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Cytomegalovirus was discovered by researchers in the twentieth century and was named by a combination of the Greek words "cytos" - cell, "mega" - large and the Latin "virus" - poison. By the very name of cytomegalovirus it is clear that it has a toxic effect on the cells of the body and is a poison for the cell.

The structure of CMV is a representative of the genus of human herpes virus type five. There are three known strains of cytomegalovirus. Like all types of herpes viruses, cytomegalovirus can remain in the human body for a long time, asymptomatically, but the person is contagious to his partners.

Cytomegalovirus has a tropism in the cells of the salivary glands, so doctors often begin their search for it with the salivary glands.

The virus develops in human connective tissue cells (fibroblasts). Infected cells grow to gigantic sizes as virus particles accumulate. Cytomegalovirus replication occurs in white blood cells and ends with the formation of daughter virions that rupture the affected cells, enter the bloodstream and attack healthy cells.

Epidemiology

Cytomegalovirus is widespread throughout globe, antibodies to cytomegalovirus antigens are present in 57.9% of people over six years of age. In the group of elderly people, 91% of the population are strongly positive according to serological testing.

Routes of infection:

• Contact household
• Sexual
• Vertical
• Iatrogenic

There are several types of antiviral drugs with pronounced clinical effectiveness in newborns, people with immunodeficiency and pregnant women.

Ganciclovir is used in patients with secondary immunodeficiencies or those with severe systemic diseases or malignant neoplasms. There is a drug that has an antiviral effect even when taken orally (Valganciclovir). Now scientists note a decrease in its effectiveness due to the emergence of resistant types of the virus. If there is resistance to ganciclovir, cidofovir is used; it is toxic and mainly affects kidney function.

Prevention of infection development

Prevention is personal hygiene for those in family contact with a patient with cytomegalovirus infection. This is especially true for women. The use of barrier contraception (condoms) is reduced, although the possibility of infection with cytomegalovirus infection is not excluded.

Since this infection is especially dangerous for the fetus in the first trimester of pregnancy, a vaccine has been developed that is used only for pregnant women. The effectiveness of the vaccine does not exceed 50 percent, so researchers are now working to improve it.

Cytomegalovirus (CMV) is one of the most common viruses in the human population. It affects more than 90% of the urban population of the entire planet, more than half of children of any age and a significant number of the rural population. At the same time, medicine still does not have the means to completely destroy it in the body, and therefore everyone infected with cytomegalovirus at any age is a carrier of it.

All these qualities of cytomegalovirus are due to the peculiarities of its structure and biology. Which, by the way, were studied in detail relatively recently...

History of the discovery of cytomegalovirus

The CMV virus itself was discovered in 1956 by researcher Margaret Gladys Smith. She also owns the first detailed description of the virus. As often happens in science, almost simultaneously the virus was discovered by a group of scientists led by Smith and Rowe in the urine of a sick child.

Long before this, in 1881, the German pathologist Ribberts discovered cells in the kidney tissue of a stillborn child that were very large in size and had a clearly visible nucleus. It was Ribberts who was the author of the name of these cells “owl eyes” and the assumption that their appearance is associated with the action of some kind of infection.

A little later, scientists Tolbert and Goodpasture called such cells cytomegals, which later gave the name to the virus itself.

Virologist Weller connected the virus discovered by Margaret Smith and cytomegaly in 1957. He studied the properties of the virus in detail and found out that it is precisely because of its action that cells turn into “owl eyes”.

Description of cytomegalovirus

Cytomegalovirus belongs to the herpesvirus family and has a structure similar to most of them.

The CMV viral particle - the so-called virion - has a spherical shape. The outer shell of the particle consists of two layers: the inner protein layer and the outer lipoprotein layer. Inside the particle, tightly packed, is a viral DNA molecule.

Most of the lipoprotein molecules protrude above the surface of the particle and form a kind of “fur” of it. The task of these molecules is to analyze the surfaces with which the particle comes into contact during its wanderings throughout the body. As soon as the virion collides with the cell wall, which is quickly recognized by lipoproteins, the particle attaches itself to it, drills through the cell wall and injects its DNA inside.

Then everything happens according to the usual scenario for all viruses: DNA penetrates into the cell nucleus, and the cell itself, along with the proteins it needs, begins to produce viral proteins. From the latter, new viral particles are collected, which leave the cell and go in search of the next “victims”.

Infection with cytomegalovirus and methods of its transmission

Cytomegalovirus multiplies most actively in the cells of the mucous membranes - in the salivary glands, nasopharynx, and vagina. And through them it most often penetrates the body. In this regard, the main methods of its transmission are:

• contact path by direct touch. Very often the virus is transmitted through kissing and sexual intercourse, less often through contact between children and adults.
• Airborne.
• Transplacental from mother to fetus
• When blood transfusion or reusable use of medical instruments without sterilization.

Unlike many other herpes viruses, cytomegalovirus has a weak ability to infect the body, therefore, for its transmission, the contact between the carrier and the infected person must be quite dense and long-lasting.

Cytomegalovirus in the human body

CMV can infect almost all organs and tissues. The most favorable environment for its reproduction is epithelial cells, so most often the infection affects the membranes of organs. The severity and extent of the lesions depends on the state of the immune system and the method of infection.

In the body of adults, after contact with the mucous membranes, the virus enters the bloodstream. Here it multiplies and is stored for a long time in leukocytes. The ability of some types of leukocytes to migrate into tissues leads to the spread of the virus throughout the body. Reproduction of the virus in bone marrow cells produces new generations of infected leukocytes, making it almost impossible complete removal pathogen from the body.

With reduced immunity, the virus can cause inflammation of the gastrointestinal tract with the formation of ulcers of the esophagus, stomach, large and small intestines. Such patients often develop hepatitis, pneumonia, damage to the spleen, peripheral nerves, and retinal necrosis. Occasionally, inflammation of the heart muscle, joints, lining of the lungs and brain is observed.

When CMV is transmitted from mother to fetus through the placenta, the infectious process begins from the mucous membranes of the respiratory tract. Most often, this leads to the development of atypical pneumonia with the replacement of normal lung tissue with connective tissue (scarring). Cytomegalovirus can also invade the kidneys, brain, and spinal cord, causing fetal developmental defects.

A characteristic sign of cytomegalovirus multiplication in the body is the appearance of giant cells. Their core contains clusters of viral particles, which is why it greatly increases in size, giving the cell a resemblance to an owl’s eye:

Tissue damage during cytomegalovirus infection is caused by the reaction of the immune system - the destruction of virus-infected cells by T-lymphocytes. In severe forms of the disease, immune complexes—aggregates of antibodies with viral particles—are formed in large quantities in the blood and organs. These complexes are dissolved by the complement system, which is accompanied by damage to surrounding tissues and the development of inflammation.

The body's immune response to CMV

Immediately after a surge in the number of viral particles in the body, the immune system produces special proteins - immunoglobulins (Ig), which are able to bind and destroy virions. First of all, class M immunoglobulins appear, followed by IgG, specific to cytomegalovirus. The former do not live long and provide short-term protection for the body. The latter, after appearing in the body, remain in it for life, providing lifelong immunity.

Cytomegalovirus infection and its complications

When the body is severely affected, cytomegalovirus causes symptoms collectively called cytomegalovirus infection . It is characterized by inflammatory processes in different parts of the body, and depending on the strength of the body’s immune system, it may show almost nothing, or may cause serious complications:

• mononucleosis-like syndrome, manifested by cold symptoms, sore throat, malaise and fever
• liver inflammation
• pneumonia
• encephalitis
• retinitis.

All these diseases are characteristic almost exclusively of people with immunodeficiencies and, rarely, of newborns. In most cases, cytomegalovirus infection is asymptomatic in the body, and a person may not even know that he has become infected and has had it.

Diagnosis of cytomegalovirus infection

To accurately diagnose cytomegalovirus infection, one should resort to quite expensive and complex analysis methods. This is only relevant for pregnant women, immunocompromised patients and infants. The presence of CMV in their blood is determined using:

• ELISA method trying to find antibodies produced against the virus
• PCR- a polymerase chain reaction method that allows you to find virus genes in tissues and blood
• cultural method, based on determining the nature of the virus by the nature of its damage to a special nutrient medium.

Based on external symptoms and examination, it is almost impossible to unambiguously determine the nature of the virus.

Fighting cytomegalovirus

The fight against cytomegalovirus is justified only if the person exhibits sufficiently strong symptoms of the disease. There are two different approaches to combat cytomegalovirus, which should be used in a comprehensive manner.

The first method of control is the use of antiviral drugs. Their action is to suppress the CMV replicative cycle and prevent it from multiplying freely in the body. Special agents have been developed that selectively penetrate infected cells without damaging healthy ones. But it is worth considering that taking these medications is contraindicated for pregnant women, as they have a toxic effect on the body and can have a number of side effects. Therefore, the dose of the antiviral drug (especially Foscarnet, as the most active) must be accurately adjusted by the doctor.

The best known drugs against cytomegalovirus are Foscarnet, Ganciclovir, Viferon, Cidofovir.

The second method is the use of immunoglobulins. These are special proteins obtained from blood plasma that are capable of infecting foreign cells. Immunoglobulins act selectively: a specific type of immunoglobulin infects one type of virus. As a result, immunoglobulins are more effective in the fight against cytomegalovirus than antiviral drugs, the dose of which must be much higher. In addition, immunoglobulins are preferable because they do not have a toxic effect on the body and reduce the risk of re-infection.

To combat cytomegalovirus, the drugs Megalotect and Cytotect are used.

CMV infection during pregnancy

Prevention of complications of cytomegalovirus infection

The main rule for preventing cytomegalovirus infection is to maintain a strong immune system. This guarantees that the initial outbreak of infection will be easily tolerated and that there will be no relapses in the future.

Prevention of complications of cytomegalovirus infection in people with weakened immune systems is the regular introduction of human immunoglobulins into the blood or the use of antiviral drugs, but in lower doses than those used to treat the disease. However, individual doses and schedules for using drugs should only be determined by a doctor.

A little more than half a century has passed since cytomegalovirus (CMV) was discovered in 1956, after which its photos and pictures appeared. This unusual microorganism was immediately assigned to the herpesvirus family, where the type 1 and type 2 viruses causing herpes on the lips and genital herpes had already been identified much earlier. Some of its properties are similar to those of representatives of this family. One of them is lifelong presence in the body of an infected person, mainly in a latent form. Although cytomegalovirus is still not a thoroughly studied microorganism, there is enough information about it, so it’s time to answer the main question, what does cytomegalovirus mean?

What is cytomegalovirus disease?

About 90% of the population are carriers of cytomegalovirus infection, but few of this number know what cytomegalovirus means and what it looks like in photos and pictures. CMV was discovered by Margaret Gladys Smith, who gave a detailed description of the microorganism.

The effect of CMV is ambiguous. It can, like other types of herpes, remain in the body all the time, remaining in a latent form. With reduced immunity, cytomegalovirus infection, also called cytomegaly, is active. As soon as it enters a healthy cell, it begins to increase in size. That is why cytomegaly literally means “giant cell”. Cells affected by CMV quickly change their structure and swell excessively. The main habitat of the virus is the salivary glands.

Routes of infection with the cytomegalovirus virus

When CMV infection was first identified, it was defined as “kissing disease” and was assumed to be transmitted only through saliva during kissing. After a more detailed study of the virus, other ways of its spread became known. CMV infection usually occurs at any age. Children in early childhood become infected through everyday contact from their parents or friends in kindergartens; sexual partners transmit the infection to each other during intimacy. Such routes of infection as infection of the fetus with a virus in utero or transmission of CMV to the infant through breast milk cannot be excluded. Household contacts of transmission of the virus are practically not observed; perhaps only patients who do not have very weak immunity are capable of being infected through common objects.

Symptoms and signs of the presence of cytomegalovirus

Most often, cytomegalovirus infection in children is asymptomatic. And the signs depend on how strong the immune system of the carrier of the infection is. If the virus does not show any activity, it is completely safe for those in whose body it has taken root. Its only danger is that it can cause illness to those who are nearby and have weakened immune systems.

Sometimes, after infection, symptoms of cytomegalovirus may appear. In all respects, it resembles colds:

• Feeling worse
• Weakness
• Temperature increase
• Cough
• Runny nose
• Enlarged salivary glands
• Pain when swallowing

Soon the symptoms disappear, health returns to normal, and antibodies appear in the blood of the infected patient. They will be reliable protectors against the virus that remains in the body.

If patients have immunodeficiency, CMV infection causes severe complications that will take a long time to treat. Among the consequences of such virus activity may be sepsis, pneumonia, damage to various internal organs. Often, in children, against the background of active reproduction of CMV infection in the body, cytomegalovirus rhinitis occurs, in which patients first experience blurred vision, which, as inflammation of the retina develops, leads to complete blindness.

The most dangerous manifestation of cytomegalovirus, as in the photo, is brain encephalitis. If left untreated, it leads to loss of limb mobility.

Diagnostics and tests for cytomegalovirus

A healthy person has no need to look for cytomegalovirus disease in his body. This diagnosis is prescribed for pregnant women who have an immunodeficiency or are unable to bear a child, patients with oncology, atypical pneumonia, and frequent groundless increases in temperature.

In laboratory conditions, it is possible to determine both the presence of the virus itself or its DNA in the test material (sputum, saliva), and antibodies in the blood. To diagnose the virus, it is effective to conduct a smear examination and culture of the patient’s material under study. Since CMV has DNA, in severe cases of the disease a PCR test is prescribed. Blood serum is tested to detect antibodies to cytomegalovirus. The presence of IgG antibodies indicates a previous disease and the presence of immunity; the presence of IgM antibodies to CMV infection is alarming, since such a result indicates a current infection, which is dangerous for patients at risk.

Treatment of CMV infection

If cytomegalovirus is detected, as with latent herpes, treatment is not required if the immune system is strong and properly itself copes with protecting the body from the manifestation of the virus. After the infection has been tolerated, protective immunoglobulins will be produced that will prevent you from contracting cytomegaly in the future.

The situation is completely different for those who have a weakened immune system. They will have to treat the disease with antiviral drugs, as well as strengthen the immune system. The doctor prescribes only those drugs that can block the active reproduction of the virus, preventing it from infecting new cells. Cidofovir, foscarnet, and viferon are proposed as effective medications for the treatment of diseases caused by cytomegalovirus. Panavir is considered universal for combating cytomegalvirus infection, which is prescribed by injection. These medications cannot be prescribed independently because they have a number of contraindications and require a specific dosage for a particular patient.

Immune therapy is carried out in combination with the main treatment. Cytotect is recommended as a drug that strengthens the immune system.

Prevention of cytomegalovirus infection

Preventive measures will help protect people with weakened immune systems from contracting cytomegalovirus infection, as well as herpes and other diseases. You don’t have to do anything supernatural, just follow the basic rules of taking care of your health and the virus will not attack:

• Using a condom when having contact with an unfamiliar partner, regardless of what type of sex is practiced (vaginal, oral, anal).
• Develop the habit of never using other people's things. It can be especially unpleasant and dangerous to use towels and washcloths that belong to others.
• You cannot use someone else’s dishes, bed linen, or razors for personal purposes.
• Do not have close contact even with people you know well if you know that they may be carriers of viruses.

People who have a strong immune system, eat right and exercise healthy image life, there is no need to be afraid of cytomegalovirus infection. They are simply not afraid of CMV.

Not everyone is familiar with cytomegalovirus. Symptoms of this disease may not express themselves for a long time, it all depends on the immune system of the human body. If the immune system is normal and the virus is present in the body, then the person is a carrier and can infect others without knowing that he himself is sick.

If a decrease in immunity occurs under the influence of provoking factors: hypothermia, stress, then the disease begins to manifest itself.

Cytomegalovirus (CMV) belongs to the herpesvirus family. Today, 80 varieties of Herpes viruses are known. A person is susceptible to eight types, which are divided into groups:

• a-viruses. This group includes herpes simplex types 1 and 2, chickenpox and herpes zoster. This group affects and affects the nervous system;
• c-virus. herpes type VI. Affects the kidneys and salivary glands;
• Y-virus. VII and VIII types of Herpes, infectious mononucleosis (Epstein-Barr disease).

These diseases affect lymphocytes in the blood and the human immune system suffers.

Transmission routes

Let's look at how you can become infected with cytomegalovirus and what the consequences of this disease are.
The disease can be congenital or acquired.
The congenital route of infection is when the virus is transmitted through the placenta and amniotic fluid.
Purchased for a baby - this is the birth canal and breastfeeding. When breastfeeding, the virus is transmitted from the mother through milk.

Entry gates for cytomegalovirus healthy person are the mouth, genitals, gastrointestinal tract.

The virus is transmitted from humans: through kissing, through other people's dishes, bed linen, sexual contact and personal hygiene items, during surgery - organ transplantation, through blood donation. Very rare, but airborne transmission is still possible.

Pathogenesis

When cytomegalovirus penetrates through the oral cavity, esophagus or genitals, the virus is localized in the salivary glands, epithelium of the lungs and kidneys.

Less commonly affected are monocytes and lymphocytes in the blood. When a virus penetrates the cell membrane, it strives for the nucleus, inserts its DNA, and causes changes in the structure of a healthy cell. The cell becomes three times larger. The edges of the cell are painted in a light shade, and a dark inclusion appears in the center of the nucleus. Therefore, under a microscope it will look like a bird's eye. Once inside the cell, the virus does not kill it, but covers it with its cellular secretion. Therefore, the human immune system cannot recognize it and the virus can exist in such a latent state for a long time. Once the immune system weakens, the number of unhealthy cells begins to increase. The consequences of cell growth are the symptoms of the disease.

Symptoms

The disease is transmitted unnoticed; sometimes, when infected, mononucleosis can develop, which stops itself. Characteristic symptoms:

• temperature rises to 37-38 degrees;
• throat red, painful;
• nasal congestion, runny nose;
• headache, weakness, malaise.

All symptoms are very similar to Acute Respiratory Viral Infection. If the immunity is normal, then the symptoms disappear within a few days and the disease becomes latent, i.e. hidden form. When immunity is impaired, cytomegalovirus is much more severe. The severe course of the disease is influenced by factors such as HIV, taking glucocorticoid drugs, radiation sickness, oncology, stress and lack of vitamins in the human diet.

The disease interferes with the functioning of the lymphatic system. Mainly affected are the cervical lymph nodes, behind the ears, sublingual, and submandibular. Sialadenitis may develop, where the salivary glands are affected.

Severe course

Let's look at how cytomegalovirus is dangerous.

At bad work immunity, a severe course of the disease entails complications. There are different forms of complications:

1. Respiratory. After an organ transplant operation from a sick person, pneumonia develops. Statistics show death in 90% of cases.
2. Cerebral. Inflammation in the brain. The cerebral form of the course leads to dementia.
3. Gastrointestinal form. The disease manifests itself with symptoms of colitis, peptic ulcer. Often the consequences lead to ulcer perforation and peritonitis.
4. The hepatobiliary form of the disease, in which hepatitis is a complication, the liver increases in size.
5. Renal course of the disease. In this form, cytomegalovirus damages the urinary organs.
6. The hematological form, where the function of blood creation suffers, sepsis can become a complication.

With weak immunity, the virus can cause eye damage and retinitis. Necrosis occurs in the retina of the eye, which can lead to blindness. Cytomegalovirus disease in men manifests itself as symptoms of testicular inflammation. In women, the disease is characterized by vulvovaginitis, endometritis, and colpitis.

Diagnostic test

To determine the type and form of the disease, laboratory blood tests are performed, saliva, genital smear, and urine are examined.

A biopsy is performed and the tissue taken is examined. Breast milk is taken, if necessary, as well as rinsing after bronchopulmonary lavage.

The most accessible diagnosis is a microscopy study of a blood smear. This method detects altered cells, but its accuracy is up to 70%. To make a diagnosis, you need to determine antibodies to cytomegalovirus infection. Exist laboratory methods, with the help of which this can be done. RIF is an immunofluorescence reaction, PCR is a polymerase chain reaction, ELISA is an enzyme-linked immunosorbent assay. The most modern and effective method for detecting the disease is PCR - it allows you to detect cytomegalovirus in the early stages, even if there are no obvious symptoms. ELISA - allows you to determine the concentration of immunoglobulin in the blood. At high levels, the significance of the active disease process can be identified. If immunoglobulin G is detected in the blood, we can talk about a latent form of carriage.

In addition to these blood tests, the doctor will prescribe an ultrasound of the kidneys and liver. It is recommended to consult a neurologist, a gynecologist, and for men a urologist.

Therapeutic measures

You need to know that cytomegalovirus is resistant to many drugs that are used for herpes, therefore, in order to cure the disease, the following is prescribed:

1. The drug Ganciclovir. The dose is selected individually according to age and severity of the disease. Children under 5 years of age and with severe disease are prescribed intravenous administration of 5 to 10 mg per 1 kg per day. For a milder form, adults are prescribed the drug in tablets. Dosage – 3 g. Within 24 hours. Treatment lasts up to three months. The use of this drug is accompanied by many side effects on the part of hematopoiesis - the number of platelets and granulocytes decreases. Allergic urticaria, kidney dysfunction, headaches are noted, the liver suffers, and convulsions appear.
2. Foscarnet is contraindicated for use in infants. Has a risk of developing multiple complications. It is practically not absorbed in the stomach, so it is prescribed by injection. Adults dose – 180 mg per kg. For children, 120 mg per kg in the first three days, then the dose is reduced to 90 mg per kg. The course is three weeks.

These drugs inhibit the process of synthesis and renewal of cytomegalovirus DNA, but have a bad effect in diseases of the digestive system, pulmonary system, and in cases of brain disease. During pregnancy, these drugs are contraindicated, but are prescribed if the benefit to the mother outweighs the risk to the life of the fetus. Contraindicated during the lactation period.

These drugs showed good results with the simultaneous administration of recombinant interferons, such as Viferon, Reaferon. Interferons increase the effectiveness of essential drugs.

Against the background of the disease, a person often develops secondary infections, for the treatment of which antibiotics are prescribed. The doctor will prescribe additional treatment: B - vitamins, magnesium, hepatoprotectors - drugs to restore the liver, antioxidants, drugs to prevent damage to brain neurons (neuroprotectors), drugs for blood circulation. Antiviral drugs are prescribed: Amiksin, Cycloferon, Tiloron.
To prevent the disease, immunoglobulin - Cytotect - is used. It is indicated for people with weakened immune systems, two weeks before organ transplant surgery - 1 ml per kg.

CMV in pregnancy

If a disease is discovered during pregnancy, doctors recommend termination and taking measures to treat the woman.

During pregnancy female immunity weakens due to hormonal changes, so the woman is at risk of contracting CMV. If she is already a carrier of cytomegalovirus, and the disease is dormant, then during pregnancy the virus is activated. The consequences become dangerous, because infection of the fetus through the placenta can cause its death or impairment general development systems and various pathologies. Also, CMV infection can occur already at the embryonic stage, through sperm. Often the baby becomes infected during labor when it passes through the birth canal. Dangerous consequences of the disease for the fetus will occur in the 1st trimester to the 23rd week of pregnancy.

When a fetus is infected with cytomegalovirus during the prenatal period, the following pathologies may develop:

• intrauterine death of a child, premature birth;
• pathologies of the development of the heart and vascular system;
• decreased hearing and vision of the child, there may be a complete loss of these functions;
• underdevelopment of the brain;
• liver enlargement, hepatitis;

• underdevelopment of musculoskeletal function;
• CNS lesions;
• microcephaly, dropsy.

Prevention during pregnancy

For those planning a pregnancy, prevention plays an important role, so before conception you should undergo all tests for CMV and, if necessary, undergo treatment. If a woman previously gave birth to a baby with a disease, then the next birth can only be planned after two years.

Basic preventive measures

In order to avoid becoming infected with cytomegalovirus, it is necessary to follow the rules of personal hygiene. Be aware of the modes of transmission of the disease and be careful with direct contact with body fluids. Towel, dishes, toothbrush, bed linen, etc. must be individual. Frequent hand hygiene is the most effective means of protection against the virus. During sexual intercourse, protection (condoms) should be used. Taking vitamins strengthens the immune system, which will help prevent illness and will not cause complications if infected. Remember that any stress can lead to a decrease in the immune system, which means awakening a dormant virus. Therefore, it is worth learning not to be exposed stressful situations and deal with them.

Good preventative measures would also include avoiding crowded places during outbreaks of respiratory diseases. Try not to become infected with ARVI, so as not to expose your body to the risk of CMV infection. A prolonged cold or some symptoms of acute respiratory infections: runny nose, cough or low-grade fever are indications for testing for a virus of this etiology. For any herpes, you also need to get tested, since frequent herpetic reactions on the skin can be a sign of a more dangerous viral infection. If mononucleosis is detected, this is also the reason for referral for laboratory tests of CMV.
It must be remembered that the presence of symptoms of severe disease is typical for HIV-infected patients, therefore, if they occur, it is recommended to undergo an HIV test.

Be sure to monitor your diet and boost your immunity with physical activity.

To summarize, we can say that CMV is especially dangerous in people with weakened immune systems and in children whose infection occurred in the womb. Take care of your immunity, carry out diagnostics on time, and then the terrible virus will bypass you.

Cytomegaly

General information

Cytomegaly– an infectious disease of viral origin, transmitted sexually, transplacentally, domestically, or by blood transfusion. Symptomatically occurs in the form of a persistent cold. There is weakness, malaise, headaches and joint pain, runny nose, enlargement and inflammation of the salivary glands, and excessive salivation. It is often asymptomatic. The severity of the disease is determined by the general state of the immune system. In the generalized form, severe foci of inflammation occur throughout the body. Cytomegaly in pregnant women is dangerous: it can cause spontaneous miscarriage, congenital malformations, intrauterine fetal death, and congenital cytomegaly.

Other names for cytomegaly found in medical sources are cytomegalovirus infection (CMV), inclusion cytomegaly, viral disease of the salivary glands, and inclusion disease. The causative agent of cytomegalovirus infection, cytomegalovirus, belongs to the human herpesvirus family. Cells affected by cytomegalovirus increase in size many times over, so the name of the disease “cytomegaly” is translated as “giant cells.”

Cytomegaly is a widespread infection, and many people who are carriers of cytomegalovirus do not even know it. The presence of antibodies to cytomegalovirus is detected in 10-15% of the population during adolescence and in 50% of adults. According to some sources, carriage of cytomegalovirus is detected in 80% of women of the childbearing period. First of all, this applies to the asymptomatic and low-symptomatic course of cytomegalovirus infection.

Not all people who carry cytomegalovirus are sick. Often, cytomegalovirus remains in the body for many years and may never manifest itself or cause harm to a person. The manifestation of a latent infection usually occurs when the immune system is weakened. Cytomegalovirus poses a threatening danger in its consequences in people with reduced immunity (HIV-infected people who have undergone bone marrow or internal organ transplantation, taking immunosuppressants), with a congenital form of cytomegaly, and in pregnant women.

Routes of transmission of cytomegalovirus

Cytomegaly is not a highly contagious infection. Typically, infection occurs through close, prolonged contact with cytomegalovirus carriers. Cytomegalovirus is transmitted in the following ways:

• airborne: when sneezing, coughing, talking, kissing, etc.;
• sexually: during sexual contact through sperm, vaginal and cervical mucus;
• blood transfusion: with blood transfusion, leukocyte mass, sometimes with organ and tissue transplantation;
• transplacental: during pregnancy from mother to fetus.

Mechanism of development of cytomegaly

Once in the blood, cytomegalovirus causes a pronounced immune reaction, manifested in the production of protective protein antibodies - immunoglobulins M and G (IgM and IgG) and an antiviral cellular reaction - the formation of CD 4 and CD 8 lymphocytes. Inhibition of cellular immunity during HIV infection leads to the active development cytomegalovirus and the infection it causes.

The formation of immunoglobulins M, indicating a primary infection, occurs 1-2 months after infection with cytomegalovirus. After 4-5 months, IgM is replaced by IgG, which is found in the blood throughout the rest of life. With strong immunity, cytomegalovirus does not cause clinical manifestations, the course of the infection is asymptomatic and hidden, although the presence of the virus is detected in many tissues and organs. By infecting cells, cytomegalovirus causes an increase in their size; under a microscope, the affected cells look like the “eye of an owl”. Cytomegalovirus is detected in the body for life.

Even with an asymptomatic infection, a cytomegalovirus carrier is potentially infectious to uninfected individuals. The exception is the intrauterine transmission of cytomegalovirus from a pregnant woman to the fetus, which occurs mainly during the active course of the process, and only in 5% of cases causes congenital cytomegaly, in the rest it is asymptomatic.

Forms of cytomegaly

Congenital cytomegaly

In 95% of cases, intrauterine infection of the fetus with cytomegalovirus does not cause the development of the disease, but is asymptomatic. Congenital cytomegalovirus infection develops in newborns whose mothers have suffered primary cytomegaly. Congenital cytomegaly can manifest itself in newborns in various forms:

• petechial rash - small skin hemorrhages - occurs in 60-80% of newborns;
• prematurity and intrauterine growth retardation - occurs in 30% of newborns;
• Chorioretinitis is an acute inflammatory process in the retina of the eye, often causing decreased and complete loss of vision.

Mortality from intrauterine infection with cytomegalovirus reaches 20-30%. Of the surviving children most of has mental retardation or hearing and vision disabilities.

Acquired cytomegaly in newborns

When infected with cytomegalovirus during childbirth (during the passage of the fetus through the birth canal) or in the postpartum period (through household contact with an infected mother or breastfeeding), in most cases an asymptomatic course of cytomegalovirus infection develops. However, in premature infants, cytomegalovirus can cause prolonged pneumonia, which is often accompanied by a concomitant bacterial infection. Often, when children are affected by cytomegalovirus, there is a slowdown in physical development, enlarged lymph nodes, hepatitis, rash.

Mononucleosis-like syndrome

In persons who have emerged from the neonatal period and have normal immunity, cytomegalovirus can cause the development of mononucleosis-like syndrome. The clinical course of mononuclease-like syndrome does not differ from infectious mononucleosis, caused by another type of herpes virus - the Ebstein-Barr virus. The course of mononucleosis-like syndrome resembles a persistent cold infection. It is noted:

• long-term (up to 1 month or more) fever with high body temperature and chills;
• aches in joints and muscles, headache;
• severe weakness, malaise, fatigue;
• sore throat;
• enlargement of lymph nodes and salivary glands;
• skin rashes resembling rubella rash (usually occurs during treatment with ampicillin).

IN in some cases mononucleosis-like syndrome is accompanied by the development of hepatitis - jaundice and an increase in liver enzymes in the blood. Even less commonly (up to 6% of cases), pneumonia is a complication of mononucleosis-like syndrome. However, in individuals with normal immune reactivity, it occurs without clinical manifestations, being detected only by chest x-ray.

The duration of mononucleosis-like syndrome ranges from 9 to 60 days. Then, complete recovery usually occurs, although residual effects in the form of malaise, weakness, and enlarged lymph nodes may persist for several months. IN in rare cases activation of cytomegalovirus causes relapses of infection with fever, sweating, hot flashes and malaise.

Cytomegalovirus infection in immunocompromised individuals

Weakening of the immune system is observed in persons suffering from congenital and acquired immunodeficiency syndrome (AIDS), as well as in patients who have undergone transplantation of internal organs and tissues: heart, lung, kidney, liver, bone marrow. After organ transplantation, patients are forced to constantly take immunosuppressants, leading to a pronounced suppression of immune reactions, which causes the activity of cytomegalovirus in the body.

In patients who have undergone organ transplantation, cytomegalovirus causes damage to donor tissues and organs (hepatitis during liver transplantation, pneumonia during lung transplantation, etc.). After bone marrow transplantation, in 15-20% of patients, cytomegalovirus can lead to the development of pneumonia with high mortality (84-88%). The greatest danger is when donor material infected with cytomegalovirus is transplanted into an uninfected recipient.

Cytomegalovirus affects almost all HIV-infected people. At the onset of the disease, malaise, joint and muscle pain, fever, night sweats. In the future, these symptoms may be accompanied by damage to the lungs (pneumonia), liver (hepatitis), brain (encephalitis), retina (retinitis), ulcerative lesions and gastrointestinal bleeding.

In men, cytomegalovirus can affect the testicles, prostate, in women - the cervix, inner layer of the uterus, vagina, ovaries. Complications of cytomegalovirus infection in HIV-infected people may include internal bleeding from affected organs and loss of vision. Multiple organ damage by cytomegalovirus can lead to organ dysfunction and death of the patient.

Diagnosis of cytomegaly

In order to diagnose cytomegalovirus infection, a laboratory determination in the blood of specific antibodies to cytomegalovirus - immunoglobulins M and G is carried out. The presence of immunoglobulins M may indicate a primary infection with cytomegalovirus or reactivation of a chronic cytomegalovirus infection. Determination of high IgM titers in pregnant women can threaten infection of the fetus. An increase in IgM is detected in the blood 4-7 weeks after infection with cytomegalovirus and is observed for 16-20 weeks. An increase in immunoglobulin G develops during the period of attenuation of the activity of cytomegalovirus infection. Their presence in the blood indicates the presence of cytomegalovirus in the body, but does not reflect the activity of the infectious process.

To determine cytomegalovirus DNA in blood cells and mucous membranes (in scraping materials from the urethra and cervical canal, in sputum, saliva, etc.), the PCR diagnostic method (polymerase chain reaction) is used. Particularly informative is quantitative PCR, which gives an idea of ​​the activity of cytomegalovirus and the infectious process it causes. The diagnosis of cytomegalovirus infection is based on the isolation of cytomegalovirus in clinical material or a fourfold increase in antibody titer. Treatment of cytomegalovirus infection in individuals at risk is carried out with the antiviral drug ganciclovir. In cases of severe cytomegaly, ganciclovir is administered intravenously, since tablet forms of the drug have only a preventive effect against cytomegalovirus. Since ganciclovir has significant side effects (causes suppression of hematopoiesis - anemia, neutropenia, thrombocytopenia, skin reactions, gastrointestinal disorders, fever and chills, etc.), its use is limited in pregnant women, children and people suffering from renal failure (only for health reasons), it is not used in patients without immunocompromise.

For the treatment of cytomegalovirus in HIV-infected people, the most effective drug is foscarnet, which also has a number of side effects. Foscarnet can cause disturbances in electrolyte metabolism (decreased plasma magnesium and potassium), genital ulceration, urination problems, nausea, and kidney damage. Data adverse reactions require careful use and timely adjustment of the drug dose.

Prevention

The issue of preventing cytomegalovirus infection is especially acute for people at risk. The most susceptible to infection with cytomegalovirus and the development of the disease are HIV-infected people (especially AIDS patients), patients after organ transplantation and people with immunodeficiency of other origins.

Nonspecific methods of prevention (for example, personal hygiene) are ineffective against cytomegalovirus, since infection with it is possible even by airborne droplets. Specific prevention of cytomegalovirus infection is carried out with ganciclovir, acyclovir, foscarnet among patients at risk. Also, to exclude the possibility of cytomegalovirus infection of recipients during organ and tissue transplantation, careful selection of donors and monitoring of donor material for the presence of cytomegalovirus infection is necessary.

Cytomegalovirus is especially dangerous during pregnancy, as it can cause miscarriage, stillbirth, or cause severe congenital deformities in the child. Therefore, cytomegalovirus, along with herpes, toxoplasmosis and rubella, is one of those infections for which women should be screened prophylactically, even at the stage of pregnancy planning.

Cytomegalovirus (CMV)- another domestic horror story, which I’ve been hearing about more and more often lately, so it’s time for another exorcism.

CMV is part of the herpes virus family, that is, it is another type of herpes virus that most of us become infected with during our lives, and it stays with us forever. According to American data, more than 50% of people over 40 years of age are infected with CMV. This virus is secreted by all biological fluids (saliva, blood, secretions, sperm, milk, etc.), so most often infection occurs in childhood or during children’s interactions with each other in groups or from parents through milk or kisses. If in childhood infection was avoided, then the virus awaits us already in the romantic period of life - there kissing and sexual intercourse become the main route of infection. In the vast majority of cases, no symptoms are observed after the virus enters the body. In childhood, the disease can occur under the guise of a common cold; a characteristic manifestation will be drooling, enlargement of the submandibular lymph nodes and plaque on the tongue. In adulthood, such symptoms may not exist. After entering the body, the virus remains in it forever and can periodically appear in various biological fluids, where doctors happily identify it and begin to treat it. Now based exorcism phase

1. CMV is completely safe for the vast majority of people and does not require detection or treatment. CMV is dangerous only for people infected with HIV, those undergoing organ transplantation, bone marrow transplantation, those suffering from cancer and receiving chemotherapy. In other words, for those who have a severely damaged immune system.
2. Everything terrible that you read about this disease on the Internet or your doctor tells you will never happen to you, of course, if you are not infected with HIV or you do not receive a kidney, heart or bone marrow transplant.
3. You do not have any reason to be tested for CMV - that is, you do not need to take a blood test for CMV, much less a PCR smear for CMV. These studies don't make any sense
4. Separate topic: CMV and pregnancy- the most terrible myths and misconceptions live here. So:
   • 50% of women enter pregnancy with a previous CMV infection and 1-4% become infected for the first time during pregnancy.
   • The likelihood of infection of the fetus is higher if a pregnant woman is infected with CMV for the first time during pregnancy, while the risk of infection in the first and second trimester is 30-40%, and in the third - 40-70%
   • In 50-75% of cases, infection of the fetus occurs in pregnant women who have previously had CMV infection due to reactivation of the infection or infection with a new strain.
   • Only one in 150 newborns is diagnosed with CMV infection, and only one in 5 infected newborns develops long-term consequences of CMV
   • Clinical manifestations of CMV in a newborn: premature birth, low weight, microcephaly (small head), abnormalities in the functioning of the kidneys, liver and spleen.
   • 40-60% of newborns with signs of congenital CMV infection may develop delayed disorders: hearing loss, visual impairment, mental retardation, microcephaly, coordination disorders, muscle weakness, etc.
   • Now a very important point - in the West it is not recommended to conduct studies to identify CVM for pregnant women and women planning pregnancy. This is due to the following reasons: there are only a few drugs for the treatment of CMV infection (ganciclovir and valganciclovir, etc.), these drugs have many severe side effects, so such treatment is justified only in patients with immunodeficiency, when the disease threatens health. As shown above, the likelihood of the fetus developing delayed serious problems health problems are so low that it is not advisable to terminate the pregnancy if a primary infection or reactivation of the infection is detected during pregnancy. The decision to prescribe treatment to infected newborns is made only after a serious assessment of the benefits and risks. Treating asymptomatic women before pregnancy is not even considered.

The situation in our country is frighteningly illiterate:

• They take a smear for CMV from the vagina - this makes no sense. Yes, from time to time in a previously infected person the virus may appear in all biological fluids, but this is not dangerous either for the pregnancy or for the partner. Let me remind you that in a person without immunodeficiency, CVM is not capable of causing a picture of a serious illness with damage to internal organs
• Before pregnancy, a test is prescribed for TORCH infection, which includes CMV, IgG to CMV is detected and treatment is prescribed. Moreover, this, of course, is not treatment with the heavy drugs described above, but favorite immunomodulators, drugs for herpes simplex and other bullshit. The funny thing is that IgG to CMV reflects the fact of the presence of protective antibodies to this virus, that is, it indicates the fact of a previous infection and the degree to which the body responded to it. Have you assessed the degree of absurdity of the doctors' actions?
• Some doctors insist on terminating the pregnancy if suddenly during pregnancy CMV is detected in smears or a primary infection is diagnosed based on blood tests (the appearance of IgM to CMV in the blood or IgG in those patients who did not have it before pregnancy). This absolutely cannot be done, since the risk of developing serious consequences for the newborn, even in this case, is very low.

To summarize:

1. CVM is not dangerous for you, more than half of the adult population were infected with this virus unnoticed and it did not affect their health in any way
2. You do not need to take tests to detect CMV - neither a smear nor a blood test - there is no point in that. Even if CMV is detected, no treatment is necessary.
3. If you are planning a pregnancy, it makes sense to get tested for TORCH infection. If the results reveal that you do not have IgG to CMV, the only recommendation is to wash your hands more often after interacting with children and generally avoid contact with children, especially if they have signs of a “cold.”
4. It makes no sense to be examined for the detection of CMV during pregnancy, since no treatment for CMV is carried out during pregnancy, since the drugs have many severe side effects, and the fact of detection of acute CMV infection is not an indication for termination of pregnancy.
5. Testing for CMV in newborns is carried out only if there is a suspicion of intrauterine infection, and the decision to prescribe treatment is made individually.

Cytomegalovirus infection (CMVI, inclusion cytomegaly) is a very widespread viral disease, usually characterized by a latent 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.

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 the majority 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.

Classification

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).

Etiology and pathogenesis

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 specific clinical symptoms), but most often it is associated with the salivary glands (it 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.

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 the protective forces are weakened, the cells, under the influence of an 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 can be a consequence of AIDS, chemotherapy with the use of cytostatics and immunosuppressants carried out for cancer, as well as ordinary hypovitaminosis.

Microscopy reveals that the affected cells have acquired characteristic appearance"owl's eye" They contain inclusions (inclusions), which are clusters of viruses.

At the tissue level, pathological changes are 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. The direct effect on cellular immunity is due to the suppression of the generation of T lymphocytes.

Symptoms of cytomegalovirus infection

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 the cells of the gastrointestinal tract causes diarrhea or constipation; It is also possible that pain or discomfort in the abdominal area and a number of other unclear symptoms may occur. Clinical manifestations of exacerbation of CMV infection, as a rule, disappear on their own after several days.

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.

Cytomegalovirus infection: symptoms in men

In men, the replication of the virus in the organs of the reproductive system in most cases does not manifest itself in any way, i.e. we're talking about about asymptomatic course.

Cytomegalovirus infection: symptoms in women

In women, CMV infection manifests itself as inflammatory diseases of the genital organs.

The following pathologies may develop:

• (inflammatory lesion of the cervix);
• endometritis (inflammation of the uterine endometrium - the inner layer of the walls of the organ);
• vaginitis (inflammation of the vagina).

Important:in severe cases (usually at an 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 by a severe course, similar to. In such cases, the outcome is often unfavorable.

Damage to the gastrointestinal tract leads to development, in which bleeding is frequent and perforation is not excluded, resulting in 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 short time causes dementia.

Possible complications of CMV infection also include:

• vegetative-vascular disorders;
• inflammatory joint lesions;
• myocarditis;
• pleurisy.

In AIDS, cytomegalovirus in some cases affects the retina of the eyes, causing gradually progressive necrosis of its areas and blindness.

Cytomegalovirus during pregnancy

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 excluded.

In the acute course of CMV infection, pregnant women may experience the following symptoms:

• whitish (or bluish) discharge from the genitals;
• increased fatigue;
• general malaise;
• mucous discharge from the nasal passages;
• hypertonicity of the uterine muscles (resistant to drug therapy);
• polyhydramnios;
• early aging of the placenta;
• the appearance of cystic neoplasms.

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:

• cardiac septal defects;
• atresia (fusion) of the esophagus;
• abnormalities of the kidney structure;
• microcephaly (underdevelopment of the brain);
• macrogyria (pathological enlargement of brain convolutions);
• underdevelopment of the respiratory organs (pulmonary hypoplasia);
• narrowing of the aortic lumen;
• clouding of the lens of the eye.

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.

Cytomegalovirus infection in children

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:

• jaundice of various origins;
• hemolytic anemia (anemia due to the destruction of red blood cells);
• hemorrhagic syndrome.

The acute congenital form of the disease in some cases leads to death in the first 2-3 weeks.

Over time, serious pathologies such as

• speech disorders;
• deafness;
• atrophy optic nerve against the background of chorioretinitis;
• decreased intelligence (with damage to the central nervous system).

Treatment of cytomegalovirus infection

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 system practically does not give a 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

is a hidden virus found in the human body. Its main feature is that most people do not even suspect that they are infected.

According to medical examinations, 15-20% of adolescents and 60% of the population over 40 years of age are carriers of type 5 herpes.

Infection is dangerous because medicine is on modern stage development is not able to prevent infection and help sick people.

Cytomegalovirus (CMV) is a virus from the herpevirus family that can cause cytomegaly in humans.

If a man’s immune system is weakened (due to acute respiratory viral infections or pneumonia, the presence of cancer, etc.), then the functioning of internal organs may be disrupted:

1. Diseases of the genitourinary system, accompanied by pain during urination.
2. Pneumonia, myocarditis, encephalitis (in critical cases).
3. Paralysis and death (in very rare cases).

It should be aimed at eliminating the inflammatory process and keeping the virus in an inactive form.

What are the risks for women?

Cytomegalovirus is dangerous for girls, as well as for men, in case of reduced immunity. Infection can cause various diseases:

• inflammation of the female genital organs;
• pleurisy, pneumonia;
• intestinal inflammation;
• neurological diseases (in extreme cases - encephalitis).

The most dangerous. Especially if the infection occurred in the first trimester of pregnancy. The virus can infect the fetus, and this will lead to the death of the embryo. At a later stage of pregnancy, infection can have Negative influence on the formation of the baby’s internal organs. Therefore, it is important to check for infections when planning a pregnancy. If cytomegalovirus and antibodies to it are present in a girl’s body before pregnancy, a favorable outcome is most likely (the child will be a passive carrier of CMV).

For children

Many parents wonder if it is dangerous? It depends on the type of infection and the age of the baby. The most dangerous consequences are detected in the congenital form of the disease in a child under 1 year of age:

• disruption of the liver and spleen;
• bronchitis, pneumonia;
• jaundice.

If the baby acquired the virus during the first year of life, the disease will be milder. Symptoms are similar to ARVI:

• runny nose;
• heat;
• swollen lymph nodes;
• increased fatigue.

In older people, the disease is most often asymptomatic. Sometimes drowsiness and fever may occur. The disease in its acquired form rarely causes complications on the child’s health.

Features of development and impact on the body

Cytomegalovirus is a fairly large virus (150-190 nm). Thanks to this, CMV got its name, literal translation, “giant cell.” The virus enters a healthy cell and increases its size many times over. The contents of the cell are significantly reduced (stick together), and the entire space is filled with liquid. Infected cells become large, stop dividing and die. In this case, inflammation of the surrounding tissue occurs.

Depending on the route of entry of CMV into the human body, the degree of influence on internal systems depends:

• if the virus penetrates through saliva, then the nasopharynx and bronchi suffer;
• when affected through the genitals, the infection penetrates into the bladder, kidneys, and uterus;
• in the blood, CMV infects leukocytes, lymphocytes, and then the centers of the spinal cord and brain.

However, a strong immune system quickly detects the virus and begins to fight it by forming antibodies. After this, the virus goes into a dormant form and remains in the human body forever.

Why carriers are dangerous

The source of infection with cytomegalovirus can be a patient with an active stage of the disease, or a person without any special signs of infection. After infection, a healthy body begins to produce antibodies. This stage is called the latent period of the disease and lasts 4-8 weeks.

The carrier of the virus is most dangerous during the period, which begins after the latent stage and lasts from 15 to 60 days. During this period, the patient develops symptoms of the disease similar to ARVI:

• chills;
• high body temperature;
• headache;
• runny nose;
• skin rash;
• malaise and increased fatigue.

At this stage, CMV multiplies very actively and the patient is dangerous to others. You can become infected through saliva and other secretions. However, this risk of infection applies to specific groups of the population. First of all, the risk group includes people with reduced immunity:

• girls and their baby during pregnancy;
• preschool children;
• patients with oncology after courses of chemotherapy;
• people with HIV infection;
• patients after organ transplantation.

For the rest of the population, cytomegalovirus carriers do not pose a great threat.

Consequences of the virus after recovery

With timely treatment of CMV, significant consequences in human health are not observed. In the acute form of herpes, the patient is usually prescribed and. If cytomegaly is asymptomatic, then there is no need for treatment.

To summarize, we can say that cytomegalovirus is dangerous for people with weakened immune systems. Because there are no medications yet to combat the disease. But a person can always improve his health: play sports, toughen up,... A strong immune system is the best cure for infections.