taking cytostatic drugs, etc.;
- clinical picture of infectious mononucleosis in the absence of infection caused by the Epstein-Barr virus;
- hepato-splenomegaly of unknown nature;
- fever of unknown etiology;
- increased levels of liver transaminases, gamma-GT, alkaline phosphatase in the absence of markers of viral hepatitis;
- atypical course of pneumonia in children;
- miscarriage (frozen pregnancy, recurrent miscarriages).
It is recommended to donate blood in the morning, between 8 am and 12 pm. Blood is drawn on an empty stomach, after 4–6 hours of fasting. It is allowed to drink water without gas and sugar. On the eve of the examination, food overload should be avoided.
Interpretation of results
Units of measurement: UE*
A positive result will be accompanied by an additional comment indicating the sample positivity rate (SP*):
- CP >= 11.0 - positive;
- KP<= 9,0 - отрицательно;
- CP 9.0–11.0 - doubtful.
- CMV infection;
- intrauterine infection is possible, the likelihood of its occurrence is unknown.
- No CMV infection was detected;
- infection occurred within the previous 3–4 weeks;
- intrauterine infection is impossible (except in the presence of IgM).
*Positivity rate (PR) is the ratio of the optical density of the patient's sample to the threshold value. CP - positivity coefficient, is a universal indicator used in enzyme immunoassays. CP characterizes the degree of positivity of the test sample and can be useful to the doctor for the correct interpretation of the result. Since the positivity rate does not linearly correlate with the concentration of antibodies in the sample, it is not recommended to use CP for dynamic monitoring of patients, including monitoring the effectiveness of treatment.
