Cytomegalovirus IgG antibodies found what it means? What does anti-cmv-igg mean and what to do if the antibodies to the cytomegalovirus showed a positive result of cytomegalovirus is treated or not.
Modern statistics says that for 1 year of life, every fifth child is infected with cytomegalovirus infection. Among the ways of infection, the most dangerous is intrauterine infection. Thus infects from 5 to 7 percent of children. About 30 percent of cases of virus transmission to the child occurs during feeding with maternal milk. The rest of the children are infected with infection in children's teams. In adolescence, the virus is found in 15 percent of children. At the age of 35 years, more than 40 percent of the population faces the disease, and 99 percent of people are infected with the virus to 50 years of life.
In the United States of America, congenital infection is diagnosed in 3 percent of all newborns, of which 80 percent observed clinical manifestations in the form of various pathologies. Mortality for congenital cytomegalovirus with complications at the time of birth is 20 percent, which ranges from 8,000 to 10,000 children annually. In the absence of complications at the time of birth, 15 percent of children infected during the period of intrauterocal development of children subsequently develop various diseases in terms of gravity. From 3 to 5 percent of children around the world are infected with infection in the first 7 days of life.
About 2 percent of women are among pregnant primary infection. The probability of transmitting the virus at the time of having a child during primary infection is from 30 to 50 percent. Such children are born with the following deviations - neurosensory disorders - from 5 to 13 percent; Guide in mental development - up to 13 percent; Two-sided hearing loss - up to 8 percent.
Interesting facts about cytomegalovirus infection
One of the names of the cytomegalovirus is the expression "disease of civilization", which explains the widespread distribution of this infection. Also there are such names as viral disease salivary glands, cytomegaly, disease with inclusions. At the beginning of the 19th century, this disease was the romantic name "Kiss Disease", since at that time it was believed that the infection of this virus occurs through saliva at the time of kisses. The true causative agent of infection was opened by Margaret Gladys Smith in 1956. This scientist managed to highlight the virus from the urine of an infected child. A year later, the scientific group of Veller began to study the causative agent of infection, and after another three years, the name "Cytomegalovirus" was introduced.Despite the fact that by 50 years of life, almost every person on the planet came across this disease, none in a developed country of the world it is not recommended to conduct a study on the detection of CMV in pregnant women in normal order. In the publications of the American College of Obstetricians and the American Academy of Pediatrics, it is said that the diagnosis of CMV infection in pregnant and newborn children is not appropriate for the absence of vaccine and specially developed treatment against this virus. Similar recommendations published the Royal College of Okusher and Gynecologists of Great Britain in 2003. According to representatives of this organization, the diagnosis of cytomegalovirus infection in pregnant women is not necessary, since there is no way possible to predict which complications will develop in a child. Also, in favor of this output, the fact that today there is no adequate prevention of transmission of infection from mother to the fetus.
The conclusions of the Colleges of America and the United Kingdom are reduced to the fact that a systematic survey on the definition of cytomegalovirus in pregnant women is not recommended due to the large number of non-factors of this disease. Mandatory to fulfill the recommendation is to provide all pregnant women with information, which will comply with precautions and hygiene in the prevention of this disease.
What is cytomegalovirus?
Cytomegalovirus is one of the most common pathogenic microorganisms for a person. Once in the body, the virus can cause a clinically pronounced cytomegalovirus infection or persist in sleeping condition throughout life. To date, there are no drugs that could bring cytomegalovirus from the body. Building cytomegalovirus
Cytomegalovirus - is one of the largest viral particles. Its diameter is 150 - 200 nanometers. Hence his name - translated from the ancient Greek - "big viral cell".An adult ripe cytomegalovirus viral particle is called a virion. The virion has a spherical shape. Its structure is complex and consists of several components.
The components of the virion cytomegalovirus are:
- virus gene;
- nucleocapsid;
- protein ( belkova) the matrix;
- supercupside.
The genome of the cytomegalovirus is concentrated in the kernel ( core) Virion. It is a lump of a tightly packed double-stranded spiral of DNA ( deoxyribonucleic acid), in which all genetic information of the virus is laid.
Nucleocapsid
"Nucleokapsid" translates from ancient Greek as a "core shell". It is a protein layer that surrounds the virus gene. Nucleocapsid is formed from 162 capsages ( protein fragments shell). Capsometers form a geometric shape with pentagonal and hexagonal faces located according to the type of cubic symmetry.
Protein matrix
The protein matrix takes the entire space between the nucleocapside and the outer sheath of the virion. The proteins included in the protein matrix are activated when the virus penetrates the host cell and participate in the reproduction of new viral units.
Super CupSide
The outer sheath of the virion is called supercapsid. It consists of a large number of glycoproteins ( complex protein structures containing carbohydrate components). Glycoproteins are located in the supercupsis of Nonodynakovo. Some of them oppose the surface of the main layer of glycoproteins, forming small "spines". With these glycoproteins, the virion "feels" and analyzes the external environment. When the virus comes into contact with any cell of the human body, with the help of "spins" it is attached and penetrates into it.
Cytomegalovirus properties
Cytomegalovirirus has a number of important biological properties that determine its pathogenicity.The main properties of the cytomegalovirus are:
- low virulence ( the degree of pathogenicity);
- latency;
- slow reproduction;
- pronounced cytopathic ( destroying cell) Effect;
- reactivation for immunosuppression host organism;
- instability in the external environment;
- low contagiousness ( infection ability).
More than 60 - 70 percent of the adult population up to 50 years and more than 95 percent of the population over 50 years are infected with cytomegalovirus. However, most people do not even know that there are carriers of this virus. Most often, the virus is in a latent form or causes minimal clinical manifestations. This is due to its low virulence.
Latency
Once in the human body, cytomegalovirus is preserved in it for life. Thanks to the immune defense of the body, the virus can exist in a latent, sleeping state for a long time, without causing any clinical manifestations of the disease.
With the help of glycoprotein "spins", the virion recognizes and joins the shell of the cell necessary. Gradually, the outer membrane of the virus is merged with the cell membrane and the nucleicapsid penetrates inside. Inside the host cell, the nucleocapsid introduces its DNA into the kernel, leaving the protein matrix on the nuclear membrane. Using cell core enzymes, viral DNA multiplies. The protein matrix of the virus, which remained outside the kernel, synthesizes new capsid proteins. This process is the longest - takes an average of 15 hours. Synthesized proteins pass inside the nucleus and are connected to new viral DNA, forming nucleicapsid. Gradually synthesized proteins of a new matrix, which joins nucleicapsid. The nucleocapsid comes out of the nucleus of the cell, it is attached to the inner surface of the cell membrane and is enveloped by it, creating a supercapside. Copies of the Virion, published from the cell, are ready to penetrate into another healthy cell for further reproduction.
Reactivation in immunosuppression host organism
For a long time, cytomegalovirus can be in the human body in the latent state. However, in immunosuppression conditions, when the human immune system is weakened or destroyed, the virus is activated and begins to penetrate the host cells for the reproduction. As soon as the immune system comes to normal, the virus is suppressed and flows into the "hibernation".
The main adverse factors of the external environment for cytomegalovirus are:
- high temperatures ( more than 40 - 50 degrees Celsius);
- freezing;
- fat solvents ( alcohol, Ether, Detergents).
With single contact with the virus, it is almost impossible to infect cytomegalovirus infection, thanks to a good immune system and protective barriers of the human body. For infection, the virus requires a long constant contact with the source of infection.
Methods of infection with cytomegalovirus
The cytomegalovirus has quite low contagiousness, therefore, it is necessary to have several favorable factors for infection. Favorable factors for infection with cytomegalovirus are:
- permanent, long and close contact with the source of infection;
- violation of the biological protective barrier - the presence of tissue damage ( cuts, wounds, microtrauma, erosion) at the point of contact with infection;
- violations in the work of the body's immune system during supercooling, stress, infection, various internal diseases.
Methods of infection with cytomegalovirus
| Ways transfer | Through what is transmitted | Entrance doors |
| Contact-household |
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| Air-drip |
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| Contact-sex |
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| Oral |
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| Transplascent |
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| Yatrogenic |
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| Transplantation |
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Domestic contact
The contact-household path of infection with cytomegalovirus is more common in closed teams ( family, kindergarten, camp). Object items and personal hygiene of the virus carrier or patient are infected with various body fluids ( saliva, urine, blood). With constant non-compliance with hygienic standards, cytomegalovirus infection is easily distributed throughout the team.Air-drip
Cytomegalovirus is highlighted from the organism of the patient or carrier with a spray, saliva, a tear. When coughing, sneezing these fluids are distributed in the air in the form of microparticles. A healthy person is infected with a virus when inhaling these microparticles. Entrance gates are the mucous membranes of the upper respiratory tract and the mouth cavity.Contact-sex
One of the most frequent routes of transmission of cytomegalovirus infection is a contact-sex path. Unprotected sexual acts with a patient or a virus monitor lead to cytomegalovirus infection. The virus is highlighted with sperm, mucus of the cervix and vagina and penetrates the body of a healthy partner through the mucous membranes of the genital organs. With non-traditional sexual acts, the entrance gate can be mucous anus and oral cavity.Oral way
In children, the most frequent means of infection with cytomegalovirus is an oral path. The virus enters the body through contaminated hands and items that children are constantly pulling into the mouth.Infection can spread with saliva when kisses, which also relates to an oral transmission path.
Transplascent path
When the cytomegalovirus infection is activated in pregnant women against the background of reduced immunity, child infection occurs. The virus can get into the organism of the fetus with the blood of the mother through the umbilical artery, causing various pathologies for the development of the fetus.Also infection is possible during childbirth. With the blood of the feminine, the virus enters the skin and mucous membranes of the fetus. If their integrity is broken, the virus penetrates the newborn body.
Yatrogena Path
Infection of the organism by cytomegalovirus may be as a result of hemotransphus ( blood transfusion) From the infected donor. One-time blood transfusion usually does not lead to the distribution of cytomegalovirus infection. The most vulnerable are patients who need frequent or constant hemotransphuses. These include patients with various blood diseases. The body of such patients is weakened. Their immune system is suppressed by the main disease and cannot fight the virus. Permanent blood transfusions contribute to the infection with cytomegalovirus.Cytomegalovirus can also penetrate the body with a reusable use of a non-saturated medical inventory.
Transplant path
Cytomegalovirus can be maintained for a long time in the organs and tissues of the donor. When transplanting organs, immunosuppressive therapy is prescribed to prevent rejection. Against the background of immunosuppression, cytomegalovirus is activated and propagated by the patient's body.The propagation of cytomegalovirus infection in the body flows into several stages.
The distribution stages of cytomegalovirus infection are:
- local cell damping;
- distribution in regional lymph nodes;
- primary immune response;
- circulation in the circulatory and lymphatic system;
- dissemination ( spread) in organs and tissues;
- secondary immune response.
Cytomegalovirus infection in most cases falls into the body through the skin or mucous membranes, which have integrity.
At this time, an immune system is activated in the human body, which suppresses the propagation of alien particles on the blood and lymph. However, immunity is not able to completely destroy the infection. Cytomegalovirus can be maintained in latent state in lymph nodes.
In the case of immunosuppression, the body is not able to stop the breeding of the virus. Cytomegalovirus penetrates blood cells and extends to all organs and tissues, hitting them.
With a secondary immune response, a large number of antibodies are produced to the virus that suppress its further replication ( reproduction). The patient recovers, however, becomes a carrier ( the virus is preserved in lymphoid cells.).
Symptoms of cytomegalovirus infection in women
Symptoms of cytomegalovirus infection in women depend on the form of the disease. In 90 percent cases, women have a latent form of the disease without pronounced symptoms. In other cases, cytomegalovirus proceeds with severe damage in the internal organs. After the penetration of the cytomegalovirus in the human body comes the incubation period. In this period, the virus actively multiplies in the body, but without the manifestation of any symptoms. When cytomegalovirus infection, this period lasts from 20 to 60 days. Next comes the sharp phase of the disease. In women with severe immunity, this phase can flow with light influenza-like symptoms. An insignificant temperature may be observed ( 36.9 - 37.1 degrees Celsius), Easy malaise, weakness. As a rule, this period is inconspicuous. However, in favor of the presence of a cytomegalovirus in the body of a woman, an increase in the titer of antibodies in its blood is evidenced. If it will make serological diagnostics during this period, the antibodies of the acute phase to this virus are detected ( anti-CMV IGM).
The period of acute phase in the cytomegalovirus lasts from 4 to 6 weeks. After that, the infection subsides and activated only with the decrease in immunity. In such a form, the infection can be maintained for life. Only with random or planned diagnostics, it can be detected. In this case, in the blood of a woman or in a smear, if the PCR is carried out, the antibodies of the chronic phase to cytomegalovirus are detected ( anti-CMV IgG).
It is believed that 99 percent of the population is a carrier of latent cytomegalovirus infection, and these people have anti-CMV IgG. If the infection does not show itself, and the immunity of the woman is quite strong so that the virus remains in inactive form, then it becomes a virus carrier. As a rule, virons is not dangerous. But, at the same time, in women latent cytomegalovirus infection can be the cause of miscarriage, the birth of dead children.
In women with a weakened immunity, the infection proceeds in active form. In this case, two forms of the disease are observed - an acute mononucleoside and generalized form.
Acute form of cytomegalovirus infection
This form of infection resembles infectious mononucleosis. It begins sharply, with raising temperature and chills. The main characteristic of this period is generalized lymphadenopathy ( increased lymph nodes). As with infectious mononucleosis, an increase in lymph nodes from 0.5 to 3 centimeters is observed. The nodes are painful, but not match between themselves, and soft and elastic.First increase the cervical lymph nodes. They can be very large and exceed 5 centimeters. Next, submandibular, axillary and inguinal nodes increase. Internal lymph nodes also increase. Lymphadenopathy appears first of the symptoms and the latter disappears.
Other symptoms of the acute phase are:
- malaise;
- liver increase ( hepatomegaly);
- an increase in blood leukocytes;
- appearance in the blood of atypical mononuclear.
Differences of cytomegalovirus from infectious mononucleosis
In contrast to the infectious mononucleosis at the cytomegalovirus, there is no angina. It is also extremely rare an increase in the occipital lymph nodes and spleen ( splenomegaly). With laboratory diagnostics, Paul-Bunnel reaction, which is inherent in infectious mononucleosis, is negative.
Generalized form of cytomegalovirus infection
This form of the disease is extremely rare and proceeds very hard. As a rule, it develops in women with immunodeficiency or against the background of other infections. Immunodeficiency conditions may be a consequence of chemotherapy, radiotherapy or HIV infection. With generalized form, internal organs, vessels, nerves, salivary glands may be affected.The most frequent manifestations of generalized infection are:
- lesion liver with the development of cytomegalovirus hepatitis;
- damage to the lungs with the development of pneumonia;
- defeat of the retina with the development of retinit;
- the defeat of the salivary glands with the development of sialogenite;
- defeat kidney with the development of jade;
- damage to the organs of the sexual system.
When cytomegalovirus hepatitis is affected as hepatocytes ( liver cells) and liver vessels. In the liver, inflammatory infiltration is developing, the phenomenon of necrosis ( separations). Dead cells are listed and filled with bile ducts. It is observed bile, resulting in jaundice. Skin color acquires a yellowish tint. There are such complaints as nausea, vomiting, weakness. The level of bilirubin, hepatic transaminase increase in the blood. The liver increases, becomes painful. Hepatic insufficiency develops.
The flow of hepatitis can be sharp, subacute and chronic. In the first case, the so-called lightning hepatitis develops, often with fatal outcome.
The diagnosis of cytomegalovirus infection is reduced to the puncture biopsy. At the same time, with the help of puncture, a piece of hepatic fabric is taken for further histological examination. In the study, huge cytomegal cells are found in the tissue.
Cytomegalovirus pneumonia
In the cytomegalovirus, as a rule, interstitial pneumonia is initially developing. At the same time, the pneumonia is affected by alveoli, but their walls, capillaries and tissue around lymphatic vessels. This pneumonia is difficult to treat, resulting in a long time.
Very often, such protracted pneumonia is complicated by the addition of bacterial infection. As a rule, staphylococcus flora with the development of purulent pneumonia joins. The body temperature rises to 39 degrees Celsius, evolves fever and chills. The cough quickly becomes wet with the release of a large amount of purulent sputum. Dyspnea develops, pain in the chest appears.
In addition to pneumonia, bronchitis, bronchiolites may develop with cytomegalovirus infection. Lymph nodes of lungs are also affected.
Cytomegalovirus retinit
When you retire the retina's retina. Retinit, as a rule, flows the bilateral and may complicate blindness.
Symptoms of retinit are:
- photophobia;
- turbidity of vision;
- "Flies" before your eyes;
- the appearance of lightning and outbreaks before your eyes.
Cytomegalovirus Salyagenit
Salyagenitis is characterized by damage to the salivary glands. Easy glands are amazed very often. In the acute flow of sialoenitis, the temperature increases, shooting pains in the area of \u200b\u200bthe gland appear, the salivation decreases and dryness is felt in the mouth ( xerostomy).
Very often, cytomegalovirus sialogenite is characterized by a chronic flow. In this case, periodic pains are observed, minor swelling in the area of \u200b\u200bthe parotid gland. The main symptom continues to be reduced salivation.
Defeat kidney
Very often, people with an active form of cytomegalovirus infection are affected by the kidneys. In this case, inflammatory infiltration is found in the kidney channels, in its capsule and in the glomers. In addition to the kidney, ureterals can be amazed, bladder. The disease proceeds with the rapid development of renal failure. A precipitate appears in the urine, which consists of epithelium and cytomegalovirus cells. Sometimes hematuria appears ( blood in the urine).
Damage to sexual system
In women, the infection occurs in the form of cervicitis, endometritis and salpingitis. As a rule, they proceed chronically with periodic exacerbations. A woman can make complaints about periodic, neurko pronounced pain at the bottom of the abdomen, pain when urination or pain during sexual intercourse. Sometimes urination disorders can appear.
Cytomegalovirus infection in women with AIDS
It is believed that 9 of 10 patients with AIDS suffer from the active form of cytomegalovirus infection. In most cases, cytomegalovirus infection is the cause of the death of patients. Studies have shown that cytomegalovirus is reactivated when the number of CD-4 lymphocytes becomes less than 50 in one millilitress. Pneumonia and encephalitis are most often developed.In patients with AIDS, double-sided pneumonia with diffuse lesion of pulmonary fabric are developing. Pneumonia is most often protracted, with painful coughing and sideways. Pneumonia is one of the most frequent causes of death in HIV infection.
Also in patients with AIDS develop cytomegalovirus encephalitis. With encephalitis with encephalopathy, dementia is rapidly developing ( dementia), which is manifested by a decrease in memory, attention, intelligence. One of the forms of cytomegalovirus encephalitis is Ventriculoenetsephalitis, in which the ventricles of the brain and the cranial brain nerves are affected. Patients impose complaints of drowsiness, sharp weakness, violation of visual acuity.
The damage to the nervous system during cytomegalovirus infection is sometimes accompanied by polyradiculopathy. At the same time, the roots of the nerves are plurally affected, which is accompanied by weakness and pain in the legs. Cytomegalovirus retinitis in women with HIV infection is often the cause of full loss of vision.
Cytomegalovirus infection with AIDS is characterized by multiple damage in internal organs. In the last stages of the disease, polyorgan deficiency with the lesion of the heart, blood vessels, liver, eye is detected.
Pathologies that cause cytomegalovirus in women with immunodeficiency are:
- kidney defeat - acute and chronic nephritis ( kidney inflammation), foci of necrosis on adrenal glands;
- diseases of the liver - hepatitis, sclerosing cholangitis ( inflammation and narrowing of intrahepatic and extrahepatic biliary tract), jaundice ( disease at which the skin and mucous membranes are painted in yellow), liver failure;
- diseases of the pancreas - Pancreatitis ( inflammation of the pancreas);
- diseases of the gastrointestinal tract - Gastroenterocolite ( joint inflammation of the thin, large intestine and stomach), esophagitis ( defeat of the mucosa of the esophagus), enterocolit ( inflammatory processes in a thin and colon), colitis ( inflammation of the colon);
- lung disease - Pneumonia ( pneumonia);
- eye disease - Retinit ( network disease), retinopathy ( defeat of the eyeball of a non-inflammatory character). Problems with eyes arise in 70 percent of patients with HIV infection. The order of one fifth of the patients is losing sight;
- spinal and brain lesions - Meningoencephalitis ( inflammation of shells and brain substances), encephalitis ( beaming brain), myelitis ( inflammation of the spinal cord), polyradiculopathy ( the defeat of the nerve spinal cord roots), polyneeropathy of the lower extremities ( violations in the peripheral nervous system), cerebral cortex infarction;
- diseases of the urogenital system - cervical cancer, ovarian lesions, uterine pipes, endometrial.
Symptoms of cytomegalovirus infection in children
In children, there are two forms of cytomegalovirus infection - congenital and acquired. Congenital cytomegalovirus infection in children
Almost always the infection of children with cytomegalovirus occurs intrauterine. Through the placenta, the virus penetrates the body of a child from the mother's blood. At the same time, the mother may suffer primary cytomegalovirus infection, or it can be reactivated chronic.Cytomegalovirus refers to a group of Torch infections that lead to severe developmental defects. When the virus peals into the blood of the child does not always develop a congenital infection. According to various data from 5 to 10 percent of children, in the blood of which the virus penetrates, develop an active form of infection. As a rule, these are children of those mothers who transferred primary cytomegalovirus infection during pregnancy.
In reacting a chronic infection during pregnancy, the degree of intrauterine infection does not exceed 1 - 2 percent. In the future, 20 percent of such children there are serious pathologies.
Clinical manifestations of congenital cytomegalovirus infection are:
- vices for the development of the nervous system - microcephaly, hydrocephalus, meningitis; meningoencephalitis;
- dandy Walker syndrome;
- heart defects - cardits, myocardits, cardiomegaly, valve development vices;
- the defeat of the hearing aid is congenital deafness;
- defeat the visual apparatus - cataracts, retinitis, chorioretinites, keratoconjunctivitis;
- dental development anomalies.
In the blood of such children there is an increase in hepatic enzymes, bilirubin, the number of platelets sharply falls ( thrombocytopenia). Mortality in this period is very high. The surviving children subsequently there is a delay in mental development, a speech disorder. Most children with congenital cytomegalovirus infection suffer deafness, less often notes blindness.
Due to the damage to the nervous system, paralysis, epilepsy, intracranial hypertension syndrome, are developing. Subsequently, such children are lagging behind not only in mental, but also in physical development.
A separate embodiment of congenital cytomegalovirus infection is Dandy Walker syndrome. In this case, the syndrome observed various abnormalities of the cerebellum and the expansion of the ventricles. Mortality in this case ranges from 30 to 50 percent.
The frequency of symptoms with intrauterine infection CMV in children is as follows:
- breaking on the skin - from 60 to 80 percent;
- hemorrhages in the skin and mucous membranes - 76 percent;
- jaundice - 67 percent;
- the increase in liver and spleen - 60 percent;
- reducing the dimensions of the skull and brain - 53 percent;
- disorders of the digestive system - 50 percent;
- prematurity - 34 percent;
- hepatitis - 20 percent;
- brain inflammation - 15 percent;
- inflammation of blood vessels and retina - 12 percent.
Acquired cytomegalovirus infection in children
The acquired cytomegalovirus infection is the one that the child is infected after birth. Cytomegalovirus infection can occur both intranatally and postnatally. Intranatal infection is something that occurs during the childbirth themselves. Infection with cytomegalovirus is in this way during the passage of the child in sex paths. Postnatal ( after birth) Infection can occur with breastfeeding or contact-domestic pathway from other family members.The nature of the consequences of the acquired cytomegalovirus infection depends on the age of the child and the state of its immune system. The most frequent consequence of the virus are acute respiratory diseases ( Orz), which are accompanied by inflammation of the bronchi, pharynx and larynx. Often there is a defeat of the salivary glands, most often in the near-wing zones. A characteristic complication of the acquired infection is inflammatory processes in connecting tissues in the area of \u200b\u200bpulmonary alveoli. Another manifestation of cytomegalovirus infection is hepatitis, which proceeds in a subacute or chronic form. A rare complication of the virus is the defeat of the central nervous system as encephalitis ( brain inflammation).
Symptoms of cytomegalovirus infection of the acquired type are:
- children up to 1 year - Loge in physical development with motor impairment and frequent convulsions. There may be lesions of the gastrointestinal tract, problems with vision, hemorrhage;
- children from 1 year to 2 years - most often the disease is manifested by mononucleosis ( viral disease), the consequences of which are an increase in lymph nodes, swelling of the mucous throat, lesion of the liver, change of blood composition;
- children from 2 to 5 years - The immune system at that age is not able to adequately react to the virus. The disease causes such complications as shortness of breath, cyanosis ( blue Skin Casting), pneumonia.
Acquired cytomegalovirus infection in children can also be a consequence of blood transfusions or internal organ transplantation. In this case, the penetration of the virus into the body occurs with donor blood or organs. Such an infection usually proceeds by the type of mononucleosic syndrome. In this case, the temperature increases, sections from the nose and the pain in the throat appear. Simultaneously in children there are lymphatic nodes. The main manifestation of post-transfusion cytomegalovirus infection is hepatitis.
In 20 percent cases, cytomegalovirus pneumonia develops after transplantation. After transplantation of the kidneys or heart, the virus causes hepatitis, retinitis and colitis.
In children with immunodeficiency ( for example, suffering malignant diseases) Cytomegalovirus infection proceeds very difficult. As in adults, it leads to protracted pneumonias, lightning hepatitis, impact of vision. The reactivation of the virus begins with the rise of temperature and chills. Often, children appear hemorrhagic rash that affects the whole body. In the pathological process, such internal organs as a liver, light, central nervous system are involved.
Symptoms of cytomegalovirus infection in women during pregnancy
Pregnant women are most vulnerable to the harmful effects of the cytomegalovirus, as the immune system during the child's rover significantly weakens. Increases both the risk of primary infection and aggravation of the virus, if it is already in the body of the patient. Complications can develop both a woman and the fetus. In the primary infection of the virus or its reactivation in pregnant women, a number of symptoms may be observed that can manifest themselves or in the complex. In some women, an increased tone of the uterus is diagnosed, which does not affect therapy.
Manifestations of CMV infection in pregnant women are:
- multi-way;
- premature aging or placenta detachment;
- improper attachment of the placenta;
- big blood loss in childbirth;
- spontaneous miscarriages.
In inflammatory processes in the urinary system in pregnant women with CMV are:
- endometritis (inflammatory processes in the uterus) - painful feelings in the stomach ( lower part). In some cases, pains may be given to the lower back or the crushes. Also, patients complain about poor overall health, lack of appetite, headaches;
- cervicit (defeat of the cervix) - discomfort during intimate proximity, itching in the genitals, and pain in the crotch and lower abdomen;
- vaginit (inflammation of the vagina) - irritation of the genital organs, an increase in body temperature, unpleasant sensations during a relationship, painfulness at the bottom of the abdomen, redness and swelling of external genital organs, frequent urination;
- ooforit (inflammation of ovarian) - a sense of pain in the pelvis and the lower parts of the abdomen, the bloody discharges arising after sexual intercourse, the feeling of discomfort at the bottom of the abdomen, pain at proximity to a man;
- cervical erosion - The appearance of blood in the discharges after intimate proximity, abundant vaginal discharge, sometimes painful sensations may occur with rigorously expressed during intercourse.
The effect of CMV on the body of a pregnant woman
Cytomegalovirus is a viral infection, which is more often of all other diseases of pregnant women.The consequences of the virus are:
- inflammation of the salivary glands, almonds;
- pneumonia, pleurisy;
- myocarditis.
With a highly weakened immunite, the virus can take a generalized form, hitting the entire body of the patient.
Complications of generalized infection in women during pregnancy are:
- inflammatory processes in the kidneys, liver, pancreas, adrenal glands;
- dysfunction of the digestive system;
- vision problems;
- violation of the lungs.
Diagnosis of cytomegalovirus infection
The diagnosis of cytomegalovirus infection depends on the form of pathology. Thus, in the innate and acute form of this disease, it is advisable to highlight the virus in cell culture. In chronic, periodically exacerbating forms, serological diagnostics are carried out, which is aimed at identifying antibodies against the virus. Also carry out a cytological study of various organs. At the same time, they are found typical of cytomegalovirus infection change. Diagnostic methods for cytomegalovirus infection are:
- selection of the virus, by cultivating it in cell culture;
- polymerase chain reaction ( PCR);
- linked immunosorbent assay ( IFA);
- cytological method.
Selection of virus
The selection of the virus is the most accurate and reliable method of diagnosing cytomegalovirus infection. Blood and other biological fluids can be used to highlight the virus. The identification of the virus in saliva is not a confirmation of an acute infection, since the selection of the virus after recovery occurs for a long time. Therefore, the blood of the patient is most often investigated.The selection of the virus occurs on cell culture. Most often single-layer cultures of human fibroblasts are used. The studied biological material is initially centrifuged to highlight the virus itself. Next, the virus is applied to cell cultures and placed in a thermostat. It happens, as if, infection of cells by this virus. Cultures are incubated within 12 - 24 hours. As a rule, several cell cultures are infected and at the same time. Next, the cultures obtained are identified using various methods. Most often, the culture is stained with fluorescent antibodies and are examined under the microscope.
The disadvantages of this method are the considerable time of time to cultivate the virus. The duration of this method is from 2 to 3 weeks. At the same time, to highlight the virus need fresh material.
PCR
An essential advantage has such a diagnosis method as a polymerase chain reaction ( PCR). With this method, the DNA of the virus is determined in the material under study. The advantage of this method is that to determine DNA, a slight presence of a virus in the body is required. Just only one DNA fragment to determine the virus. Thus, it is defined both acute and chronic form of the disease. The disadvantage of the method is its relatively high cost.Biological material
For PCR, any biological fluids are taken ( blood, saliva, urine, spinal fluid), smears from the urethra and vagina, feces, washes from the mucous membranes.
PCR
The essence of the analysis is reduced to the release of the DNA of the virus. Initially, a fragment of DNA threads find a fragment. Next, this fragment with the help of special enzymes cloned many times to obtain a large number of copies of DNA. The received copies are identified, that is, they determine to which virus they belong. All these reactions occur in a special apparatus, which is called an amplifier. The accuracy of this method is 95 - 99 percent. The method is carried out quite quickly, which allows it to be widely used. Most often, it is applicable in the diagnosis of hidden urinary infections, cytomegalovirus encephalitis and for screening Torch infections.
IFA
Linked immunosorbent assay ( IFA) It is a method of serological research. With the help of it, antibodies to cytomegalovirus are determined. The method is used in comprehensive diagnostics with other methods. It is believed that the definition of a high titer of antibodies, together with the detection of the virus itself, is the most accurate diagnosis of cytomegalovirus infection.Biological material
The patient's blood is used to detect antibodies.
IFA
The essence of the method is reduced to the detection of antibodies to cytomegalovirus both in the acute phase and in chronic. In the first case, Anti-CMV IGM is found, in the second - Anti-CMV IgG. The analysis is based on the antigen antigen reaction. The essence of this reaction is that antibodies ( which are produced by the body in response to the penetration of the virus) Specifically bind to antigens ( squirrels on the surface of the virus).
The analysis is carried out in special plates with wells. Biological material and antigen is placed in each well. Next, the tablet is placed in a thermostat for a certain time during which the formation of antigen antigen complexes occurs. After that, it is planted with a special substance, after which the resulting complexes remain at the bottom of the wells, and non-toning antibodies are washed away. After that, antibodies treated with a fluorescence substance are added to the wells. Thus, the "sandwich" is formed from two antibodies and antigen in the middle, which are processed by a special mixture. When this mixture is added, the color of the solution in the wells changes. The intensity of the color is directly proportional to the number of antibodies in the material under study. In turn, the intensity is determined using such a device as a photometer.
Cytological diagnostics
A cytological research is to study pieces of tissues for specific changes in the cytomegalovirus. So, under the microscope in the studied tissues, gigantic cells with internal tenant inclusions are found, which are similar to the eyes of the owl. Such cells are characteristic exclusively for the cytomegalovirus, so their detection is absolute confirmation of the diagnosis. The method is used to diagnose cytomegalovirus hepatitis, jade.Treatment of cytomegalovirus infection
An important link in the activation and distribution of cytomegalovirus infection in the patient's body is to reduce immune protection. Immune preparations are used for stimulation and maintaining immunity in a viral infection - interferons. Currently, natural and recombinant are used ( artificially created) Interferons.
Mechanism of therapeutic action
Interferon preparations do not have a direct antiviral effect in the treatment of cytomegalovirus infection. They are involved in the fight against the virus, affecting the affected cells of the body and the immune system as a whole. Interferons have a number of effects in the fight against infection.Activation of cell protection genes
Interferons activate a number of genes that participate in cellular protection against the virus. Cells become less vulnerable to penetrate viral particles.
Activation of protein P53.
The P53 protein is a special protein that launches the processes of reparation of cells when damaged. If the cell damage is irreversible, then the P53 protein launches the process of apoptosis ( programmed death) Cells. In healthy cells, this protein is in inactive form. Interferons have the ability to activate the P53 protein in the cells infected with cytomegalovirus. It estimates the state of the infected cell and launches the process of apoptosis. As a result, the cage dies, and the virus does not have time to multiply.
Stimulation of the synthesis of special immune system molecules
Interferons stimulate the synthesis of special molecules that help the immune system easier and quickly recognize viral particles. These molecules are associated with receptors on the surface of the cytomegalovirus. Cells - "Killer" ( T-lymphocytes and natural killers) Immune system find these molecules and attack the virions to which they are attached.
Stimulation of the cells of the immune system
Interferons have the effect of direct stimulation of some cells of the immune system. Such cells include macrophages and natural killers. Under the action of interferons, they migrate to the affected cells and attack them, destroying along with intracellular virus.
In the treatment of cytomegalovirus infection, various drugs based on natural interferons are used.
Natural interferons applied in the treatment of cytomegalovirus infection, are:
- human leukocytar interferon;
- leukinferon;
- walloferon;
- feron.
Release form and methods for using some natural interferons with cytomegalovirus infection
| Name of the drug | Form release | Mode of application | Duration of therapy |
| Human leukocyte interferon | Dry mix. | In an ampoule with a dry mixture, add distilled or boiled cold water to the mark. Shake until the powder is completely dissolved. The resulting liquid is buried into the nose of 5 drops every one and a half - two hours. | From two to five days. |
| Leucinferon | Rectal candles. | 1 - 2 candles twice a day daily 10 days, then the dose decreases every 10 days. | 2 - 3 months. |
| Wallferon | Injection. | It is introduced subcutaneously or intramuscularly 500 thousand - 1 million IU ( international units) per day. | From 10 to 15 days. |
The biggest minus of natural preparations is their high cost, so they are used less often.
Currently, there are a large number of recombinant drugs of the interferon group, which are used in complex therapy of cytomegalovirus infection.
The main representatives of recombinant interferons are the following drugs:
- viferon;
- kipferon;
- realdron;
- refaferon;
- laferon.
Release form and methods for using some recombinant interferons with cytomegalovirus infection
| Name of the drug | Form release | Mode of application | Duration of therapy |
| Viferon |
|
|
|
| Kipferon |
| It is used on one candle every 12 hours daily 10 days, then a day for 20 days, then in 2 days another 20 - 30 days. | On average one and a half - two months. |
| Realdiron |
| It is applied subcutaneously or intramuscularly to 10,000,000 meters per day. | From 10 to 15 days. |
In the treatment of cytomegalovirus infection, properly selected integrated therapy with the necessary doses of drugs is important. Therefore, the treatment of interferon should be started only on the instructions of the specialist.
Assessment of the method of treatment
An assessment of the treatment of cytomegalovirus infection with interferons is carried out on the basis of clinical features and laboratory data. Reducing the severity of clinical manifestations to their complete absence indicates the effectiveness of the treatment. The treatment of therapy is carried out on the basis of laboratory studies - detecting antibodies to cytomegalovirus. Reducing the level of immunoglobulin M or its absence indicates the transition of the acute form of cytomegalovirus infection in the latent.
Is it necessary to treat asymptomatic cytomegalovirus infection?
Since the latent cytomegalovirus infection is not dangerous with a good immunity, many experts do not consider it appropriate to conduct its treatment. Also, in favor of the inexpediency of treatment, there is still the fact that there is no specific treatment or a vaccine that would kill the virus or prevent re-infection. Therefore, the main moment in the treatment of asymptomatic cytomegalovirus infection is to support immunity at a high level.To do this, it is recommended to bring the prevention of chronic infections ( especially urinary), which are the main cause of reduced immunity. It is also recommended to receive immunostimulants, such as Echinacea Hxhal, Derinat, Milayph. Take them only to appoint a doctor.
What are the consequences of cytomegalovirus infection?
The nature of the consequences of the cytomegalovirus is influenced by such factors as the age of the patient, the path of infection and the state of immunity. In terms of gravity of complications of patients with cytomegalovirus infection, it is possible to divide into several groups. The consequences of cytomegalovirus for people with normal immunity
Penetrating into the human body, the virus is introduced into the cells than causes the inflammatory process and violating the functionality of the affected organ. Also, the infection has a general toxic effect on the body, disrupts blood coagulation processes and inhibits the functionality of the adrenal cortex. Cytomegalovirus can provoke the development of both systemic diseases and the defeat of individual organs. In some cases, CMV ( cytomegalovirus);Consequences of cytomegalovirus infection for the fetus
The nature of the complications of the fetus depends on when the virus infection occurred. If the infection was before conception, the risk of destructive consequences for the embryo is minimal, since antibodies that will protect it in the body of a woman. The probability of fetal infection is no more than 2 percent.The possibility of developing congenital cytomegalovirus infection increases when a woman has become infected with a virus during pregnancy. The risk of transmission of the disease of the fruit is 30 - 40 percent. When primary infection, pregnancy period has great importance during the child tooling.
Depending on the moment of infection with the consequences of cytomegalovirus infection for the developing fetus are:
- blastopathy(development defects that occur when infected from 1 to 15 pregnancy day) - the death of the embryo, underdeveloped pregnancy, spontaneous interruption of pregnancy, various systemic pathology in the fetus;
- embrypathy(infeitation for 15 - 75 months of pregnancy) - pathology of vital systems of the body ( cardiovascular, digestive, respiratory, nervous). Some of these malformations are incompatible with the life of the fetus;
- fetopathy(when infected at later timing) - Infection can provoke the development of jaundice, liver damage, spleen, lungs.
The consequences of cytomegalovirus infection for children who have undergone an acute form of the disease
The most vulnerable at cytomegalovirus infection is the central nervous system, which is the cause of lesions of the brain and violations of motor and mental activity. Therefore, one-third of infected children develop encephalitis and meningoencephalitis. The manifestations of these diseases are not always pronounced.The consequences of infection with cytomegalovirus in children are:
- jaundice From the first days of life, there are 50 - 80 percent of patients with children;
- hemorrhagic syndrome It is recorded in 65 - 80 percent of the patients and is manifested by hemorrhages in the skin, mucous membranes, adrenal glands. It is also possible to bleeding from the nose or umbilical wound;
- hepatoslenomegaly ( enlargement of liver and spleen) diagnosed in 60 - 75 percent of children. Together with jaundice and hemorrhagic syndrome, this disease is the most common complication of CMV, developing in infected children from the first days of life;
- interstitial pneumonia manifests symptoms of respiratory disorders;
- nephritis is a complication that develops in a third of sick children;
- gastroenterocolit arises in 30 percent of cases;
- myocarditis ( inflammation of the heart muscle) Diagnosed in 10 percent of patients.
Other complications of cytomegalovirus are:
- retardation in psychomotor development;
- damage to the gastrointestinal tract;
- pathology of the organ of vision ( chorioretinitis, Uveit);
- blood impairment ( anemia, thrombocytopenia).
(other name - CMV infection ) - this is an infectious disease that belongs to the family herpessvirus . This virus affects man both intrauterine and other ways. Thus, cytomegalovirus can be transferred by sex, air-drip alimentary.
According to an existing statistical study, antibodies to cytomegalovirus are detected by about 10-15% of adolescents. Already at the age of 35 years, the number of such people increases to 40%.
Cytomegalovirus scientists opened in 1956. A feature of this virus is its affinity with the tissues of the salivary glands. Therefore, if the disease has a localized form, then detect the virus can be exclusively in these glands. This virus is present in the human body for life. However, cytomegalovirus does not differ in high levels of infinity. As a rule, in order to infect the virus, prolonged and multiple contacts are needed, close communication with the carrier.
Today there are three groups of people, controlling the activity of cytomegalovirus for which is particularly relevant. These are pregnant women, people who have a recurrent herpes , as well as patients who have a broken immune response.
Causes of cytomegalovirus
A person can infect cytomegalovirus in different ways. So, the contamination can occur with contact path, through the use of infected things, in the process of transplanting organs, as well as blood transfusion from the donor previously infected with cytomegalovirus. The disease is transmitted, in addition, with sexual contacts, air-droplet, during pregnancy intrauterine and in the process of childbirth. The virus is in the blood, saliva, breast milk, sperm, discharge from female genital organs. But the virus that falls into the human body cannot be recognized immediately, because in this case the duration of the incubation period is about 60 days. These days, the virus may not manifest themselves at all, but after the incubation period expiration occurs a sharp principle. The supercooling and the subsequent decrease in immunity becomes factors provoking cytomegalovirus. Symptoms of the disease are manifested and due to stress.
Symptoms of cytomegalovirus
If the virus is introduced into the body, it begins the restructuring of the immune system. And after the acute phase of the disease ended, the manifestation of vegetative-vascular disorders and asthenization over a long time.
In people with immunodeficiency (in people who have undergone chemotherapy, HIV-infected people, as well as persons passing immunosuppressive therapy during organ transplantation), the presence of cytomegalovirus can provoke a manifestation of very severe diseases. Defeats that manifest themselves in such patients may cause fatal outcome.
Diagnosis of cytomegalovirus
When diagnosing, it is necessary to take into account the fact that the presence of cytomegalovirus can be found only in the case of special urine studies, saliva, blood, sperm, as well as fragments of genital organs during the primary infection of the disease or during the exacerbation of the infection. If the virus is detected at another time, it does not have a determining value for diagnostics.
After entering this infection, it is started to be generated in it - antibodies to cytomegalovirus. They suspend the development of the disease, as a result of which it proceeds asymptomatic. In the process of laboratory testing of the blood, you can reveal such antibodies. However, the identification of the antibody titer does not allow to distinguish the infection current from infection transferred. Indeed, in the body of the carrier of the virus and cytomegalovirus, and the antibodies are constantly present. In this case, antibodies do not prevent infection, and immunity is not produced to cytomegalovirus. In the case of a non-response diagnostics, the patient must pass the tests again after a few weeks.
Treatment of cytomegalovirus
If a person is diagnosed with cytomegalovirus, treatment of the disease will be aimed at strangle all forms of the disease and eliminate unpleasant symptoms. After all, today physicians do not have a means destroying the virus in the human body completely.
If the symptoms are not manifested in patients who were diagnosed with cytomegalovirus, treatment of the disease is not required. After all, this indicates a normal virus immunity.
If the virus is detected in the blood, therapy implies support and strengthening the immune system. Therefore, it is necessary to carry out immunomodulatory, as well as a general fascination treatment. The reception of vitamin complexes is also appointed.
In the treatment of cytomegalovirus in children and adults, it is important to use an integrated approach to the appointment of therapy. As a rule, when treatment is assigned tools with antiviral and immune exposure. With the right approach to treatment, the protective forces of the body are activated, and the activation of the latent form of the disease will continue under control.
It is very important to pass all the necessary surveys and timely determine the exacerbation of the disease during
. Accordingly, if a pregnant woman has been identified by cytomegalovirus, the treatment is selected taking into account all the individual characteristics of its organism. If the case of a disease is heavy, sometimes recommended to resort to interruption of pregnancy. Such a conclusion is based on information obtained due to virological studies, clinical indications, ultrasound placenta and fetus.
Treatment aimed at maintaining immunity includes procedures for strengthening and hardening the body. So, often in this case, bath procedures are recommended, and those who have a certain preparation can be periodically swimming in icy water.
There are many medicinal herbs whose decoctions stimulate the improvement of the overall condition of the body. Applying herbs with choleretic influences: rosehip, cornflower, immortals, yarrow. You can rinse the mouth with a weak solution .
The doctors
Medicine
Prevention of cytomegalovirus
The prevention of cytomegalovirus is mainly in the careful observance of the rules of both personal and sex hygiene. It is important to keep proper caution, contacting with infected people. Care must be most carefully taken during the pregnancy period: in this case, random sexual communications cannot be allowed. Another important moment in the issue of the prevention of cytomegalovirus is support for immunity. It should be done physically active life, it is necessary to eat, walk in fresh clean air, take vitamins, avoid stressful situations. Children need to be accustomed to the right way of life and hygiene from the first years of life.
Cytomegalovirus in children
When infected with cytomegalovirus children, the incubation period can continue from 15 days to 3 months and even more. Eliminate congenital and acquired cytomegalovirus infection. Very often, cytomegalovirus in children proceeds without pronounced symptoms. With a congenital form of the disease, the fruit is infected during intrauterine development, infecting from the mother. From the blood of the mother, the virus enters the placenta, after which it turns out to be in the blood of the fetus and then penetrates the tissue of the salivary glands. If the fruit was infected in early pregnancy, he can perish. Otherwise, the child is born with a number of heavy defects. So, cytomegalovirus in children can cause microcephaliya
,
, as well as other pathologies of the brain, followed by development oligophrenia
. Perhaps the birth of children with pathology of the cardiovascular system, gastrointestinal tract, lungs, respiratory tract. Also cytomegalovirus in children causes causes
,
.
If the infection of the child occurred in the later dates, then the newborn has no pronounced defects, but the disease is expressed expressed jaundice The child has increased spleen and liver, damage to the lungs and intestines.
If there is a sharp course of cytomegalovirus infection, then the newborn has a number of symptoms:, poor appetite, the temperature can increase, the child is poorly gaining weight, has an unstable stool. Possible hemorrhagic rashes on the skin. After a certain time, due to a bad set develops anemia , hypotrophy . In general, a very difficult course of cytomegalovirus infection is marked, and as a result often ends with the death of a child in the first month of life.
If the disease has a chronic form or asymptomatic flow, the child's condition remains satisfactory.
With the acquired form of the disease, the child is infected in the process of childbirth, or receives an infection in the first days of life while contacting the carrier of infection.
Two options for cytomegalovirus flow in children are possible: or salivary glands are isolated, or a few or one organ is defeated. As the symptoms of the child, a high temperature is manifested, an increase in lymph nodes and neck, and in other places. The mucous pharynx swells, almonds, spleen, liver increase. The child refuses to eat, the chair is broken - either diarrhea manifest. The lesions of the lungs, the gastrointestinal tract, the jaundice of the scool, trembling limbs appear. Possible I. sepsis But the effect of therapy with antibacterial drugs does not appear. The course of the disease is long, the diagnosis is usually difficult to determine, because cytomegalovirus in the blood and saliva is sometimes not detected.
Also, when infected with the child, cytomegalovirus can appear cytomegalovirus hepatitis . Such children are born with severe hemorrhagic syndrome and a number of developmental defects described above. Very often the course of the disease ends fascinated.
Cytomegalovirus in pregnant women
However, the most serious complications of this ailment are manifested in women who expect the appearance of a child. Cytomegalovirus and pregnancy - a rather dangerous combination, because infection with this disease sometimes leads even to premature birth. It is the cytomegalovirus that is one of the most commonly manifested causes of abortion.
In addition, the child in a patient may be born with a low body weight, as well as with serious lesions of the lungs, liver and the central nervous system. Cytomegalovirus and pregnancy is the risk that the child may not survive at all. So, according to different calculations, from 12-30% of such newborns die. In children who survived, about 90% of cases there is a number of late complications: they can lose hearing, sometimes there are violations of speech, the visual nerves are atrophy.
Consequently, a very important step is to examine the presence of cytomegalovirus infection in the child's birth planning process. If you correctly approach the use of both therapeutic and preventive measures, then the negative effect of cytomegalovirus on the course of pregnancy and the probability of manifestation of pathologies in a child can be warned.
Diet, nutrition at cytomegalovirus
List of sources
- Krasnov V.V., Malysheva E.B. Cytomegalovirus infection. Nizhny Novgorod: Publishing House of NGMA, 2004;
- Isakov, V.A., Arkhipova E.I., Isakov D.V. Herpese infections of man: guide for doctors. - St. Petersburg: Speclit., 2006;
- Samokhin P. A. Cytomegalovirus infection in children. - M.: Medicine, 1987;
- Borisov L.B. Medical Microbiology, Virology, Immunology: M.: LLC Medical Information Agency, 2002.
Cytomegalovirus refers to the family of herpes viruses, namely. It will help to detect blood test to the virus.
Cytomegalovirus cells are subjected to different types:
- salivary glands;
- kidney;
- liver;
- placenta;
- eye and ears.
But, although the list is impressive, in most cases cytomegalovirus is not dangerous to human health!
What is the danger of cytomegalovirus?
- loss of hearing;
- violation or even loss of vision;
- mental retardation;
- the emergence of convulsion.
Such consequences may occur during primary infection, and when activated. It is only necessary to remember the likelihood of such serious consequences.
The infant who has become infected during pregnancy is possible such external manifestations of cytomegalovirus infection:
- intracerebral calcinates;
- ventriaculegalia (extended side ventricles of the brain);
- the liver and spleen increase;
- there is an excess fluid in the peritoneum and the chest cavity;
- microcephaly (small head);
- petechia (small hemorrhages on the skin);
- jaundice.
What is the analysis on IgG?
If IgG is positive, it is evidence that the patient has developed immunity to the virus, but at the same time a person is his carrier.
This does not mean that cytomegalovirus proceeds actively or for a patient arose a threat. The physical condition and immunity of the patient will play a primary role.
The most important thing is the positive test for a pregnant woman, since the infant's body is still developing and does not produce antibodies to cytomegalovirus.
During the IgG study to the cytomegalovirus from the patient's body, the samples are taken to find specific antibodies to the cytomegalovirus IgG. Іgg is a reduction from the Latin word "Immunoglobulin".
This is a variety of protective protein that is generated by immunity to combat the virus.
The immune system is beginning to produce special antibodies for each new virus, which turns out to be in the body.
As a result, when reaching, a person can already have a whole "bouquet" of such substances. The letter G is denoted by a certain class of immunoglobulins, a person is noted by the literals A, D, E, G, M.
Thus, the body that has not yet come across the virus is not able to produce antiviral antibodies. That is why the presence of antibodies in a person indicates that earlier the body has already been prone to the virus.
It should be considered: antibodies of one species that are intended to combat various viruses, there are significant differences. That is why the results of cytomegalovirus analyzes on IgG are quite accurate.
How is the analysis decryp?
An important feature of the cytomegalovirus is that after the initial defeat of the body, it remains in it forever. To get rid of its presence will help no treatment.
The virus functions virtually no harm in the internal organs, blood and in salivary glands, and its carriers are not suspected of what they are carriers of the virus.
What is the differences between immunoglobulins M and G?
IgM combines rapid "large" antibodies, produced by the body in order to respond as soon as possible to enter the virus.
IgM does not provide immunological memory, moving for six months, and the defense that they must perform is eliminated.
IgG includes antibodies that clictates the body from the moment they appear. This is done to maintain protection against a certain virus throughout human life.
These Kcitomegalovirus antibodies have smaller sizes and later developing time. As a rule, they are made on the basis of IGM antibodies after the suppression of infection.
That is why IGM cytomegalovirius discovered in the blood, which reacts to, it can be argued that the person has become infected with the virus relatively recently and at the moment there may be an exacerbation of infection.
To obtain more complete information, you need to study additional research indicators.
Antibodies to cytomegalovirus IgG
What can be additional analyzes?
It may not only from the information about the cytomegalovirus, but also to carry out other necessary data. Specialists interpret the data and prescribe treatment.
To better understand the meanings, it is worth familiar with the laboratory tests:
- Іgg-, Igm +: Specific IGM antibodies are found in the body. With a large probability, infection has happened recently, and now - the exacerbation of the disease;
- Іgg +, IgM- Means: the disease proceeds inactive, although the infection has long happened. Since immunity, particles of the virus already managed to work out, repeatedly penetrating the body, quickly destroyed;
- igg-, IgM- - evidence of the lack of immunity to cytomegalovirus, as this virus is not yet recognized;
- Іgg +, Igm + - Certificate of re-activation of cytomegalovirus and exacerbation of infection.
Immunomodulins are called another important indicator:
- below 50% - certificate of primary infection;
- 50 - 60% - the result is indefinite. A repeated analysis should be carried out after 3 to 4 weeks;
- over 60% - there is immunity to the virus, although a person belongs to carriers or illness passed into a chronic form;
- 0 or negative result - the body is not infected.
If a person has no diseases of the immune system, the positive should not cause concerns.
At any stage of the disease, a good immunity is a guarantee of an imperceptible and asymptomatic course of the disease.
Only occasionally cytomegalovirus is manifested by such symptoms:
- common malaise.
It is important to remember that intensive and acute proceedings of infection, even in the absence of external signs, it is recommended to reduce their activity for several weeks:
- less often appear in public places;
- as you can communicate with children and pregnant women.
At this stage, the virus is actively spread, capable of infecting another person and requiring serious treatment with cytomegalovirus.
?
The greatest danger to the fetus exists when the virus enters the female organism during pregnancy. The danger increases if the woman is infected for the first time and is located on the 4th - 22 week of pregnancy.
If we are talking about the reactivation of cytomegalovirus during pregnancy, the danger of infection for the fetus is minimal, but during pregnancy cytomegalovirus infection may result in such consequences:
- the birth of the mentally backward child;
- the infant appears cramps, hearing loss or vision.
But it should not be panic: the tragic consequences of cytomegalovirus are registered in 9% of cases at primary cytomegalovirus infection and 0. 1% with re-infection.
Thus, in the overwhelming majority of women with such an infection, healthy children are born!
Situations characteristic of pregnant women:
- If before pregnancy, the blood test showed antibodies to cytomegalovirus), then such a woman will never have a primary infection during pregnancy, since it has already occurred in the past - this is evidenced by antibodies in the blood.
- The blood test for antibodies was first given during pregnancy and antibodies to the virus were revealed. In such cases, infection may occur during pregnancy, and the likelihood of serious fetal damage is 0. 1%.
- The blood test was deposited before pregnancy. The woman did not find antibodies to cytomegalovirus (IgG-, CMV Igm-).
Based on other medical publications, it can be argued: unfortunately, in domestic medicine, everything is bad, which happens to the child, is familiar to the cytomegalovirus infection.
Therefore, repeated analyzes are assigned to CMV IgG and CMV IGM, as well as the PCR test to the CMV mucus mucus from the cervix.
If there are evidence of the constant levels of CMV IgG and the absence of CMV IGM in the cervix, it is safe to deny that possible complications of pregnancy are caused by cytomegalovirus.
Treatment of cytomegalovirus infection
It should be emphasized: none of the existing methods of treatment from the virus completely relieves.
If cytomegalovirus proceeds without symptoms, women with normal immunity in treatment do not need.
Therefore, if even cytomegalovirus or antibodies to it have been identified in a patient with a good immunity, there are no testimony for treatment.
Evaluation of use, polyoxide and so on. Not a panacea.
It can be argued: immunotherapy for cytomegalovirus infection is usually caused not as medical as commercial considerations.
Treatment of cytomegalovirus in people with weakened immunity comes down to use (Gancyclovir, Foscarnet, Tsidofovir).
Cytomegalovirus penetrates the child's cells immediately, remaining there for life, existing in the inactive state.
Children at the age of 2 - 6 months are infected with almost no symptoms and any serious health problems.
But if the child has become infected in the first months of life, infection can provoke a real tragedy.
We are talking about innate infections when the child has become infected in a mother's belly, during the birth.
Who among children does the virus are more dangerous?
- children who have not yet been born are infected during the period of intrauterine development;
- with a weakened immune system;
- children of all ages with weakened immunity or its absence.
Congenital infection with cytomegalovirus entails the risk of child defeat with serious nerve disorders, digestive systems, vessels and musculoskeletal system.
There is the likelihood of irreversible lesions in hearing and vision organs.
Diagnosed with laboratory analysis. In the Russian Federation today is a common immunoferment analysis.
Preventive measures
The use of condoms reduces the risk of acquiring an infection during sexual contacts.
Holders of congenital infection should be abandoned by random intimate ties during pregnancy.
Cytomegalovirus is a virus widespread worldwide among adults and children relating to the Herpes Viruses Group. Since this virus was discovered relatively recently, in 1956, it is considered not yet sufficiently studied, and in the scientific world so far is the subject of active discussion.
Cytomegalovirus is spread quite strongly, the antibodies of this virus are found in 10-15% of adolescents and young people. In people at the age of 35 and more years, it is found in 50% of cases. Cytomegalovirus is in biological tissues - sperm, saliva, urine, tears. When penetrating the body, the virus does not disappear, but continues to live with its owner.
What it is?
Cytomegalovirus (another name - CMV infection) is an infectious disease that belongs to the herpesviruses family. This virus affects man both intrauterine and other ways. Thus, cytomegalovirus can be transferred by sex, air-drip alimentary.
How is the virus transmitted?
The ways of transmitting cytomegalovirus are diverse, since the virus can be in the blood, saliva, milk, urine, feces, seed fluid, secrete cervix. Aerial drip transmission is possible, transmitted when blood transfusion, sexually transplantary intrauterine infection. An important place is in charge of infection during childbirth and when feeding the milk of the patient of the mother.
There are no discrepancies when the carrier of the virus does not even suspect this, especially in those situations where symptoms are almost not manifested. Therefore, it is not necessary to consider the patients with each carrier of the cytomegalovirus, as there is no existing in the body, he can never show himself in a lifetime.
However, supercooling and the subsequent decrease in immunity become factors provoking cytomegalovirus. Symptoms of the disease are manifested and due to stress.
Cytomegalovirus IgG antibodies detected - what does this mean?
Igm is antibodies that the immune system begins to generate 4-7 weeks after the person is infected with cytomegalovirus for the first time. Antibodies of this type are also produced every time cytomegalovirus, which remained in the human body after the previous infection, begins to actively multiply again.
Accordingly, if you have discovered a positive (elevated) IGM type antibody titer against cytomegalovirus, then this means:
- That you were infected with cytomegalovirus recently (no earlier than in the last year);
- What you were infected with cytomegalovirus for a long time, but recently this infection began to multiply in your body again.
The positive titer of an IGM type antibodies can be maintained in human blood for at least 4-12 months after infection. Over time, the IGM type antibodies disappear from the blood of a man with an infected cytomegalovirus.
Development of the disease
The incubation period is 20-60 days, an acute flow of 2-6 weeks after the incubation period. Finding in the body in a latent state both after infection and during attenuation periods - an unlimited time.
Even the field of treatment of the course of treatment, the virus in the body lives life, keeping the risk of recurrence, so the safety of pregnancy and full-fledged tooling doctors cannot guarantee even when the rack and long-lasting remission occurs.
Symptoms of cytomegalovirus
In many people who are carriers of the cytomegalovirus, it does not show any symptoms. Signs of cytomegalovirus can manifest itself as a result of violations in the work of the immune system.
Sometimes people with normal immunity have this virus causes the so-called mononucleosus-like syndrome. It occurs after 20-60 days after infection and lasts 2-6 weeks. It manifests itself high, chills, fatigue, malaise and headache. Subsequently, under the influence of the virus, the immune system of the body prepared for the reflection of the attack occurs. However, in the event of a lack of forces, the sharp phase passes into a calmer shape, when vascular-vegetative disorders are often manifested, and the internal organs occur.
In this case, three manifestations of the disease are possible:
- Generalized form - Defeat CMV of internal organs (inflammation of hepatic tissue, adrenal glands, kidneys, spleen, pancreas). The data of the bodies may cause that the state further worsens and has increased pressure on the immune system. At the same time, treatment with antibiotics is less effective than with the usual leakage of bronchitis and / or pneumonia. At the same time, it can be observed in the peripheral blood, the defeat of the intestinal walls, the vessels of the eyeball, the brain and the nervous system. Externally appears, in addition to increased salivary glands, skin rash.
- - In this case, this is weakness, general malaise, headaches, runny nose, increasing and inflammation of the salivary glands, fast fatigue, slightly elevated body temperature, whipped raids in the language and gums; Sometimes it is possible to have inflamed almonds.
- Defeat of the organs of the genitour - manifests itself in the form of periodic and nonspecific inflammation. At the same time, as in the case of bronchitis and pneumonia, inflammation is poorly treatable with traditional antibiotics for this local disease.
Special attention must be paid to the CMWI from the fetus (intrauterine cytomegalovirus infection), in newborn and young children. An important factor is the gestational period of infection, as well as the fact, whether the infection of pregnant has come for the first time or the infection has occurred - in second case, the likelihood of infection of the fetus and the development of heavy complications is significantly lower.
Also, in the case of a pregnant woman to infect a pregnant woman, the fruit pathology is possible when the fruit is infected in the blood from the outside of the CMV, which leads to the unbearab of the fetus (one of the most frequent causes). It is also possible to activate the latent form of the virus infecting the fruit through the blood of the mother. Infection leads either to the death of a child in the womb / after childbirth, or to the damage to the nervous system and brain, which is manifested in various psychological and physical diseases.
Cytomegalovirus infection during pregnancy
When infected with a woman during pregnancy in most cases, it develops an acute form of the disease. Perhaps lungs, liver, brain.
The patient notes complaints to:
- fatigue, headache, general weakness;
- increasing and pain in touching salivary glands;
- discharge discharge from the nose;
- selection of whitish color from sex tract;
- pain in the stomach (due to the increased tone of the uterus).
When infecting the fetus during pregnancy (but not during childbirth), it is possible to develop a congenital cytomegalovirus infection in a child. The latter leads to severe diseases and defeats of the central nervous system (lag in mental development, hearing lobs). In 20-30% of cases, a child dies. Congenital cytomegalovirus infection is observed almost exclusively in children, whose mothers are first infected with cytomegalovirus for the first time.
Treatment of cytomegalovirus during pregnancy includes antiviral therapy based on intravenous acyclovir injection; The use of drugs for immunity correction (cytotect, immunoglobulin intravenously), as well as conducting control analyzes after passing the course of therapy.
Cytomegalovirus in children
Congenital cytomegalovirus infection is diagnosed in a child usually in the first month and has the following possible manifestations:
- cramps, trembling limbs;
- drowsiness;
- vision impairment;
- problems with mental development.
The manifestation is possible and more adulthood, when the child is 3-5 years old, and it usually looks like an ARZ (temperature, sore throat, runny nose).
Diagnostics
Cytomegalovirus is diagnosed using the following methods:
- identification of the presence of a virus in the biological fluids of the body;
- PCR (polymerase chain reaction);
- sowing on cell culture;
- detection of specific antibodies in blood serum.
Cytomegalovirus (abbreviated CMV or CMV) is a causative agent of an infectious disease belonging to the family of herpesviruses. Once upon a time in the human body, he remains there forever. Antibodies generated by the immune system in response to the penetration of the virus are the main diagnostic feature for the detection of infection.
Cytomegalovirus infection can occur both asymptomatic and multiple damage in internal organs and systems. In damaged tissues, normal cells turn into a giant, for which this disease and received its name (cytomegalia: from Greek. Cytos - "Cell", Megalos - "Big").
In the active stage of development of infection, cytomegaloviruses cause significant changes in immunity:
- violation of the function of macrophages, destroying bacteria and viruses;
- suppression of the production of interleukins governing the activities of immune cells;
- the oppression of the synthesis of interferon, providing antiviral immunity.
Antibodies to cytomegalovirus, determined using laboratory methods, serve as the main markers of CMV. Their detection in serum allows diagnosis of the disease in the early stages, as well as control the course of the disease.
Varieties of antibodies to CMV and their features
If you get into the body of alien bodies there is a response from the immune system. Special proteins are produced - antibodies that contribute to the development of protective inflammatory reactions.
The following types of antibodies are distinguished to CMV, differing in structure and role in the formation of immunity:
- IGA, the main function of which is the protection of mucous membranes from infections. They are contained in saliva, tear liquid, breast milk, and also exist on mucous duals, respiratory tract and urinary tract. Antibodies of this type are associated with microbes and prevent their adhesion and penetration into the body through the epithelium. Immunoglobulins circulating in the blood provide local immunity. The time of their life is only a few days, therefore their periodic examination is necessary.
- IgG.which constitute the bulk of human serum antibodies. They can be transmitted from a pregnant woman to the fetus through the placenta, providing the formation of its passive immunity.
- Igm.which are the largest type of antibodies. They arise with primary infection in response to the penetration of unknown previously alien substances. Their main function is the receptor - the transmission of the signal inside the cell when the molecule is connected to the antibody of a certain chemical.
According to the ratio of IgG and Igm, it is possible to identify in which stage there is a disease - acute (primary infection), latent (hidden) or active (reactivation of "sleeping" infection at its carrier).
If the infection occurred for the first time, the amount of IGM antibodies, IgA and IgG quickly increases during the first 2-3 weeks.
From the second month from the beginning of infection, their level begins to decline. IGM and IGA can be detected in the body within 6-12 weeks. These types of antibodies are recorded not only for the diagnosis of CMV, but also to identify other infections.
IgG antibodies
IgG antibodies are produced by the body at the late stage, sometimes only after 1 month after infection, but they are saved throughout life, providing lifelong immunity. If the risk of re-infection with another strain of the virus occurs, their development increases sharply.
When contacting the same culture of microorganisms, the formation of protective immunity occurs in a more compressed duration - up to 1-2 weeks. A feature of cytomegalovirus infection is that the causative agent can avoid the action of immune forces by creating other varieties of the virus. Therefore, infection with modified microbes proceeds as during primary contact.
Antibodies to cytomegalovirus. The photo provided an IGG antibody. However, in the human body, group-drug-specific immunoglobulins are produced, which impede their active reproduction. Antibodies to Class G cytomegalovirus are more often detected among the urban population. This is due to the high concentration of people on small areas and a weaker immunity than rural residents.
In families with low living standards, the CMV infection among children is marked in 40-60% of cases even before reaching them for 5 years, and the antibodies are already detected by 80%.
Igm antibodies
IGM antibodies act as the first line of protection. Immediately after the introduction of microorganisms into the body, their concentration increases sharply, and its peak is observed in the range from 1 to 4 weeks. Therefore, they serve as a recent infection marker, or the acute stage of the CMV infection. In serum, they persist up to 20 weeks, in rare cases - up to 3 months or more.
The last phenomenon is observed in patients with impairment impairment. The decrease in the level of IGM in the following months is occurring even if the treatment is not carried out. However, their absence is not a sufficient basis for a negative result, since the infection may occur in chronic form. With reactivation, they also arise, but in smaller quantities.
IGA
IGA antibodies are detected in blood after 1-2 weeks after infection. If treatment is carried out, and it is effective, their level is reduced in 2-4 months. When re-infected with CMV, their level also increases. A stable high concentration of antibodies of this class is a sign of a chronic form of the disease.
People with weakened immunity IGM are not formed even in the phase of the acute stage. For such patients, as well as for those who conducted a transplant of organs, a positive result of IGA analysis helps to recognize the form of the disease.
Avidity Immunoglobulinov
Adjusting the ability of antibodies to contact the viruses. In the initial period of the disease, it is minimal, but gradually grows and reaches a maximum of 2-3 weeks. During the immune response, immunoglobulins evolve, the effectiveness of their binding increases, due to which "neutralization" of microorganisms occurs.
The laboratory diagnostics of this parameter is performed to estimate the infection time. Thus, for acute infection, the identification of IgM and IgG with low avidity is characterized. Over time, they become highlyaavid. Low-avid antibodies disappear from the blood in 1-5 months (in rare cases - longer), and highlyavid remains until the end of life.
Such a study is important in the diagnosis of pregnant women. For this category of patients are characterized by frequent false positive results. If in the blood, highlyavid IgG antibodies will be detected, this will eliminate the sharp primary infection, dangerous to the fetus.
The degree of avidity depends on the concentration of viruses, as well as on individual differences in the molecular levels. In the elderly people, the evolving of antibodies takes place slower, so after 60 years, resistance to infections and the effect of vaccination is reduced.
CMV content standards in blood
The numerical value of the "normal" content of antibodies in biological fluids does not exist.
The concept of calculation of IgG and other types of immunoglobulins has its own characteristics:
- The concentration of antibodies is determined by titration. The serum is gradually divorced by a special solvent (1: 2, 1: 6 and other concentrations, multiple two). The result is considered positive if the titration remains a reaction to the presence of a studied substance. For cytomegalovirus infection, a positive result is detected during dilution 1: 100 (threshold titer).
- Titres are an individual response of the body, which depends on the general condition, lifestyle, activity of immunity and metabolic processes, age, the presence of other pathologies.
- Titres give an idea of \u200b\u200bthe aggregate activity of the antibodies of class A, G, M.
- In each laboratory, their test systems can be used to identify antibodies with a certain sensitivity, so they must issue the final interpretation of the results in which the reference (border) values \u200b\u200band units of measurement are indicated.
Avidity is estimated as follows (units of measure -%):
- <30% – low-avid antibodies, primary infection that happened about 3 months ago;
- 30-50% – There is no possibility to accurately determine the result, the analysis must be re-conducted after 2 weeks;
- >50% – High-mavid antibodies, infection occurred for a long time.
In adults
Deciphering results for all groups of patients is made in the manner specified below in the table.
Table:
| IgG value | IGM value | Interpretation |
| positive | positive | Secondary reinfection. Need treatment |
| negative | positive | Primary infection. Receive treatment |
| positive | negative | Immunity has been formed. Man is a carrier of the virus. The exacerbation of the disease is possible with a decrease in immunity |
| negative | negative | Immunity is absent. CMV infection was not. There is a risk of primary infection |
Antibodies to cytomegalovirus can be at a low level for several years, and when reinfeating by other strains, the amount of IgG quickly rises. To obtain an accurate diagnostic picture, the IgG and IgM level is determined simultaneously, and repeated analysis is also carried out after 2 weeks.
In children
In children during the period of newborn and breastfeeding in the blood, the IGGs obtained by their intrauterine from the mother may be present. Their level in a few months begins to decrease smoothly due to the lack of a permanent source. Igm antibodies often give a false positive or false negative result. In this regard, the diagnosis at this age causes difficulties.
Given the general clinical picture, immunological analyzes are interpreted as follows:
Multiple testing allows you to determine the infection time:
- after birth - increasing titer;
- intrauterine - Permanent level
During pregnancy
The diagnosis of CMV in pregnant women are carried out by the same principle. If the trimester is found that IgG is positive, and IGM is negative, it is necessary to hand over the PCR analysis to confirm the lack of reactivation of infection. In this case, the fruit will receive maternal antibodies that will protect it from the disease.
The female consultation doctor should issue directions for controlling the IGG titer also in the II and III trimesters.
If a low Avidity Index was revealed on a period of 12-16 weeks, then infection could occur before the occurrence of pregnancy, and the likelihood of fetal infection is almost 100%. On July 20-23, this risk is reduced to 60%. Determining the infection time during pregnancy plays great importance, since the transfer of the virus to the fetus leads to the development of heavy pathologies.
To whom and why prescribe an analysis of antibodies to CMV
Analysis is shown to those persons who fall into the risk group of infection:
In healthy people with strong immunity, primary contamination often proceeds asymptomatic and without complications. But the CMV in active form is dangerous in immunodeficiency and pregnancy, as it causes numerous complications. Therefore, doctors recommend to undergo a survey to the planned conception of the child.
Methods of virus detection and deciphering research results
All research methods for determining the CMW can be divided into 2 groups:
- Straight - Cultural, cytological. Their principle consists in growing the culture of viruses or the study of the characteristic changes occurring in cells and tissues under the influence of microorganism.
- Indirect - serological (ELISA, method of fluorescent antibodies), molecular biological (PCR). They serve to identify an immune response to an infection.
The standard in the diagnosis of this disease is the use of at least 2 methods from the above.
Analysis on antibodies to cytomegalovirus (ELISA - solid-phase immunoassay analysis)
The ELISA method is the most common thanks to its simplicity, cheapness, high accuracy and ability to automate, eliminating the mistake of a laboratory assistant. Analysis can be spent in 2 hours. IgG, IgA, IGM classes antibodies are detected in the blood.
The definition of immunoglobulins to cytomegalovirus is as follows:
- In several holes, the patient's blood serum is placed, control positive, negative and "threshold" samples. The latter titer is 1: 100. The tablet in which there are wells are made of polystyrene. It is pre-precipitated by the purified CMV antigens. When reacting with antibodies, specific immune complexes are formed.
- The tablet with samples are placed in a thermostat, where it is withstanding it for 30-60 minutes.
- Wash the wells with a special solution and make a conjugate in them - a substance with antibodies, laundered by an enzyme, then placed again in the thermostat.
- The wells are washed and the indicator solution is added to them, withstand in the thermostat.
- A stop reagent is added to stop the reaction.
- The results of the analysis are recorded in the spectrophotometer - the optical density of the serum of the patient in two modes is measured and compared with the values \u200b\u200bfor the control and threshold samples. Calibration schedule is built to determine the titer.
If antibodies to CMV are present in the test sample, then under the influence of the indicator it changes its color (optical density), which is recorded by a spectrophotometer. The disadvantages of the ELISA include the risk of false positive results due to cross-reactions with normal antibodies. The sensitivity of the method is 70-75%.
The Award Index is determined similarly. In samples of the patient's serum, a solution is added, with which low-avid antibodies remove. Then the conjugate and organic substance with the dye are introduced, the optical absorption is measured and compared with the control moons.
Method of polymerase chain reaction (PCR) for the diagnosis of cytomegalovirus
The essence of PCR is to identify DNA fragments or a RNA of the virus.
After preliminary cleaning, the sample is registered with one of 2 methods:
- ElectrophoreticIn which the DNA molecules of viruses move in an electric field, and a special dye makes them fluoresce (glow) under the influence of ultraviolet rays.
- Hybridization. Artificially synthesized DNA sections labeled with dye, bind to the DNA of the virus in the sample. Next, they are fixed.
PCR method has a greater sensitivity (95%) compared to ELISA. The duration of the study is 1 day. As biological fluids for analysis, not only blood serum, but also an oily or spinal fluid, saliva, urine, secret from the cervical canal can be used.
Currently, this method is the most informative. If DNA of the virus is found in blood leukocytes, it serves as a sign of primary infection.
Selection of cell culture (sowing) for the diagnosis of CMV
Despite the high sensitivity (80-100%), sowing cell culture is rare, as there are the following limitations:
- the large complexity of the method, the analysis time takes 5-10 days;
- the need for high qualifications from medical personnel;
- the accuracy of the study strongly depends on the quality of the fence of the biological material and the time between the surcharge and sowing;
- a large number of false negative results, especially when conducting diagnostics later than 2 days.
Just as when conducting PCR analysis, you can define a specific type of pathogen. The essence of the study lies in the fact that the samples taken in the patient are placed in a special nutrient medium, in which the growth of microbes occurs and their subsequent study.
Cytology for the diagnosis of cytomegalovirus
Cytological research refers to primary diagnostic species. Its essence lies in the study of cytomegal cells under a microscope, the presence of which indicates a typical change in CMV. For analysis usually take saliva and urine. This method cannot serve the only reliable in the diagnosis of cytomegalovirus infection.
What if IgG is positive to CMV?
Antibodies to cytomegalovirus found in blood and other biological fluids may indicate three possible states: primary or re-infection, recovery and virus carriage. The results of the analyzes require a comprehensive assessment.
If IgG is positive, then to determine the acute phase, the most dangerous to health, it is necessary to consult an infectious doctor and conduct additional IFA studies on IGM, IGA, Avidity or PCR analysis.
When IgG detects, a child under the age of 1, such a survey is recommended to pass and mother. If approximately the same antibody titles are identified, then with a high probability there has been a simple transmission of immunoglobulins during pregnancy, and not infection.
It should be borne in mind that a small amount of IGM can be detected within 2 or more years. Therefore, their presence in the blood does not always serve as a sign of recent infection. In addition, the accuracy of even the best test systems can give both false-positive and false-negative results.
What does it mean if anti-cmv igg is detected?
In the case of re-detection of antibodies to the CMV and the lack of other signs of acute infection, the results of the tests indicate that a person is a lifelong medium of the virus. In itself, this condition is not dangerous. However, before planning pregnancy, as well as in immunodeficiency, it is necessary to periodically monitor the level of immunoglobulins.
In healthy people, this disease is hidden, sometimes with the manifestation of flu-like symptoms. Recovery suggests that the body has successfully coped with infection, and lifelong immunity has developed.
To control the dynamics of the disease, analyzes are prescribed every 2 weeks. If the IGM level is gradually decreasing, the patient recovers, otherwise the disease progresses.
Do you need to treat cytomegalovirus?
It is impossible to get rid of cytomegalovirus completely. If a person is a carrier of this infection, but there are no symptoms, then treatment is not required. The prevention of CMV is of great importance, which is aimed at strengthening immunity. It allows you to keep the virus in the "sleeping" condition and avoid exacerbation.
The same tactics are held against pregnant women and children. In people with severe immunodeficiency states, complications may develop complications in the form of pneumonia, colon and retina. For the treatment of such a category of persons, strong antiviral agents are prescribed.
How to treat cytomegalovirus
CMV therapy is carried out in stages:
Depending on which organs are affected by the virus, the doctor prescribes additional drugs.
In severe cases, the following therapy methods are used:
- for disinfecting the organism - droppers with saline, azesole, di- and trisoli;
- to reduce swelling, inflammation with the damage to the central nervous system - corticosteroid drugs (prednisone);
- in the case of an attachment of the secondary bacterial infection - antibiotics (ceftriaxone, cefepim, ciprofloxacin and others).
During pregnancy
In pregnant women, patients with CMV, treatment is carried out by one of the following funds specified in the table below:
| Name | Form release | Daily dosage | The average price, rub. |
| Acute phase, primary infection | |||
| Cytoteject (immunoglobulin human anticylovirus) | 2 ml per 1 kg of weight every 2 days | 21 000/10 ml | |
| Interferon recombinant alpha 2b (Viferon, Genferon, Hiaferon) | Rectal candles | 1 candle 150 000 IM 2 times a day (after a day). At 35-40 week of pregnancy - 500 000 IU 2 times a day daily. Course duration - 10 days | 250/10 pcs. (150,000 IU) |
| Reactivation or reinfection | |||
| Cimevian (Gancyclovir) | Solution for intravenous administration | 5 mg / kg 2 times a day, course - 2-3 weeks. | 1600/500 mg |
| Walgancyclovir | Pills for oral administration | 900 mg 2 times a day, 3 weeks. | 15 000/60 pcs. |
| Panavir | Solution for intravenous administration or rectal candles | 5 ml, 3 injections with an interval between them in 2 days. Candles - 1 pc. overnight, 3 times, every 48 hours | 1500/5 ampoules; 1600/5 candles |
Preparations
The basis of the treatment of CMV is antiviral drugs:
As an immunomodulatory media, the doctor may assign the following:
- Cycloferon;
- Amixin;
- Laveomax;
- Galavit;
- Tiloron and other drugs.
Immunomodulators used in the remission phase can be used during recurrence. After the end of the acute phase of the disease, both a lining and physiotherapeutic treatment is also shown, it is necessary to eliminate chronic inflammatory and infectious foci.
Folk remedies
In folk medicine, there are several recipes for the treatment of CMV infection:
- Grind fresh grass holly and squeeze juice out of it. Heat 1 l of dry wine on fire is about 70 ° C (at the same time the whitening haze will be raised), add 7 tbsp. l. Honey, mix. Pour 3 tbsp. l. Wrinkle juice, turn off the fire, mix. Take the "Willow Wine" in 1 winery every other day.
- Wormwood, Flowers of Pijmas, crushed roots Nather mixed in equal proportions. 1 tsp. Mixtures poured 0.5 liters of boiling water. This amount is drinking equal portions 3 times a day for half an hour before meals. The duration of treatment with fees is 2 weeks.
- The crushed boron of alder, aspen and willows are mixed in equal proportions. 1 tbsp. l. Collection brew 0.5 liters boiling water and accepted the same as in the previous recipe.
Forecast and complications
Cytomegalovius infection is most often benign, and its signs are confused with ORVI, since patients have the same symptoms - elevated temperature, head and muscle pain, general weakness, chills.
In severe cases, infection can lead to the following complications:
This infection is most dangerous in the early periods of pregnancy, since the fetus and miscarriage often occurs.
The surviving child may have the following congenital deviations:
- reduction of the size of the brain or its watering;
- malformations of heart, lungs and other organs;
- liver damage - hepatitis, cirrhosis, obstruction of biliary tract;
- hemolytic disease of newborns - hemorrhagic rash, hemorrhages in mucous, chair and vomiting with blood, bleeding from the umbilical wound;
- strabismus;
- muscular disorders - cramps, hypertonus, asymmetry of facial muscles and others.
Subsequently, mental delay can be revealed. IgG antibody identified in the blood is not a sign that an active CMV infection flows in the body. A person can already have a lifelong immunity to cytomegalovirus. The most difficult thing to determine the diagnostic picture in newborns. The disease in passive form does not require treatment.
Article clearance: Lozinsky Oleg.
Video about antibodies to cytomegalovirus
Cytomegalovirus IgG and Igm. IFA and PCR with cytomegalovirus:
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