Cytomegaly is a disease caused by cytomegalovirus. It brings a lot of discomfort during the period of its activation. The danger of this infection is that it is impossible to completely recover from it. In order to protect yourself from getting it into the body, you should know how cytomegalovirus is transmitted. Let's focus on this issue.
This virus can be active only in human body. Therefore, the routes of infection with cytomegalovirus are based on contact with an affected person. How can you become infected with cytomegalovirus? Let's consider all the ways of transmitting it.
Unprotected sexual contact is the source of many viral or infectious diseases. Many people are aware of sexually transmitted infections. For example, one of the partners is diagnosed with cytomegalovirus - how is it transmitted to another person?
This process occurs as a result of sperm entering the mucous membranes of the vagina. If a woman is infected, CMV cells are found in her vaginal mucus. But you should know that sexual contact with a condom cannot completely protect a healthy partner from infection. They also become infected with cytomegalovirus during anal or oral sex. Therefore, it is necessary to carefully and responsibly approach the choice of a sexual partner.
Sometimes cytomegalovirus is transmitted by contact, since viruses are also found in saliva. Close contact with a sick person or kissing them can lead to infection.
This type of infection is characterized in many ways, although it occurs quite rarely:
That is, living under the same roof with a person who has been diagnosed with cytomegalovirus poses a risk of infection. The saliva of a sick person poses a risk of infecting healthy family members. Therefore, care should be taken when in contact with a patient, and also conduct a preventive examination to detect cytomegalovirus in the body.
How can a child become infected with cytomegalovirus? This process occurs in utero, that is, the infection enters the baby’s body through the placenta or at the moment natural birth. This disease poses a particular danger to the fetus and newborn. The risk group includes the following category of children:
Intrauterine CMV infection poses a danger to the baby in his or her further development. An infected child is susceptible to various pathological processes in the nervous, digestive, cardiovascular and musculoskeletal systems.
The main symptoms of cytomegaly in children are: prematurity, visual impairment (manifested as strabismus), jaundice, and lack of sucking reflex.
Over time, other ailments are added:
Congenital cytomegalovirus infection is the most dangerous. It is for this reason that conceiving children should be approached with the utmost seriousness. Before this process, steam in mandatory must go through everything necessary examinations and get tested. This will help to detect a pathological virus in a timely manner, and then take the required measures in order to give birth to healthy offspring.
Women who become infected also face the possibility of danger. If a child was born healthy, then there is an increased possibility of his being damaged by breastfeeding– the disease can be transmitted through mother's milk. It is also contagious.
The disease that appeared on early stages pregnancy, most often leads to the death of the fetus or to significant deviations in its development. The appearance of cytomegalovirus in the third trimester can cause the following pathologies in an infected baby:
Infected women after birth healthy baby It is better to completely abandon breastfeeding, despite the fact that it is the most beneficial for the newborn. In this way, a new mother will protect her baby from the virus entering his body.
Since this infection is active in the blood, then through it a healthy person can become infected from a patient. Contact of infected blood with a wound, scratch or other damage to skin leads to infection of a healthy person.
How else does cytomegalovirus infection occur through the blood? The risk of infection manifests itself in the following ways:
In order to protect yourself from this virus entering the body through the hematological route, a person must contact trusted clinics with positive reviews. Also, one of the ways of safety is the vigilance of the potential patient. That is, at the time of medical procedures (injections, IVs), a person is obliged to monitor this process for the use of disposable medical instruments.
The variety of methods of infection with cytomegalovirus is due to the fact that the infection is found in the patient’s saliva, semen, vaginal secretions, urine, blood, breast milk, and tears. That's why defeat healthy people can occur with any direct contact with the patient at a short distance.
A person is sometimes unaware of the acquired pathology. Since obvious symptoms of cytomegaly are not always observed. In such situations, he poses a danger to loved ones.
But you should know that cytomegalovirus infection does not always pose a significant danger to people around the infected person. A person during an exacerbation is considered the most dangerous.
Persons most susceptible to infection are:
It is for this reason that cytomegalovirus infection is widespread in countries and areas with low level life. That is, it most often concerns neglected sections of the population.
With such groups of people it is better to limit close communication or eliminate it completely. In this way, everyone will protect themselves from infection not only with cytomegalovirus, but also with other dangerous diseases.
After infection with cytomegalovirus, the transmission routes of which are diverse, clinical symptoms do not appear immediately. During the first month, the affected person may not be aware of CMV in their body. But over time, the patient gradually experiences the following ailments:
Over time, a patient with cytomegalovirus infection may begin to experience degenerative changes And inflammatory processes internal organs, such as the liver, spleen, lungs.
Cytomegalovirus may not make itself felt for a long period. This applies to people with normal functioning of the immune system.
The development of cytomegalovirus infection causes inflammatory processes in the organs of the genitourinary system. Long-term exacerbation of the disease = leads to the following pathologies:
Of particular danger is the infection of a pregnant woman by a sick person during an exacerbation. In such situations, the unborn baby is most susceptible to the penetration of virus particles through the placenta into his body. The likelihood of fetal death in utero increases. If a pregnant woman was infected before conception, her body produces antibodies. This significantly reduces the risk of cytomegalovirus infection in the unborn baby. The affected person has such characteristic of this disease pathologies:
As for an adult, then active development Cytomegaly leads to the following unpleasant consequences:
Insufficient treatment or ignoring the disease contributes to the active destruction of internal organs and systems. Therefore, you need to contact a specialist for help. It will help you choose the most effective and safe treatment, taking into account the individual characteristics of the course of the disease of each patient. Since it is not possible to completely get rid of cytomegalovirus, therapy should be aimed at eliminating dangerous symptoms, as well as suppressing the activity of the virus using antiviral and antibacterial drugs.
Transmission routes
The source of infection is a person, the location of the virus is saliva, blood, breast milk, sperm, discharge from the cervix and vagina. Infection can occur: through contact through the use of contaminated objects, through blood transfusion and organ transplantation from an infected donor, through airborne droplets, through sexual contact, in utero during pregnancy and during childbirth.
Manifestations of infection
Cytomegalovirus can remain in the human body for a long time in the form of a latent infection and usually manifests itself against the background of some other disease that sharply reduces immunity. Cytomegalovirus, which is “dormant” in the body, may become active against the background of influenza, acute respiratory infections, stress, pregnancy, chronic diseases. The vast majority of people get a cytomegalovirus infection like a common cold. Many do not even know that they are infected, and do not know that they pose a danger to others through various contacts. Against the background of a sharp decrease in immunity, the central nervous system (encephalitis), kidneys (nephritis), lungs (pneumonia), heart (myocarditis), spleen, liver, and intestines are affected.
In women, the virus can cause cervicitis, cervical erosion, inflammation of the ovaries, fallopian tubes. These diseases occur without pronounced manifestations, are chronic, and occasionally cause pain in the genital area.
Course of cytomegalovirus infection during pregnancy
The insidiousness of cytomegalovirus infection lies in its asymptomatic course in most pregnant women. The virus has a high ability to penetrate from a woman to a fetus and ranks first among infections in intrauterine infection of the fetus. The infection rate in women of childbearing age is currently about 80%. For this reason, cytomegalovirus infection is included in the group of diseases (along with toxoplasmosis, rubella and herpes), for which it is better for a woman to be examined before conception.
There are three ways of transmitting the virus to the fetus:
1. During conception, infection with a virus from sperm is possible.
2. The virus can penetrate from the mucous membrane of the uterus or from the cervical canal through the fetal membranes and infect the amniotic fluid, and then the fetus.
3. The virus can reach the fetus through the placenta.
Penetration of cytomegalovirus to the fetus can lead to:
* Development of intrauterine asymptomatic infection without consequences for the child’s health.
* Development of severe infection with intrauterine fetal death (miscarriage, spontaneous abortion, metbirth).
* The birth of a child with congenital cytomegalovirus infection, which immediately manifests itself as developmental defects.
* The birth of a child with congenital cytomegalovirus infection, which does not appear immediately, but in the 2-5th year of life (blindness, deafness, delay in mental development, speech inhibition, psychomotor disorders).
If a congenital infection is detected in a newborn using laboratory methods, this does not necessarily mean that he or she will develop the disease. On the other hand, this does not exclude the possibility of developing late manifestations of the disease. Therefore, such children should be under dispensary observation for the purpose of timely initiation of treatment in case of late development of symptoms of the disease.
The risk of transmission of cytomegalovirus depends primarily on its concentration in the mother's blood. With a primary infection, the risk of transmitting the virus to a child is higher than with an exacerbation of an old one.
Therefore, a married couple planning a child needs to be examined before pregnancy, and not during it. Remove the virus from the body modern medicine cannot, but it is possible to maintain antiviral immunity at the proper level. To do this, it is necessary to determine antiviral immunity - antibodies to the herpes virus and cytomegaly. If there are no deviations from the norm in the indicators (otherwise you need to consult a doctor), it is possible to maintain your immunity in good condition with the help of good nutrition, reasonable physical activity, good sleep etc., that is, with the help of a healthy lifestyle
Diagnostics
The presence of cytomegalovirus can only be detected by special research saliva, urine, blood, semen, smears and scrapings taken from the genitals, especially during primary infection or exacerbation of the disease. In the intervals between exacerbations, blood tests can detect antibodies to cytomegalovirus.
Laboratory diagnosis of congenital cytomegalovirus infection carried out by detecting antibodies in umbilical cord blood and the virus itself in urine, saliva, and blood in the first days of a child’s life.
Treatment
Specific antiviral drugs, such as virazole, acyclovir, etc. do not have an effect, so treatment is aimed at increasing immunity. The drugs used are decaris, T-activin, reaferon, etc. It is possible to use immune gamma globulin "Cytotex" produced in Germany.
During pregnancy it is necessary timely detection exacerbations of the disease and proper treatment. In severe cases, termination of pregnancy is recommended. At the same time, they are based on clinical indications, data from virological studies and ultrasound of the fetus and placenta.
Cytomegalovirus is a virus widespread throughout the world among adults and children, belonging to the group of herpes viruses. Since this virus was discovered relatively recently, in 1956, it is considered not yet sufficiently studied, and in scientific world is still the subject of active debate.
Cytomegalovirus is quite common; antibodies to this virus are found in 10-15% of adolescents and young adults. In people aged 35 years or more, it is found in 50% of cases. Cytomegalovirus is found in biological tissues - semen, saliva, urine, tears. When the virus enters the body, it does not disappear, but continues to live with its host.
Cytomegalovirus (another name is CMV infection) is an infectious disease that belongs to the herpesvirus family. This virus affects humans both in utero and in other ways. Thus, cytomegalovirus can be transmitted sexually or through airborne alimentary routes.
The transmission routes for cytomegalovirus are varied, since the virus can be found in blood, saliva, milk, urine, feces, seminal fluid, and cervical secretions. Possible airborne transmission, transmission through blood transfusion, sexual intercourse, and possible transplacental intrauterine infection. Important place infection occurs during childbirth and when breastfed by a sick mother.
There are often cases when the carrier of the virus does not even suspect it, especially in situations where symptoms hardly appear. Therefore, you should not consider every carrier of cytomegalovirus to be sick, since existing in the body, it may never manifest itself in its entire life.
However, hypothermia and a subsequent decrease in immunity become factors that provoke cytomegalovirus. Symptoms of the disease also appear due to stress.
IgM are antibodies that immune system begins to produce 4-7 weeks after a person is first infected with cytomegalovirus. Antibodies of this type are also produced every time the cytomegalovirus remaining in the human body after a previous infection begins to actively multiply again.
Accordingly, if you have been found to have a positive (increased) titer of IgM antibodies against cytomegalovirus, this means:
A positive titer of IgM antibodies can persist in a person's blood for at least 4-12 months after infection. Over time, IgM antibodies disappear from the blood of a person infected with cytomegalovirus.
The incubation period is 20-60 days, the acute course is 2-6 weeks after incubation period. Staying in a latent state in the body both after infection and during periods of attenuation - for an unlimited time.
Even after undergoing a course of treatment, the virus lives in the body for life, maintaining the risk of relapse, so doctors cannot guarantee the safety of pregnancy and full gestation even if a stable and long-term remission occurs.
Many people who carry cytomegalovirus do not show any symptoms. Signs of cytomegalovirus may appear as a result of disturbances in the functioning of the immune system.
Sometimes in people with normal immunity this virus causes the so-called mononucleosis-like syndrome. It occurs 20-60 days after infection and lasts 2-6 weeks. It manifests itself as high fever, chills, fatigue, malaise and headache. Subsequently, under the influence of the virus, a restructuring of the body’s immune system occurs, preparing to repel the attack. However, in case of lack of strength, the acute phase passes into a calmer form, when vascular-autonomic disorders often appear, and damage to internal organs also occurs.
IN in this case There are three possible manifestations of the disease:
Particular attention should be paid to CMV infection in the fetus (intrauterine cytomegalovirus infection), in newborns and young children. An important factor is the gestational period of infection, as well as the fact whether the pregnant woman was infected for the first time or whether the infection was reactivated - in the second case, the likelihood of infection of the fetus and the development of severe complications is significantly lower.
Also, if a pregnant woman is infected, fetal pathology is possible when the fetus becomes infected with CMV entering the blood from outside, which leads to miscarriage (one of the most common reasons). It is also possible to activate the latent form of the virus, which infects the fetus through the mother’s blood. Infection leads either to the death of the child in the womb/after birth, or to damage to the nervous system and brain, which manifests itself in various psychological and physical diseases.
When a woman becomes infected during pregnancy, in most cases she develops acute form diseases. Possible damage to the lungs, liver, and brain.
The patient notes complaints about:
If the fetus is infected during pregnancy (but not during childbirth), congenital cytomegalovirus infection may develop in the child. The latter leads to severe diseases and damage to the central nervous system (mental retardation, hearing loss). In 20-30% of cases the child dies. Congenital cytomegalovirus infection is observed almost exclusively in children whose mothers become infected with cytomegalovirus for the first time during pregnancy.
Treatment of cytomegalovirus during pregnancy includes antiviral therapy based on intravenous injection acyclovir; the use of drugs to correct immunity (cytotect, intravenous immunoglobulin), as well as control tests after completing a course of therapy.
Congenital cytomegalovirus infection is usually diagnosed in a child in the first month and has the following possible manifestations:
Manifestation is also possible in adulthood, when the child is 3-5 years old, and usually looks like an acute respiratory infection (fever, sore throat, runny nose).
Cytomegalovirus is diagnosed using the following methods:
Photo: Cytomegalovirus in the lungs under a microscope
Cytomegalovirus is so widespread among people that it is a stretch to classify this infection as a sexual infection. Although it is transmitted precisely through close physical contact through body fluids - saliva, tears, mucus, sperm, blood. It is included in the herpesvirus family as number 5, the name is often abbreviated to CMV or CMV.
It is completely safe for healthy people - if there are any manifestations, they are similar to a cold and go away on their own without treatment and without consequences. Antibodies remain in the blood, which will now protect the body from re-infection for the rest of its life.
In people with poor condition immune system, the disease is severe. In them, CMV can cause irreversible damage to the nervous, respiratory, genitourinary and other systems. At risk are unborn or premature babies, pregnant women who have not encountered cytomegalovirus before, and patients HIV And AIDS, and those undergoing immunosuppressive therapy.
In external environment Cytomegalovirus is quite stable - it can survive for hours, even days. You can catch it through any repeated close contact with a person whose infection is in the active phase. Kisses, shared towels, dishes, and hygiene products are contagious.
Babies become infected from their mothers through breast milk, older children - from their parents through everyday contact and from other children during play. Adults - during sex and through everyday life. Rarely - with blood transfusion, organ transplantation.
The incubation period ranges from several days to several weeks.
The virus primarily targets epithelial cells lining the mucous membranes. It also lives in glandular tissue, multiplying in the salivary glands, prostate and pancreas. May affect nerve tissue.
The course of the disease greatly depends on the initial state of immunity. If your health is excellent, symptoms of cytomegalovirus may be completely absent. But more often the primary infection looks like common cold: sore throat, malaise, weakness, cough, pain in muscles and joints, fever up to 38-39 degrees. The disease lasts 2-3 weeks and goes away on its own, after which the pathogen goes into a dormant state, being under the control of the immune system.
It is impossible to completely get rid of CMV. In a dormant state, it is beyond the reach of protective forces. But in case of reactivation of the virus or new contact with it from the outside, the body will be ready to defend itself immediately. The antibodies remaining in the blood serum after the first time will now deal with it so effectively that the person will not notice anything, and the fact of the disease can be established only by test results.
Bad news for those at risk: during the reactivation period, such a person, without knowing it, is still contagious. In Russia, 60% of the population over 6 years of age are carriers, and all of them are potentially dangerous to those who should not encounter cytomegalovirus. Among older people, the carrier rate reaches 91%.
In all pregnant women, the body deliberately weakens the immune system - this is how it protects itself from the fact that the fetus may be mistaken for a foreign object. Primary infection during pregnancy is especially dangerous for the baby, but the mother may also have health consequences.
In some conditions, weakened immunity is prescribed by doctors: autoimmune diseases, conditions after organ transplantation, chemotherapy treatment for cancer pathology.
And the infected HIV (AIDS) know that they have to be afraid of any foreign microbes.
For all these people, cytomegalovirus infection poses a particular danger. Complications can be serious:
Without treatment, these conditions can pose a danger to life and health and cause irreversible processes. Antiviral drugs are used as a preventative measure in such cases. Cytomegalovirus is treated with valganciclovir, ganciclovir, or cidofovir. It is imperative to constantly monitor the titer (quantity) of antibodies and viral load. They also conduct a course of immunostimulating therapy, prescribe vitamins and immunomodulators (interferon is most often used). Even during pregnancy, the potential risk from prescribing medications is lower than the risk associated with intrauterine infection of the child.
Most women first encounter CMV before conception. If this fact is known reliably, you don’t have to be particularly afraid of it. If the infection is reactivated during pregnancy, the risk of its transmission from mother to child is 1%, the risk of pathologies in the fetus is 0.1%. Yes, the numbers are non-zero, but compared to other dangers, these probabilities are not serious.
If you are planning a child, or just thinking about it, or even just one of the women of childbearing age with constant sex life– check in advance whether you have antibodies to cytomegalovirus. To do this, it is enough to take a single test for hidden infections. Save the result.
The most unfavorable is the primary infection of a woman during pregnancy. Then the virus is transmitted to the baby in 40% of cases, and the risk of pathologies is 9%.
On average, one child in 150 newborns is born with a congenital form of cytomegalovirus infection. 80% of such children do not have severe symptoms cytomegalovirus. But the absence of symptoms does not protect against long-term consequences.
The outcome depends on the period at which the infection occurred. In the first trimester, cytomegalovirus is one of the common causes of missed or undeveloped pregnancy. The reason is fetal developmental anomalies incompatible with life. The body itself prevents the birth of a seriously ill child. If this protective mechanism fails, a child may be born with developmental anomalies, the severity of which can vary widely. The most serious pathologies are absence of the brain (anencephaly), microcephaly (abnormally small head), etc.
Congenital cytomegalovirus in children also causes jaundice, skin rashes, viral pneumonia, and seizures. Possible decreased birth weight, delay intrauterine development, convulsive syndrome, blindness, deafness, mental retardation. In the absence serious illnesses health problems may appear later in life. Children who have had congenital CMV infection, more often have problems with coordination, learning, and lag behind their peers.
The basis for diagnosing cytomegalovirus is enzyme immunoassay(ELISA). The method is based on identifying specific antibodies in the blood that are produced by the body in response to pathogen invasion. The more aggressive the disease, the higher the antibody titer.
In the acute phase, an increase in antibody titer occurs due to class M immunoglobulins. The presence of anti-CMV-IgM in the blood serum indicates that the virus is in the active phase. They remain in the body for 1 to 3 months after treatment.
With chronic infection, the titer of antibodies to class G cytomegalovirus - anti-CMV-IgG - increases.
Doctors recommend testing immediately when ARVI symptoms occur in pregnant women. Subject to availability high titer immunoglobulin M is carried out preventive treatment by using antiviral drugs. This strategy helps prevent serious complications in the fetus.
Above, we explained why it is so important to establish whether the primary infection occurred during or before pregnancy. Not everyone gets tested for hidden infections in advance. Gestation lasts 9 months, while class M immunoglobulins are not present in the blood for long. In such cases, an ELISA test is performed to determine the avidity of IgG to cytomegalovirus. The method allows us to clarify the timing of infection and the activity of the virus. Its principle is based on the “strength” of antibodies. The longer the microbe is present in the body, the greater the ability of the immune system to resist the disease. Over time, antibodies improve their ability to bind the pathogen. And vice versa, brand new, still “green” antibodies do not fight the virus very effectively.
Avidity is displayed as the percentage of high-avidity antibodies to CMV. The higher the %, the more recent the penetration of the microbe. High avidity (more than 85-90%) allows us to exclude primary infection in the last 3 months.
A more accurate but more expensive method is also used diagnosis of CMV using PCR (polymerase chain reaction, PCR). Saliva, discharge from the genital organs, washings from the bronchi, cerebrospinal fluid, blood serum. Cervical mucus is taken from pregnant women. The method is based on determining the genetic information of the pathogen in samples. The sequence of genes in each bacterium or virus is unique, like the pattern of the retina of the eye. If there is genetic information characteristic of the pathogen, the method makes it possible to determine the fact of infection (qualitative analysis), the approximate amount of the pathogen in the body and the degree of its activity/replication (viral load, quantitative analysis).
Prevention is relevant only to people with immunodeficiencies and pregnant women without class G antibodies. They will have to:
Cytomegalovirus infection (CMVI, inclusion cytomegaly) is a very common viral disease, usually characterized by a hidden or mild course.
For a normal adult, the infectious agent does not pose a threat, but it can be deadly for newborns, as well as people with immunodeficiencies and transplant patients. Cytomegalovirus during pregnancy often leads to intrauterine infection of the fetus.
Please note:It is believed that long-term persistence (survival in the body) of the virus is one of the reasons for the development of oncological diseases such as mucoepidermoid carcinoma.
CMV has been found in all regions of the planet. According to statistics, it is present in the body of approximately 40% of people. Antibodies to the pathogen, indicating its presence in the body, are found in 20% of children in the first year of life, in 40% of people under the age of 35, and in almost every person aged 50 years and older.
Although most of those infected are latent carriers, the virus is by no means harmless. Its persistence negatively affects the immune system and in the long term often leads to increased morbidity due to reduced body reactivity.
It is currently impossible to completely get rid of cytomegalovirus, but it is quite possible to minimize its activity.
There is no single generally accepted classification. Congenital cytomegalovirus infection is conventionally divided according to its forms into acute and chronic. Acquired CMV infection can be generalized, acute mononucleosis, or latent (without active manifestations).
The causative agent of this opportunistic infection belongs to the family of DNA-containing herpesviruses.
The carrier is a person, i.e. CMV is an anthroponotic disease. The virus is found in the cells of a wide variety of organs rich in glandular tissue (which explains the absence of a specific clinical symptoms), but most often it is associated with salivary glands(affects their epithelial cells).
Anthroponotic disease can be transmitted through biological fluids (including saliva, semen, cervical secretions). It can be contracted through sexual contact, through kissing and through the use of shared hygiene items or utensils. When not enough high level hygiene, the fecal-oral route of transmission cannot be excluded.
Cytomegalovirus is transmitted from mother to child during pregnancy (intrauterine infection) or through breast milk. There is a high probability of infection during transplantation or blood transfusion (blood transfusion) if the donor is a carrier of CMV infection.
Please note: CMV infection was once widely known as the “kissing disease” because it was believed that the disease was transmitted exclusively through saliva during a kiss. Pathologically altered cells were first discovered during post-mortem examination of tissues at the end of the 19th century, and cytomegalovirus itself was isolated only in 1956.
Once on the mucous membranes, the infectious agent penetrates through them into the blood. This is followed by a short period of viremia (the presence of the CMV pathogen in the blood), which ends with localization. The target cells for cytomegalovirus are mononuclear phagocytes and leukocytes. The process of replication of the DNA genomic pathogen takes place in them.
Once it enters the body, cytomegalovirus, unfortunately, remains there for the rest of a person’s life. The infectious agent can actively reproduce only in some cells and under optimal conditions. Thanks to this, with a sufficiently high level of immunity, the virus does not manifest itself in any way. But if protective forces weakened, cells under the influence infectious agent lose the ability to divide, and greatly increase in size, as if swelling (i.e., cytomegaly itself occurs). The DNA genomic virus (3 strains have been discovered so far) is capable of reproducing inside the “host cell” without damaging it. Cytomegalovirus loses activity at high or low temperatures and is characterized by relative stability in an alkaline environment, but an acidic environment (pH ≤3) quickly leads to its death.
Important:decreased immunity may be a consequence of AIDS, chemotherapy using cytostatics and immunosuppressants, carried out with oncological diseases, as well as ordinary hypovitaminosis.
Microscopy reveals that the affected cells have acquired the characteristic “owl's eye” appearance. They contain inclusions (inclusions), which are clusters of viruses.
At the tissue level pathological changes manifested by the formation of nodular infiltrates and calcifications, the development of fibrosis and tissue infiltration by lymphocytes. Special gland-like structures can form in the brain.
The virus is resistant to interferons and antibodies. Direct impact on cellular immunity due to suppression of the generation of T lymphocytes.
Certain clinical manifestations may occur against the background of primary or secondary immunodeficiencies.
Symptoms of cytomegalovirus infection are nonspecific, that is, the disease can manifest itself differently, depending on which cells are predominantly affected.
In particular, when the mucous membranes of the nose are damaged, nasal congestion appears and develops. Active reproduction of cytomegalovirus in organ cells gastrointestinal tract causes diarrhea or constipation; It is also possible that pain or discomfort may occur in abdominal area and a number of others unclear symptoms. Clinical manifestations exacerbations of CMV infection usually disappear on their own after several days.
Please note: active infection can serve as a kind of “indicator” of the failure of cellular immunity.
Often, the virus can infect the cells of the mucous membranes of the genitourinary system.
In men, the virus multiplies in the organs reproductive system in most cases it does not manifest itself in any way, i.e. we are talking about an asymptomatic course.
In women, CMV infection manifests itself inflammatory diseases genitals.
The following pathologies may develop:
Important:in severe cases (usually early age or against the background of HIV infection), the pathogen becomes very active and spreads through the bloodstream to different organs, i.e., hematogenous generalization of the infection takes place. Multiple organ lesions are characterized severe course, similar to . In such cases, the outcome is often unfavorable.
Damage to the gastrointestinal tract leads to the development of bleeding, in which bleeding is frequent and perforation is not excluded, the consequence of which is life-threatening inflammation of the peritoneum (peritonitis). Against the background of acquired immunodeficiency syndrome, there is a possibility of encephalopathy with a subacute course or chronic (inflammation of brain tissue). Damage to the central nervous system in a short time causes dementia (dementia).
To the number possible complications CMV infections also include:
In AIDS, cytomegalovirus in some cases affects the retina of the eyes, causing gradually progressive necrosis of its areas and blindness.
Cytomegalovirus infection in women during pregnancy can cause intrauterine (transplacental) infection of the fetus, which does not exclude developmental defects. It should be noted that if the virus persists in the body for a long time, and, despite physiological immunosuppression, there are no exacerbations during pregnancy, then the likelihood that the unborn child will be harmed is extremely low. The likelihood of damage to the fetus is significantly higher if infection occurs directly during pregnancy (infection in the first trimester is especially dangerous). In particular, prematurity and stillbirth cannot be ruled out.
At acute course CMV infection in pregnant women may cause the following symptoms:
Manifestations often occur in combination. Placental abruption and very significant blood loss during labor cannot be ruled out.
Possible fetal malformations with CMV infection include:
Intrauterine infection is observed even less frequently than intrapartum infection (when a child is born while passing through the birth canal).
During pregnancy, the use of immunomodulatory drugs - T-activin and Levamisole - may be indicated.
Important: to prevent negative consequences, even at this stage and in the future, according to the recommendations of the gynecologist, a woman should take tests for.
CMV infection for newborns and children younger age poses a serious threat, since the immune system in children is not fully formed, and the body is not able to adequately respond to the introduction of an infectious agent.
Congenital CMV, as a rule, does not manifest itself in any way at the beginning of the baby’s life, but the following are possible:
The acute congenital form of the disease in some cases leads to fatal outcome in the first 2-3 weeks.
Over time, serious pathologies such as
Treatment of CMV infection is generally ineffective. We are not talking about complete destruction of the virus, but the activity of cytomegalovirus can be greatly reduced with the help of modern drugs.
The antiviral drug Ganciclovir is used to treat newborns for health reasons. In adult patients, it is able to slow down the development of retinal lesions, but with lesions of the digestive, respiratory and central nervous systems it has virtually no effect. positive result. Discontinuation of this drug often leads to relapses of cytomegalovirus infection.
One of the most promising drugs for the treatment of CMV infection is Foscarnet. The use of specific hyperimmune immunoglobulin may be indicated. Interferons also help the body quickly cope with cytomegalovirus.
A successful combination is Acyclovir + A-interferon. Ganciclovir is recommended to be combined with Amiksin.
Konev Alexander, therapist
