Why this test?
For diagnosis of CMV;
To determine the term of primary infection with cytomegalovirus;
To obtain data on the history of cytomegalovirus infection;
For differential diagnosis of primary infection from the chronic form and the active form of CMV in the period of reactivation (exacerbation) of persistent infection;
To confirm or exclude recent cytomegalovirus infection of pregnant women or women planning to become pregnant in the complex laboratory diagnosis of CMV.
In what cases is it prescribed?
In case of suspicion of CMV and its clinical manifestations;
To estimate the duration of CMV and the history of cytomegalovirus infection;
When determining the date of primary infection and obtaining data on the history of cytomegalovirus infection;
If CMV is suspected in pregnant women;
When planning a pregnancy - to prevent infection of the fetus;
When examining children born to mothers with CMV (it is recommended to conduct research in children older than six months of age);
With positive results of antibodies determination to cytomegalovirus classes IgM and IgG.
Cytomegalovirus (Cytomegalovirus) belongs to the family of human herpes viruses, genus Cytomegalovirus, and is the causative agent of cytomegalovirus infection. This is a widespread human infection, characterized by a mild, asymptomatic course in people under normal conditions, with a normally functioning immune system. It acquires special clinical significance in persons with pathology of the immune system, immunodeficiency states and in pregnant women due to the risk of intrauterine infection of the fetus.
The cytomegalovirus carrier is determined in 60-90% of the adult population. CMV belongs to the group of TORCH-infections (translation of the first letters of the Latin Toxoplasma - Toxoplasma, rubella - Rubella, cytomegalovirus - Cytomegalovirus, herpes - Herpes), which are potentially dangerous for the development of the fetus and cause severe organ damage in newborn children. Cytomegalovirus can be detected in 0.2-2.2% of newborns and is the leading cause of congenital infections worldwide. Approximately 10% of such children develop clinical signs of the disease from birth, in part - during the first ten years of life.
Cytomegalovirus belongs to DNA-containing viruses. It has the ability to slowly spread in the culture of infected cells, changing and increasing the size of cells (the phenomenon of cytomegaly). The source of infection is a person who sheds the virus through various biological fluids. These include blood, saliva, urine, breast milk, cervical and vaginal secretions, seminal fluid, cerebrospinal fluid, contents of the gastrointestinal tract, and other secretions. The infection is transmitted by airborne, contact, sexual means, as a result of a blood transfusion from an infected donor. Infection during organ transplantation and a vertical route of transmission, from an infected woman to a child during pregnancy or childbirth, are also possible. The duration of the incubation period of the disease is often impossible to establish, since most clinical cases are not recognized and proceed in a latent, asymptomatic form. It should be noted that CMV is characterized by long-term persistence of the pathogen in the human body. This leads to the fact that many people are carriers of this type of infection for many years and possibly for a lifetime. When the immune system is weakened, a severe course of the disease may be noted.
Acquired and congenital forms of CMV are distinguished. The acquired form of infection occurs as an acute localized process, similar in clinical symptoms to acute respiratory viral infection or infectious mononucleosis. There is an increase in body temperature, weakness, general malaise, sore throat, myalgia, and an increase in cervical lymph nodes. In rare cases, complications in the form of arthralgias, arthritis, pneumonia, and cytomegalovirus hepatitis are noted.
In children up to three months of age, as well as in persons with immune system pathology (immunodeficiency states, HIV infection, after organ transplantation, treatment with immunosuppressive drugs, with malignant diseases), CMV can proceed in a severe form with the development of serious complications. At the same time, severe damage to the lungs, kidneys, liver, gastrointestinal tract, nervous system with the development of viral encephalitis develops. The congenital form of CMV can occur as a result of transplacental transmission of infection from the mother to the fetus when a woman is infected in the early stages of pregnancy, immediately before pregnancy. There is a special danger of infection in case of primary infection of a woman during pregnancy. At the same time, the woman lacks immunity to cytomegalovirus and, therefore, the child's health is not protected. Acute congenital CMV develops, which leads to spontaneous abortion or death of the embryo. When the fetus is damaged in the later stages of pregnancy, a hemorrhagic syndrome develops with hemorrhages in the skin and internal organs, brain. Encephalomalacia, cerebral calcification, enlargement of the spleen, liver, and hepatitis are noted. It is also possible to infect the child during childbirth when passing through the birth canal. Chronic congenital CMV causes fibrosis of internal organs and malformations: hydrocephalus, microcephaly, uveitis, blindness, heart defects, sensorineural hearing loss, and other neurological disorders. There is also a delay in neurological and mental development.
Diagnosis of CMV is complex and is based on a combination of anamnestic, clinical data and the results of laboratory tests. Due to the fact that the clinical diagnosis of CMV is difficult in most cases, laboratory diagnostic methods are of great importance.