GeneralCytomegalovirus belongs to the family of herpes viruses, contains in the structure of DNA and is capable of hitting almost any human organs and tissues. Title virus due to the fact that the virus-infected cells, they increase in size (in terms giant cells).
Depending on the immune status of cytomegalovirus infection can cause a variety of changes: from asymptomatic lung and mononucleosis syndrome to severe systemic infection with pulmonary, liver, kidneys and other organs.
Causes of the diseaseCytomegalovirus is ubiquitous. Infection may occur in close contact with the patient or carrier infection. The virus is released into the environment from a variety of human body fluids: saliva, urine, feces, breast milk, semen, vaginal discharge. For transmission paths include airborne, food, sex. A newborn baby can become infected by the mother through breast milk. It should be noted vertical transmission of infection from mother to fetus during pregnancy. If the fetus is infected may develop a very severe congenital cytomegalovirus disease.
Infection can also occur through blood transfusions (in Russian blood donors for the presence of cytomegalovirus is not checked), and the transplantation of organs from a donor with a CMV infection.
Once infected by tsitomegalovirsom, people tend to last a lifetime is a carrier of the infection.
The symptoms of CMV infectionDistinguish how variants of the CMV infection.
1) CMV infection in people with normal immune.
The most common primary infection mononucleosis-like syndrome manifested. The incubation period is 20-60 days, duration of illness 2-6 weeks. As a rule, there is fever, fatigue, swollen lymph nodes, muscle pain. With a sufficient immune response, the body produces antibodies against the virus and the disease ends with self-healing. Virus isolation from biological fluids continues the months and years after recovery. After primary CMV infection can be in the body for decades in an inactive form or spontaneously disappear from the body. On average, 90-95% of adults have antibodies to CMV class G.
2) CMV infection in immunocompromised individuals (patients with lymphoproliferative diseases, hematological malignancies, HIV-infected patients after transplantation of internal organs or bone marrow).
These patients may be generalization of infection that attacks the liver, kidneys, lungs, retina, pancreas and other organs.
3) Congenital cytomegalovirus infection.
Intrauterine infection of the fetus up to 12 weeks, usually ends in miscarriage at 12 weeks after infection, a child may develop a severe disease - congenital cytomegalovirus. According to the statistics of congenital cytomegaly affects about 5% of infected infants in utero. Among its symptoms include prematurity, enlargement of the liver, kidney, spleen, chorioretinitis, pneumonia. In children undergoing intrauterine CMV infection and avoid generalization of the process, can detect psychomotor retardation, hearing loss, visual impairment, developmental abnormalities of the teeth.
DiagnosticsThe diagnosis of CMV infection based on clinical and laboratory research methods.
Laboratory methods for identification of CMV include:
- Virus isolation in cell culture;
- Cytology (light microscopy) - Detection of specific giant cells with intranuclear inclusions
- Immunoassay method (ELISA) - Detection of specific antibodies in the blood to cytomegalovirus classes M and G;
- Polymerase chain reaction - allows you to determine the CMV DNA in any biological tissues.
Treatment of cytomegalovirusOf virus and mononucleosis-like syndrome in patients with normal immunity does not require treatment.
The treatment prescribed for detecting various forms of generalized infection. All used antiviral drugs (foksarnet, ganciclovir, valganciclovir) are toxic and have a mass of complications, so they are assigned only for health reasons. In some cases, the use antitsitomegalovirusny immunoglobulin (tsitotekt). Treatment is usually carried out in a hospital.
Prevention of cytomegalovirusSpecial methods for preventing CMV infection is not designed.
Persons with healthy immune need no treatment or the prevention of this disease.
Persons with weakened immune systems are trying to transfuse blood products, and transplant organs from CMV-negative donors.
The primary prevention of infection of the fetus is to investigate the presence of CMV disease before pregnancy. Antiretroviral therapy during pregnancy is not applicable because-toxic and has a potential risk to the fetus.