How to recover from cytomegalovirus. Detection and treatment of cytomegalovirus infection in adults

Treatment of cytomegalovirus infection is carried out with medications whose effectiveness has been proven in controlled studies: ganciclovir, valganciclovir, foscarnet sodium, cidofovir. Interferon drugs and immunocorrectors are not effective for cytomegalovirus infection. For active cytomegalovirus infection (presence of cytomegalovirus DNA in the blood) in pregnant women, the drug of choice is human anticytomegalovirus immunoglobulin (neocytotect). To prevent vertical infection of the fetus with the virus, the drug is prescribed 1 ml/kg per day intravenously, 3 injections with an interval of 1-2 weeks. In order to prevent the manifestation of the disease in newborns with active cytomegalovirus infection or with a manifest form of the disease with minor clinical manifestations, Neocytotect is indicated at a dose of 2-4 ml/kg per day for 6 injections (every 1 or 2 days). If children, in addition to cytomegalovirus infection, have other infectious complications, instead of neocytotect, it is possible to use pentaglobin 5 ml/kg daily for 3 days, repeating the course if necessary, or other immunoglobulins for intravenous administration. The use of neocytotect as monotherapy in patients suffering from manifest, life-threatening or severe consequences of cytomegalovirus infection is not indicated.

Ganciclovir and valganciclovir are the drugs of choice for the treatment, secondary prevention and prevention of manifest cytomegalovirus infection. Treatment of manifest cytomegalovirus infection with ganciclovir is carried out according to the following scheme: 5 mg kg intravenously 2 times a day with an interval of 12 hours for 14-21 days in patients with retinitis: 3-4 weeks - in case of damage to the lungs or digestive tract; 6 weeks or more - with pathology of the central nervous system. Valganciclovir is used orally in a therapeutic dose of 900 mg 2 times a day for the treatment of retinitis, pneumonia, esophagitis, enterocolitis of cytomegalovirus etiology. The duration of administration and effectiveness of valganciclovir are identical to parenteral therapy with ganciclovir. The criteria for the effectiveness of therapy are normalization of the patient’s condition, clear positive dynamics according to the results of instrumental studies, and the disappearance of cytomegalovirus DNA from the blood. The effectiveness of ganciclovir in patients with cytomegalovirus lesions of the brain and spinal cord is less, primarily due to the late etiological diagnosis and untimely initiation of therapy, when irreversible changes in the central nervous system are already present. The effectiveness of ganciclovir, the frequency and severity of side effects in the treatment of children suffering from cytomegalovirus disease. comparable to indicators for adult patients. If a child develops a life-threatening manifest cytomegalovirus infection, the use of ganciclovir is necessary. For the treatment of children with manifest neonatal cytomegalovirus infection, ganciclovir is prescribed at a dose of 6 mg/kg intravenously every 12 hours for 2 weeks, then, if there is an initial effect of therapy, the drug is used at a dose of 10 mg/kg every other day for 3 months.

If the state of immunodeficiency persists, relapses of cytomegalovirus disease are inevitable. HIV-infected patients who have been treated for cytomegalovirus infection are prescribed maintenance therapy (900 mg/day) or ganciclovir (5 mg/kg/day) to prevent relapse of the disease. Maintenance treatment in patients with HIV infection who have suffered from cytomegalovirus retinitis is carried out against the background of HAART until the number of CD4 lymphocytes increases to more than 100 cells per 1 μl, which persists for at least 3 months. The duration of the maintenance course for other clinical forms of cytomegalovirus infection should be at least one month. If the disease relapses, a repeated therapeutic course is prescribed. Treatment of uveitis that develops during immune system restoration involves systemic or periocular administration of steroids.

Currently, in patients with active cytomegalovirus infection, a “preemptive” etiotropic treatment strategy is recommended to prevent the manifestation of the disease. The criteria for prescribing preventive therapy are the presence of deep immunosuppression in patients (for HIV infection - the number of CD4 lymphocytes in the blood is less than 50 cells in 1 μl) and the determination of cytomegalovirus DNA in whole blood in a concentration of more than 2.0 lgl0 gene/ml or the detection of cytomegalovirus DNA in plasma. The drug of choice for the prevention of manifest cytomegalovirus infection is valganciclovir, used at a dose of 900 mg/day. The course duration is at least a month. The criterion for stopping therapy is the disappearance of cytomegalovirus DNA from the blood. In organ recipients, preventive therapy is carried out for several months after transplantation. Side effects ganciclovir or valganciclovir: neutropenia, thrombocytopenia, anemia, increased serum creatinine levels. skin rash, itching, dyspepsia, reactive pancreatitis.

Standard treatment for cytomegalovirus infection

Treatment course: ganciclovir 5 mg/kg 2 times a day or valganciclovir 900 mg 2 times a day, duration of therapy is 14-21 days or more until the symptoms of the disease and cytomegalovirus DNA disappear from the blood. In case of relapse of the disease, a repeated treatment course is carried out.

Maintenance treatment of cytomegalovirus infection: valganciclovir 900 mg/day for at least a month.

Preventive treatment of cytomegalovirus infection in immunosuppressed patients to prevent the development of cytomegalovirus disease: valganciclovir 900 mg/day for at least a month until there is no cytomegalovirus DNA in the blood.

Preventive treatment of cytomegalovirus infection during pregnancy to prevent vertical infection of the fetus: neocytotect 1 ml/kg per day intravenously, 3 injections with an interval of 2-3 weeks.

Preventive treatment of cytomegalovirus infection in newborns and children younger age to prevent the development of the manifest form of the disease: neocytotect 2-4 ml/kg per day intravenously, 6 injections under the control of the presence of cytomegalovirus DNA in the blood.

Cytomegalovirus is a fairly common viral disease, which, however, is not known to everyone. Cytomegalovirus, symptoms and characteristic features which are determined primarily by the state of the immune system, in its normal state it may not manifest itself at all, without having any harmful effect on the body of the virus carrier. It is noteworthy that in this case the only feature of the virus carrier is the possibility of transmitting cytomegalovirus infection to another person.

general description

Cytomegalovirus is actually a relative of the common one, because it is part of the group of herpes viruses, which includes, in addition to herpes and cytomegalovirus, two diseases such as and. The presence of cytomegalovirus is noted in blood, semen, urine, vaginal mucus, and also in tears, which determines the possibility of infection through close contact with these types of biological fluids.

Considering the fact that human tears rarely enter the body, most infections occur through sexual contact and even kissing. At the same time, it is important to note that although this virus is extremely common, it is still not a particularly contagious infection - to acquire this virus it is necessary to try very intensively and for a long time to mix your own fluids and the fluids of the virus carrier. Given these features, there is no need to exaggerate the danger posed by cytomegalovirus, however, precautions should not be neglected either.

Cytomegalovirus: main types of disease

It is extremely difficult to determine the duration of the disease we are considering in latent form, because it is impossible to determine the moment that is noted in the course of the disease as the initial one. Conventionally, it is designated within a period of one to two months. As for the varieties of cytomegalovirus, experts distinguish the following: possible options:

• Congenital cytomegalovirus infection , the symptoms of which manifest themselves mostly in the form of an enlarged spleen and liver. In addition, the danger of the disease lies in the possible hemorrhage that occurs against the background of infection, occurring in the internal organs. Such features of the course lead to disturbances in the functioning of the central nervous system; in addition, in women, the infection can provoke a miscarriage.
• Acute cytomegalovirus infection. The main routes of infection here are predominantly sexual contact, but infection through blood transfusion cannot be ruled out. Features of symptoms, as a rule, are similar to those characteristic of the common cold; in addition, there is also an increase in salivary glands and the formation of white plaque on the gums and tongue.
• Generalized cytomegalovirus infection. In this case, the manifestations of the disease are expressed in the formation of inflammatory processes in the spleen, kidneys, adrenal glands, and pancreas. As a rule, inflammatory processes occur due to decreased immunity, and their course occurs in combination with a bacterial infection.

General symptoms of cytomegalovirus infection

Medical practice determines three possible options that characterize the course of cytomegalovirus, which, accordingly, determines the characteristics of its symptoms. In particular, the following possible flow options are distinguished:

• Cytomegalovirus infection, which manifests itself in a normal state that characterizes the functioning of the immune system. The duration of the latent course of the disease is about two months. Symptoms of cytomegalovirus infection include fever, muscle pain and general weakness. In addition, there is also an increase in lymph nodes. As a rule, the disease in this case goes away on its own, which becomes possible thanks to antibodies produced by the body itself. Meanwhile, cytomegalovirus can remain in it for quite a long time, remaining in an inactive state throughout the period of its presence in the body.
• Cytomegalovirus infection, which occurs when the body’s immune system weakens. In this case, we are talking about a generalized form, in accordance with the characteristics of which the disease manifests itself. In particular, the symptoms include damage to the lungs, liver, pancreas, kidneys and retina. Due to the peculiarities of the state of the immune system, cytomegalovirus infection manifests itself in patients after bone marrow or any internal organ transplantation, as well as in patients with diseases of a lymphoproliferative nature (leukemia) and patients with tumors formed by hematopoietic cells (hemoblastosis).
• Congenital cytomegalovirus infection. Its manifestations occur against the background of intrauterine infection, with the exception of miscarriages. The symptoms characteristic of the disease in this form are expressed in manifestations of prematurity, which implies a delay in development, as well as problems with the formation of the jaw, hearing and vision. There is also an increase in the spleen, kidneys, liver and some other types of internal organs.

Cytomegalovirus: symptoms in men

Cytomegalovirus infection in men is found in the body mainly in an inactive form, and the main reason causing its activation can be a decrease in protective forces, which the body encounters during stressful situations, nervous exhaustion and colds.

Dwelling on the symptoms of cytomegalovirus in men, we can highlight the following manifestations:

• temperature increase;
• chills;
• headache;
• swelling of the mucous membranes and nose;
• enlarged lymph nodes;
• runny nose;
• skin rash;
• inflammatory diseases that occur in the joints.

As you can see, the listed manifestations are similar to the manifestations noted with acute respiratory infections and. Meanwhile, it is important to consider that symptoms of the disease appear only 1-2 months from the moment of infection, that is, after completion of incubation period. The main difference that makes it possible to separate this disease from a cold is the duration of its characteristic clinical manifestations. Thus, the symptoms of cytomegalovirus persist for four to six weeks, while acute respiratory infections traditionally last no more than one to two weeks.

From the moment of infection, the patient immediately acts as an active carrier of the virus, remaining so for a period of about three years. In addition, some cases indicate that cytomegalovirus also affects the genitourinary organs, which, in turn, leads to the appearance of inflammatory diseases in the organ area genitourinary system and testicular tissue. Actual lesions due to cytomegalovirus in this area lead to discomfort when urinating.

A critical drop in immunity leads to a greater severity of cytomegalovirus, which, in turn, causes damage to internal organs, as well as disorders in the central nervous system, pleurisy, myocarditis, and encephalitis. Rare cases indicate that the presence of a number of infectious diseases in a patient can lead to the inflammatory process causing paralysis in the brain tissue, which, accordingly, leads to death.

As in other cases, the natural level of susceptibility to the infection we are considering in men in particular is extremely high, while the infectious process itself can occur with different symptoms. Meanwhile, again, provided that the immune system is functioning normally, the course of the disease is not accompanied by any pronounced manifestations. Cytomegalovirus occurs in acute form in current immunodeficiency physiological conditions, as well as in the presence of congenital or acquired types of immunodeficiency.

Cytomegalovirus and pregnancy: symptoms

During pregnancy, cytomegalovirus can cause serious problems affecting the development of the child or even lead to the death of the fetus. It should be noted that the risk of transmission of infection through the placenta is extremely high.

The most serious consequences are observed in the case of primary infection, which the fetus is exposed to when the pathogen enters the mother’s body when carrying a child for the first time. Given this feature, those women who did not have antibodies to cytomegalovirus in their blood before conception should be especially careful about their own health - in this case they are at risk.

The possibility of fetal infection is noted in the following situations:

• at conception (if there is a pathogen in the male semen);
• through the placenta or through the membranes during fetal development;
• during childbirth while the baby is passing through the birth canal.

In addition to the listed situations, infection of a newborn is also possible during feeding, which occurs due to the presence of mother's milk virus. It is noteworthy that infection of a child during labor activity, and also during the first months of his life is not as dangerous for him as for the fetus during the period of intrauterine development.

If the fetus becomes infected during pregnancy, it is possible to take various directions development of the pathological process. Some cases indicate that cytomegalovirus may not cause any symptoms and, accordingly, may not affect the child’s health in any way. This, in turn, significantly increases the chances that the baby will be born healthy.

It also happens that such children have a low birth weight, which, however, does not entail any special consequences - after some time, in most cases, both the weight and level of development of the children come to the indicators of their peers. Some children, in accordance with a number of indicators, may lag behind in development. Newborns thus become, like the vast majority of people, passive carriers of cytomegalovirus infection.

In the case of intrauterine infection of the fetus with cytomegalovirus infection, its death may occur as a result of the development of the infectious process; in particular, such a forecast becomes relevant in early stages during pregnancy (up to 12 weeks). If the fetus survives (which mainly happens if it is infected at a time later than the period determined critical for infection), then the baby is born with a congenital cytomegalovirus infection. Manifestations of its symptoms are noted immediately, or it becomes noticeable by the second to fifth years of life.

If the disease manifests itself immediately, then it is characterized by a course in combination with a number of developmental defects in the form of underdevelopment of the brain, dropsy, as well as diseases of the liver and spleen (jaundice, enlargement of the liver). In addition, a newborn may have congenital deformities; heart disease, the possibility of developing deafness, muscle weakness, cerebral palsy, etc. become relevant for him. There is a possible risk of diagnosing a child with a delay in the level of mental development.

As for the possibility of the manifestation of symptoms characteristic of cytomegalovirus at a later age, the consequences of infection during pregnancy manifest themselves in this case in the form of hearing loss, blindness, inhibited speech, psychomotor impairment and retardation in mental development. Due to the severity of the consequences that can be caused by infection with the virus in question, its appearance during pregnancy can act as an indication for artificial termination of pregnancy.

The final decision in this matter is made by the doctor based on the results obtained from ultrasound, virological examination, as well as taking into account the patient’s current complaints.

As we have already noted, the most severe consequences of infection of the fetus with cytomegalovirus infection are observed almost exclusively only in the case of primary infection of the mother with the pathogen during pregnancy. Only in this case there are no antibodies in the woman’s body that prevent the pathogenic effects of the virus. Thus, in its unattenuated state, cytomegalovirus penetrates the fetus through the placenta without any difficulty. It should be noted that the probability of possible infection of the fetus is 50% in the case under consideration.

Preventing primary infection is possible by limiting contact with a significant number of people as much as possible, especially with children, who, if they have the virus, excrete it in environment occurs before the age of five years. The presence of antibodies in a pregnant woman’s body determines the possibility of exacerbation of the disease in the event of a decrease in immunity, as well as in the presence of a concomitant type of pathology and the use of certain medications, the action of which suppresses the protective forces inherent in the body.

Now let's look at the symptoms. Cytomegalovirus, the symptoms of which in women during pregnancy are similar to the symptoms, is expressed, accordingly, in a slight increase in temperature and general weakness. It is also important to note that for the most part, the course of the infectious process can be characterized by a complete absence of symptoms, and the detection of the virus occurs only as a result of appropriate laboratory tests. To make an accurate diagnosis, it is necessary to conduct a blood test for the presence of intrauterine infections.

Treatment of a pregnant woman diagnosed with acute cytomegalovirus or if primary infection is relevant requires the use of antiviral medications, as well as immunomodulators.

It is noteworthy that timely treatment determines the possibility of minimizing the risk of intrauterine fetal development. If a pregnant woman acts as a virus carrier, treatment is not performed. The only thing a doctor can recommend in this case is the mother’s attentive attitude towards own immunity, and, accordingly, to maintaining it at an appropriate level. When a child is born with a congenital form of cytomegaly, it is recommended to postpone planning the next pregnancy for about two years.

Cytomegalovirus: symptoms in children

The reason that provokes the occurrence of cytomegalovirus infection in children is infection during intrauterine development through the placenta. When infected before 12 weeks, as we have already noted, there is a high risk of fetal death, and if infection occurs at a later date, the fetus survives, but certain disturbances in its development are noted.

Only about 17% of the total number of infected children experience various symptoms consistent with cytomegalovirus infection. Cytomegalovirus infection in children, the symptoms of which manifest themselves in the form of jaundice, an increase in the size of internal organs (spleen, liver), and changes in the composition of the blood at the biochemical level, in severe forms of its course can provoke disorders in the central nervous system. In addition, as we noted earlier, damage to the hearing aid and eyes may develop.

In frequent cases, a profuse rash appears in children within the first hours (days) from the moment of birth if they have an infection. It affects the skin of the torso, face, legs and arms. In addition, cytomegalovirus, the symptoms of which in a child are often accompanied by hemorrhages under the skin or mucous membranes, is often accompanied by bleeding of the umbilical wound along with the detection of blood in the stool.

Brain damage leads to trembling of the hands and convulsions, and increased drowsiness is noted. Cytomegalovirus infection, the symptoms of which also, in its congenital form, manifest themselves in the form of visual impairment or complete loss, can also occur in combination with developmental delays.

If the mother has an acute form of cytomegalovirus at the time of the baby’s birth, his blood is examined to determine the presence of antibodies against the pathogen, which is done during the first weeks/months of life. Determining the presence of cytomegalovirus infection during laboratory diagnosis does not indicate the inevitability of the development of an acute form of this disease.

Meanwhile, this may at the same time be a cause for concern, because the likelihood of late manifestations characteristic of the infectious process increases significantly. Taking into account this feature, children in this situation require constant supervision by specialists, which will allow them to identify symptoms corresponding to the disease in the early stages, as well as carry out the necessary treatment.

Sometimes it happens that the first symptoms of cytomegalovirus appear in the third to fifth years of life. In addition, it has been proven that transmission of infection also occurs among preschool groups, which occurs through saliva.

In children, the symptoms of cytomegalovirus infection are similar to the manifestations of acute respiratory infections, which is expressed in the following:

• temperature increase;
• enlarged lymph nodes;
• runny nose;
• chills;
• increased drowsiness.

In some cases, there is a possibility of the disease developing up to pneumonia; in addition, diseases of an endocrine nature (pituitary gland, adrenal glands) and gastrointestinal diseases also become relevant. In the latent course of the disease, there are no disorders of the immune system, while it is quite common and, as practice shows, there are no threats to the child’s health in this case.

Diagnosis of cytomegalovirus

Diagnosis of the disease is made using a number of specific studies aimed at detecting the virus in question. This includes not only laboratory methods, but also the study of clinical features:

• Cultural seeding. With its help, the possibility of detecting the virus in samples taken from saliva, semen, blood, urine, and general smear is determined. Here, not only the relevance of the presence of the virus is revealed, but also a comprehensive picture is compiled indicating its activity. In addition, through this analysis, it becomes clear how effective the therapy used against the virus is.
• Light microscopy. Using this method using a microscope, it is possible to detect cytomegalovirus giant cells located specific type intranuclear inclusions.
• ELISA. This method is based on the detection of antibodies to cytomegalovirus infection. It is not used in cases of immunodeficiency, because this condition eliminates the possibility of producing antibodies.
• DNA diagnostics. Body tissues are examined to detect the DNA of the virus in question. It is possible to obtain only information regarding the presence of the virus in the body, however, with the exception of information regarding its activity.

Considering the many various forms, in which cytomegalovirus can reside in the body, making a diagnosis involves the use of a combination of different methods, because using only one of the research methods to make an accurate diagnosis is not enough.

Treatment of cytomegalovirus

To date, there is no treatment method that can completely eliminate cytomegalovirus from the body. If the immune system is normal and there is no activity from the virus, treatment as such is not required.

If a cytomegalovirus infection is detected in the body, it is not necessary to use antiviral therapy. Moreover, the effectiveness of using immunotherapeutic drugs in combination with it has not been proven, as has the effectiveness of antiviral therapy in the presence of congenital infection.

A course of treatment is required for the following conditions:

• hepatitis;
• auditory and visual disorders;
• pneumonia;
• encephalitis;
• jaundice, subcutaneous hemorrhages and prematurity (in the case of the congenital form of cytomegalovirus).

Treatment, as a rule, involves the use of drugs in the form of suppositories (Viferon), as well as a number of antiviral drugs. The duration of administration, as well as the dosage, are determined based on the individual characteristics and condition of the patient.

To diagnose cytomegalovirus based on the presence of appropriate symptoms, you must contact a venereologist or dermatovenerologist.

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The site provides background information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Currently cytomegalovirus infection is one of the most common infections. However, with a high percentage of infection among the population of 90 - 95%, only a small number of infected people develop this disease. Diagnostics diagnosis of this disease is based on the study of the patient’s symptoms and complaints, as well as on the results of laboratory tests.

Laboratory diagnosis of cytomegalovirus infection

Usually, infectious diseases are diagnosed through a serological blood test, which determines specific antibodies to a given pathogen. In the case of cytomegalovirus infection, standard serological diagnostic methods are not so informative. It is necessary to determine in more detail the quantity and types of antibodies. We will write more about this in the continuation of the article.

Serological studies

Serology – type of laboratory blood tests to identify immunoglobulins ( antibodies). Antibodies are divided into several classes based on their structure - in the context of diagnosing CMV, we are interested in IgG And IgM . Also, antibodies of the same class may differ in specificity in relation to any disease - for example, antibodies to the hepatitis virus, to the herpes virus, to cytomegalovirus. In some cases, during the diagnostic process, it becomes necessary to study some functional features of antibodies, such as affinity And avidity (more on that later).

IgG detection indicates a past infection and contact of the immune system with virus. However, this analysis has no diagnostic value. Quantitative analysis has great diagnostic value IgG – an increase in antibody titer by 4 times the initial level is a sign of active infection or primary lesion.

Detection of IgM is a sign of active infection or primary lesion. This class of antibodies is the first to be synthesized by immune cells in response to contact with an infectious agent. This happens a few days after initial contact.
However, quantitative analysis on IgG makes it possible to identify an active process or primary infection only through a series of tests over a long period of time ( assessment of antibody titer dynamics), and with this disease the diagnosis should be made as quickly as possible. Therefore, in a serological examination, the following properties of antibodies are revealed: affinity And avidity .

Affinity – the degree of affinity of the antibody to the antigen ( virus component). In other words, how specific the antibody is to the pathogen.

Avidity – strength of connection in the antibody-antigen complex.
There is a direct relationship between these concepts - the better the antibodies match the antigen, the stronger their connection during interaction. Both avidity and affinity help determine the age of antibodies - the older the antibody, the lower these indicators. At an early stage of the disease, the body produces low-affinity antibodies and IgM , which remain active for several months. At the next stage, immune cells synthesize high-affinity IgG , which can remain in the blood for years, but with age, the affinity of these antibodies also decreases. Therefore, by analyzing the properties of antibodies, it is possible to identify the duration of infection, the form and stage of the disease.
Serological examination is carried out using the enzyme immunoassay method, using additional laboratory tests of the properties of antibodies.

Culture examination

With this examination method, biomaterial is collected, in which a high concentration of the pathogen is expected ( saliva, blood, sperm, cervical mucus, amniotic fluid). Next, the collected material is placed on a special medium. This is followed by incubation - for a week or more, a nutritious medium is placed in a thermostat, where the necessary conditions are created for the virus to multiply. Next, the nutrient medium and cellular material of the nutrient medium are studied.

Polymerase chain reaction (PCR)

This test searches for the genetic material of the virus. However, in case of a positive result, this examination does not allow distinguishing primary infection from the recurrent course of the disease in the acute stage. Although the reliability and sensitivity of the method is high and allows one to detect an infection even with low activity.

From the information provided, it is clear that laboratory diagnosis makes sense if the symptoms of the disease are not specific or it is necessary to determine whether the disease has been cured after a course of treatment. It is also advisable to test both future parents for CMV infection at the pregnancy planning stage, because this infection poses the greatest danger to the fetus during pregnancy.

Deciphering the analysis for cytomegalovirus, taking into account the risk to the fetus

Treatment of cytomegalovirus infection

You need to know that cytomegalovirus infection cannot be treated with medication. That is, with this disease drug treatment can only help the immune system fight the virus, but once a virus has infected a person, as a rule, it always remains in the host’s body. There is nothing wrong with this - after all, infection with this virus reaches 95% of the entire world population.

The state of the patient’s immune system is important in determining the timing of treatment and prevention; for women it is great importance preparation for pregnancy or developing pregnancy. Regarding pregnancy, it is worth noting that only primary infection during pregnancy or conception, as well as exacerbation of the disease during pregnancy, pose a threat to the development of the baby. In a high percentage of cases, this disease leads to spontaneous abortion or the development of congenital defects and deformities of the newborn.

Indications for treatment:
1. Detection of primary infection with severe symptoms of the disease.
2. Detection of exacerbation of the disease or primary infection when planning pregnancy or developing pregnancy.
3. Among people with immunodeficiency.

Principles of CMV treatment:

1. Maintaining immunity at a high level. This condition necessary to successfully fight the virus. The fact is that all the medications used do not destroy the virus on their own, but only help the immune system fight it. Therefore, the outcome of the disease will depend on how the immune system is prepared. To improve immunity, it is important to lead an active healthy lifestyle, eat rationally, and maintain a rational work and rest schedule. Also, the psycho-emotional mood has an important influence on the state of immunity - overwork, frequent stress significantly reduce immunity.

2. Use of immunomodulatory drugs. These medications optimize the immune system and increase activity immune cells. However, the effectiveness of these drugs is disputed by many experts due to the rather modest effect of the treatment. Therefore, the use of these drugs is more suitable for the prevention of immunodeficiency than for the treatment of the disease in the acute period.

3. Antiviral drugs. These medications interfere with the processes of virus reproduction and infection of new cells. This treatment is necessary for severe forms of the disease due to the high toxicity of these drugs and the high risk of side effects.

In conclusion, I would like to add that a cytomegalovirus infection that is detected in laboratory tests but does not manifest itself does not require treatment. Percentage of people infected ( in whom it is detected IgG to this virus) reaches 95%, so it is not surprising that you too will be infected. Treatment and prevention of the disease in most cases are measures to stimulate and maintain immunity. This disease poses a threat to people with immunodeficiency and pregnant women.

Is cytomegalovirus treated? Treatment of exacerbation

Antiviral drugs for cytomegalovirus: Acyclovir, Valtrex, Amiksin, Panavir

Interferons Viferon, Kipferon, Ergoferon, Imunofan for cytomegalovirus. Homeopathy for CMV

Before use, you should consult a specialist.

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 is still the subject of active debate in the scientific world.

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.

What it is?

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.

How is the virus transmitted?

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. An important place is occupied by infection during childbirth and when breastfeeding 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 once 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.

Cytomegalovirus igg antibodies detected - what does this mean?

IgM are antibodies that the 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:

• That you have been infected with cytomegalovirus recently (not earlier than within the last year);
• That you were infected with cytomegalovirus for a long time, but recently this infection began to multiply again in your body.

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.

Development of the disease

The incubation period is 20-60 days, the acute course is 2-6 weeks after the incubation period. Staying in a latent state in the body both after infection and during periods of attenuation - for an unlimited time.

Even after completing 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.

Symptoms of cytomegalovirus

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-vegetative disorders often appear, and damage to internal organs also occurs.

In this case, three manifestations of the disease are possible:

1. Generalized form- CMV damage to internal organs (inflammation of the liver tissue, adrenal glands, kidneys, spleen, pancreas). These organ lesions can cause, which further worsens the condition and puts increased pressure on the immune system. In this case, treatment with antibiotics turns out to be less effective than with the usual course of bronchitis and/or pneumonia. At the same time, damage to the intestinal walls, blood vessels of the eyeball, brain and nervous system. Externally it appears, in addition to enlarged salivary glands, a skin rash.
2. - in this case it is weakness, general malaise, headaches, runny nose, enlargement and inflammation of the salivary glands, fatigue, slightly elevated body temperature, whitish coating on the tongue and gums; Sometimes it is possible to have inflamed tonsils.
3. Damage to the genitourinary system- manifests itself in the form of periodic and nonspecific inflammation. At the same time, as in the case of bronchitis and pneumonia, inflammations are difficult to treat with antibiotics traditional for this local 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 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.

Cytomegalovirus infection during pregnancy

When a woman becomes infected during pregnancy, in most cases she develops an acute form of the disease. Possible damage to the lungs, liver, and brain.

The patient notes complaints about:

• fatigue, headache, general weakness;
• enlargement and pain when touching the salivary glands;
• mucous discharge from the nose;
• whitish discharge from the genital tract;
• abdominal pain (caused by increased uterine tone).

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 of acyclovir; the use of drugs to correct immunity (cytotect, intravenous immunoglobulin), as well as carrying out control tests after completing a course of therapy.

Cytomegalovirus in children

Congenital cytomegalovirus infection is usually diagnosed in a child in the first month and has the following possible manifestations:

• cramp, trembling of limbs;
• drowsiness;
• visual impairment;
• problems with mental development.

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).

Diagnostics

Cytomegalovirus is diagnosed using the following methods:

• detection of the presence of the virus in biological fluids of the body;
• PCR (polymerase chain reaction);
• cell culture seeding;
• detection of specific antibodies in blood serum.

Cytomegalovirus infection (cytomegaly) is certain changes in the body caused by cytomegalovirus that occur during critical periods of life - during pregnancy, immunodeficiency, and early infancy.

In adulthood, almost healthy people cytomegaly can last for a long time in hidden form, and the virus can remain in the body for a long time without manifesting itself clinically.

Diagnostics

The basis of diagnosis is laboratory detection of cytomegalovirus or antibodies to it in the blood.

Typically, determination of the level of antibodies of the IgM and IgG classes (Anti-CMV-IgM and Anti-CMV-IgG) is used.

• If class M immunoglobulins are detected in the blood (IgM class antibodies are positive), this indicates an active infection and a fresh infection with cytomegalovirus that occurred in the next 2-3 weeks.
• The presence of only immunoglobulins G (IgG antibodies are positive) in the blood indicates the presence of cytomegalovirus in the body in an inactive phase - this is a carriage without activation of the infection.
• The appearance in the blood of an increasing amount of immunoglobulin G (IgG class antibodies) indicates the activation of the immune system and the formation of an immune response in the body.
• If there are both classes of immunoglobulins IgM and IgG in the blood, this is an infection that developed about a month ago or a chronic active infection (like congenital cytomegaly, infection in people with immunodeficiency).

Symptoms of cytomegalovirus

CMV infection in adults

Infection with cytomegalovirus in adults can occur under the guise of a persistent cold, and there may be a prolonged runny nose and malaise, weakness, headaches and joint pain, and enlargement of the salivary glands and lymph nodes.

Most often, the infection process occurs almost unnoticed by humans.

In general, the severity of the disease will directly depend on the state of the immune system - the course can range from completely asymptomatic to severe generalized infection.

Cytomegalovirus in children

For congenital CMV infection in newborns

• a skin rash in the form of small hemorrhages may occur,
• there may be either prematurity or intrauterine growth retardation of the baby,
• Severe jaundice may appear immediately after birth,
• development of chorioretinitis (inflammation of the retina and choroid),
• the condition can be severe with a mortality rate of up to 30%.

Children with congenital cytomegaly have mental retardation or problems with vision and hearing.

In premature infants, acquired cytomegalovirus infection gives symptoms of long-term pneumonia due to the addition of a microbial infection. There may be a slowdown in physical development, manifestations of hepatitis, rash or swollen lymph nodes.

Sometimes in older children, CMV infection produces manifestations similar to mononucleosis. There are manifestations of a persistent cold with a sore throat, prolonged fever, chills and headaches, pain in the joints and muscles, enlarged lymph nodes and the area of ​​the salivary glands. In this case, there may be a skin rash similar to rubella. Sometimes jaundice or changes in liver enzyme activity may occur. There are often complications with the development of pneumonia, but usually it is not severe, sometimes being detected only on x-rays.

Treatment

The presence of the virus in the blood does not require any treatment, since in an inactive state it does not pose a danger to healthy people.

In the presence of clinical manifestations or in high-risk pregnant women, immunomodulatory therapy is carried out - Viferon, Genferon suppositories.

When the infection is activated, the drugs ganciclovir or acyclovir are indicated, but they are used strictly under the supervision of a doctor and blood tests due to the presence of numerous side effects.

For HIV infection, cytomegalovirus is treated with the drug foscarnet, but only in a hospital and under the control of blood electrolytes and blood composition. The drug is selected in individual dosages.

Forecast

A cure for cytomegalovirus has not yet been described; the virus circulates in the blood for life. Activation of the infection can last from 2-3 weeks to several months, it all depends on the strength of the immune system.

With immunodeficiencies, the prognosis is unfavorable, as well as with premature infants. In other cases, cytomegalovirus infection proceeds favorably and is mostly without symptoms.

Types of cytomegalovirus infection

Depending on the clinical manifestations, CMV infection can be:

• asymptomatic carriage,
• congenital infection
• acquired infection during the neonatal period,
• mononucleosis-like course of infection,
• cytomegaly in immunodeficiencies,
• cold-like syndrome.

Causes and mechanisms of development

CMV infection occurs as a result of infection with cytomegalovirus, which got its name because of its ability to form giant cells in the body.

Cytomegalovirus is common among adults; by the age of 30, half of the adult population has antibodies to CMV infection. For the most part, these are asymptomatic carriers or low-symptomatic manifestations of the disease. Activation of cytomegalovirus and the manifestation of infection occurs during special periods of life, characterized by a physiological or pathological decrease in immunity.

It's possible:

• during pregnancy,
• during the neonatal period, especially in premature infants,
• with immunodeficiencies of congenital and acquired nature,
• for chronic infections affecting the lymphatic and immune systems,
• for oncological diseases,
• after organ or bone marrow transplantation.

Cytomegalovirus is not a highly contagious infection; its transmission requires numerous and prolonged contacts. Usually infected

• sexually (for any type of sexual contact),
• airborne (from sneezing and coughing),
• household (when kissing, licking spoons and nipples of children),
• transplacentally (from mother to fetus),
• during blood transfusions (blood transfusions).

The entry of cytomegalovirus into the blood causes activation of the immune system and the formation of antibodies and special lymphocyte cells, which allows long-term suppression of the virus. But, when the immune system is suppressed, cytomegalovirus infection produces symptoms.