Anti-CMV-IgM (IgM antibodies to cytomegalovirus, CMV, CMV). Cytomegalovirus igm negative igg positive Cmv positive

Cytomegalovirus is a virus belonging to the herpesvirus family. This virus has a high prevalence in the human population.

Ten to fifteen percent of adolescents and forty percent of adults have antibodies to cytomegalovirus in their blood.

The incubation period is quite long - up to two months. During this period, the disease is always asymptomatic. Then a pronounced manifest beginning. Which is provoked by stress, hypothermia, or simply reduced immunity.

The symptoms are very similar to acute respiratory infections or acute respiratory viral infections. The body temperature rises, the head hurts severely, and general discomfort occurs. An untreated virus can result in inflammation of the lungs and joints, brain damage, or other dangerous diseases. The infection remains in the body throughout a person’s life.

The year the virus was discovered is 1956. It is still being actively studied, its action and manifestations. Every year brings new knowledge.

The contagiousness of the virus is low.

Routes of transmission: sexual, household contact (through kisses and saliva), from mother to child, through blood products.

Infected people are usually asymptomatic. But sometimes, in those who suffer from poor immunity, the disease manifests itself as a mononucleosis-like syndrome.

It is characterized by increased body temperature, feelings of chills, fatigue and general malaise, and severe pain in the head. Mononucleosis-like syndrome has a happy ending - recovery.

There is a particular danger for two categories of people - those who weak immunity and infants infected in utero from a sick mother.

An increase in the titer of antibodies in the blood to cytomegalovirus by four times or even more indicates activation of cytomegalovirus.

What does cytomegalovirus IgG positive mean?

At positive decoding analysis for the determination of IgG antibodies to cytomegalo viral infection what is the conclusion?

The human immune system successfully coped with cytomegalovirus infection about a month ago, or even more.

This organism has developed a lifelong, stable immunity. About 90% of people are carriers, so there is no norm of antibodies to this virus. There is also no concept of increased or decreased level.

Determination of antibodies to cytomegalovirus is only necessary to establish the correct diagnosis.

Cytomegalovirus infection is considered to be the presence of a virus in a PCR analysis, when material containing certain DNA is examined.

From the tenth to fourteenth day after infection, IgG antibodies to cytomegalovirus infection appear in the blood. Antibodies easily pass through the placenta. Therefore, newborns are not always infected; it may be the mother's immunoglobulins.

The level of immunoglobulin in the blood is checked after three weeks to clarify the diagnosis and the severity of the process. The process is considered active if the level of immunoglobulins increases.

Cytomegalovirus in children

Cytomegalovirus infection is very similar to herpes infection. And it occurs often too.

Even if the infection occurred in early childhood, but a person has good strong immunity all his life, then a cytomegalovirus infection may never manifest itself. A person is only a virus carrier all his life.

There are children who suffer greatly from cytomegalovirus:

• those exposed to intrauterine infection, since the placental barrier is not an obstacle to cytomegalovirus;
• newborns with weak and unstable immunity;
• at any age, with a severely weakened immune system, or, for example, in patients with AIDS.

Infection is most often diagnosed using ELISA (enzyme-linked immunosorbent assay). This method can determine not only the presence of cytomegalovirus infection in the child’s body. But it’s also possible to say for sure whether it is congenital or acquired.

For newborns, cytomegalovirus is infectious mononucleosis. Affected lymphatic system – lymph nodes increase, become inflamed tonsils, the liver and spleen enlarge, it becomes difficult to breathe.

In addition, congenital infection is characterized by:

• prematurity;
• squint;
• jaundice of newborns;
• disorders of swallowing and sucking reflexes.

Poor nasal breathing can cause the following symptoms:

• loss of appetite and weight loss;
• sleep disorders;
• crying and worrying.

Congenital infection of a child most often occurs in utero. But sometimes through birth canal mother or breast milk when feeding.

Most often, a very dangerous asymptomatic course of cytomegalovirus infection is observed. Even two months after being born into this world.

For such children, complications are possible:

• 20% of children with asymptomatic, actively occurring cytomegalovirus after months are characterized by the presence of severe convulsions, abnormal movements of the limbs, changes in the bones (for example, in the skull), and insufficient body weight;
• after five years, 50% have speech impairment, intellect suffers, the cardiovascular system is affected and vision is severely affected.

If a child becomes infected at a later time, and not during the neonatal period, when the immune system is already well formed, then there are practically no consequences.

Most often, it is asymptomatic or reminiscent of classic childhood ARVI.

Characterized by:

• lethargy and drowsiness;
• cervical lymphadenitis;
• pain in the musculoskeletal system (muscles and joints);
• chills and low-grade fever.

This lasts two weeks - two months. Ends with self-healing. Very rarely, if the disease does not go away for two to three months, medical consultation and treatment is necessary.

The earliest diagnosis of cytomegalovirus infection and timely treatment, significantly reduce the risk of complications. It is best to start treatment within seven to nine days after infection. Then the cytomegalovirus infection will not leave a trace.

Cytomegalovirus in women

Cytomegalovirus infection in females occurs in a chronic form. Most often this is asymptomatic, but sometimes symptoms are present. A weak immune system contributes to the active manifestation of the disease.

Unfortunately, cytomegalovirus infection affects women at any age. Provoking factors are cancer, HIV infection or AIDS, and gastrointestinal pathologies. Another similar effect is observed from taking antitumor drugs and antidepressants.

IN acute form the infection is characterized by damage to the cervical lymph nodes.

Then there is an increase in the submandibular, axillary and inguinal lymph nodes. As I already said, this clinical picture is similar to infectious mononucleosis. It is characterized by headache, general feeling unwell, hepatomegaly, atypical mononuclear cells in the blood.

Immunodeficiency (for example, HIV infection) causes a severe, generalized form of cytomegalovirus infection. Internal organs, blood vessels, nerves and salivary glands. Cytomegalovirus hepatitis, pneumonia, retinitis and sialadenitis occur.

Nine out of ten women with AIDS have a cytomegalovirus infection. They are characterized by bilateral pneumonia and the phenomena of encephalitis.

Encephalitis is characterized by dementia and memory loss.

Women with AIDS and cytomegalovirus suffer from polyradiculopathy. Such women are characterized by damage to the kidneys, liver, pancreas, eyes and MPS organs.

Cytomegalovirus during pregnancy

An infection that comes from a person who has an acute form of the disease is the most worst option for pregnant women.

There are still no antibodies in the pregnant woman's blood.

The active virus of an infecting person passes through all barriers without difficulty and has a detrimental effect on the child. According to statistics, this happens in half of infections.

If factors that weaken the immune system aggravate latent virus carriage, then this is a less dangerous situation.

There are already immunoglobulins (IgG) in the blood, the virus is weakened and not so active. The virus is dangerous by infecting the fetus in only two percent of cases. Early pregnancy is more dangerous in terms of infection. Pregnancy often ends in spontaneous miscarriage. Or the fetus develops abnormally.

Infection with cytomegalovirus infection later in pregnancy leads to polyhydramnios or premature birth (“congenital cytomegaly”). Unfortunately, it is impossible to completely destroy cytomegalovirus in the body. But you can make it inactive. Therefore, pregnant women and those planning to become pregnant should be especially careful about their health. Cytomegalovirus is very dangerous for the fetus.

Cytomegalovirus IgM positive

IgM is the first protective barrier against all kinds of viruses. They do not have a specification, but they are produced urgently, as a response to the penetration of cytomegalovirus infection into the body.

An IgM test is carried out to determine:

• primary infection by the virus (maximum antibody titer);
• stages of aggravated cytomegalovirus (the number of the virus is growing and the number of IgM is growing);
• reinfection (a new strain of cytomegalovirus has caused infection).

Later, from IgM, specific antibodies, IgG, are formed. If the strength of the immune system does not decrease, then IgG will fight cytomegalovirus all their lives. The IgG antibody titer is highly specific. From it you can determine the specification of the virus. Despite the fact that an IgM test shows the presence of any virus in the material being tested.

The number of cytomegalovirus is subject to control by immunoglobulin G, preventing the development of a picture of an acute disease.

With the results " IgM positive"If "IgG is negative", this indicates an acute recent infection and the absence of permanent immunity against CMV. An exacerbation of a chronic infection is characterized by indicators when IgG and IgM are present in the blood. The body is in a stage of serious deterioration of immunity.

There has already been infection in the past (IgG), but the body cannot cope, and nonspecific IgM appears.

The presence of positive IgG and negative IgM is the best test result for a pregnant woman. She has specific immunity, which means the child will not get sick.

If the situation is the opposite, with positive IgM and negative IgG, then this is also not scary. This indicates a secondary infection that is being fought in the body, which means there should be no complications.

It’s worse if there are no antibodies at all, of both classes. This indicates a special situation. Although this situation is very rare.

IN modern society Almost all women are infected with the infection.

Treatment of cytomegalovirus and treatment results

If a person healthy immunity, then he himself will cope with cytomegalovirus infection. You may not carry out any therapeutic actions. Immunity will only be weakened if treated for a cytomegalovirus infection that does not manifest itself. Drug treatment necessary only when immune defense does not cope and the infection actively intensifies.

Pregnant women also do not need treatment if they have specific IgG antibodies in their blood.

If the test for IgM is positive, for transfer acute condition during the latent course of the disease. You must always remember that medications for cytomegalovirus infection have many side effects. Therefore, only a knowledgeable specialist can prescribe them; self-medication should be avoided.

The active stage of infection is the presence of positive IgM. It is necessary to take into account other test results. It is especially necessary to monitor the presence of antibodies in the body for pregnant and immunodeficient people.

Antibodies of the IgM class to cytomegalovirus are specific immunoglobulins produced in the human body in acute period cytomegalovirus infection and are an early serological marker of this disease.

Synonyms Russian

Antibodies of the IgM class to cytomegalovirus (CMV).

English synonyms

Anti-CMV-IgM, CMV Antibody, IgM.

Research method

Electrochemiluminescent immunoassay (ECLIA).

What biomaterial can be used for research?

Venous, capillary blood.

How to properly prepare for research?

Do not smoke for 30 minutes before the test.

General information about the study

Cytomegalovirus (CMV) belongs to the herpes virus family. Just like other representatives of this group, it can persist in a person throughout his life. In healthy people with normal immunity, the primary infection occurs without complications (and is often asymptomatic). However, cytomegalovirus is dangerous during pregnancy (for the child) and during immunodeficiency.

Cytomegalovirus can be contracted through various biological fluids: saliva, urine, sperm, blood. In addition, it is transmitted from mother to child (during pregnancy, childbirth or breastfeeding).

As a rule, cytomegalovirus infection is asymptomatic. Sometimes the disease resembles infectious mononucleosis: the temperature rises, the throat hurts, and the lymph nodes become enlarged. The virus then remains inside the cells in an inactive state. But if the body is weakened, the virus will begin to multiply again.

It is important for a woman to know whether she has been infected with CMV in the past because this is what determines whether she is at risk for pregnancy complications. If she has already been infected before, then the risk is minimal. During pregnancy, an exacerbation of an old infection may occur, but this form usually does not cause serious consequences.

If a woman has not yet had CMV, then she is at risk and should pay special attention to the prevention of cytomegalovirus infection. It is the infection that the mother contracted for the first time during pregnancy that is dangerous for the child.

During a primary infection in a pregnant woman, the virus often enters the child’s body. This does not mean that he will get sick. As a rule, CMV infection is asymptomatic. However, in approximately 10% of cases it leads to congenital pathologies: microcephaly, cerebral calcification, rash and enlarged spleen and liver. This is often accompanied by a decrease in intelligence and deafness, and even death is possible.

Thus, it is important for the expectant mother to know whether she has been infected with CMV in the past. If so, then the risk of complications due to possible CMV becomes negligible. If not, you need to take special care during pregnancy:

• avoid unprotected sex,
• do not come into contact with another person’s saliva (do not kiss, do not share dishes, toothbrushes, etc.),
• observe the rules of hygiene when playing with children (wash your hands if saliva or urine gets on them),
• get tested for CMV if there are signs of general malaise.

In addition, cytomegalovirus is dangerous if the immune system is weakened (for example, due to immunosuppressants or HIV). In AIDS, CMV is severe and is common cause death of patients.

The main symptoms of cytomegalovirus:

• inflammation of the retina (which can lead to blindness),
• colitis (inflammation of the colon),
• esophagitis (inflammation of the esophagus),
• neurological disorders (encephalitis, etc.).

The production of antibodies is one way to fight a viral infection. There are several classes of antibodies (IgG, IgM, IgA, etc.), which differ in their functions.

Immunoglobulin M (IgM) usually appears first in the blood (earlier than other types of antibodies). Then their number gradually decreases (this process can last several months). If an exacerbation of a latent infection occurs, the IgM level will increase again.

Thus, IgM is detected:

• during primary infection (in this case the IgM level is highest),
• during exacerbation of the disease (as well as during reinfection, i.e. infection with a new form of the virus).

What is the research used for?

For the diagnosis of acute cytomegalovirus infection.

When is the study scheduled?

• During pregnancy.
• With immunodeficiency (in particular, with HIV infection).
• When a person with normal immunity has symptoms of mononucleosis (if tests do not reveal the Epstein-Barr virus).
• If CMV infection is suspected in newborn children.
• During pregnancy:
  • for symptoms of the disease,
  • if ultrasound reveals fetal developmental abnormalities,
  • for screening.

CMV infection in pregnant women is often asymptomatic. However, in some cases, the temperature rises, the lymph nodes, liver and/or spleen become enlarged.

In case of immunodeficiency, the symptoms of CMV infection can be quite varied: from general malaise to retinitis, colitis, encephalitis, etc.

• A test may be prescribed for a newborn if the child:
  • jaundice, anemia,
  • enlarged spleen and/or liver,
  • head size is smaller than normal,
  • have hearing or vision impairments,
  • there are neurological disorders (delay mental development, convulsions).

What do the results mean?

Reference values

Result: negative.

S/CO ratio (signal/cutoff): 0 - 0.7.

Negative result

• IN at the moment no current CMV infection. If there are symptoms of a certain disease, then they are caused by another pathogen. In this case, CMV may be present in a latent form. However, if the infection occurred very recently (several days ago), then IgM antibodies may not have had time to appear in the blood yet.

Positive result

• Recent infection (primary infection). During a primary infection, the IgM level is higher than during an exacerbation.

  After the primary IgM infections may not be detected for several months.

• Exacerbation of latent infection.



Important Notes

• Sometimes you need to find out whether a newborn baby is infected with cytomegalovirus. For this purpose, PCR is used and antibodies are additionally determined. If IgM is detected in the child’s blood, it means that he is truly infected with CMV.
• What is reinfection? There are several varieties of CMV in nature. Therefore, it is possible that a person already infected with one type of virus becomes infected with another.

Who orders the study?

Doctor general practice, therapist, infectious disease specialist, gynecologist.

Literature

• Adler S. P. Screening for Cytomegalovirus during Pregnancy. Infect Dis Obstet Gynecol. 2011:1-9.
• Goldman's Cecil Medicine. 24th ed. Goldman L, Schafer A.I., eds. Saunders Elsevier; 2011.
• Lazzarotto T. et al. Why is cytomegalovirus the most frequent cause of congenital infection? Expert Rev Anti Infect Ther. 2011; 9(10): 841–843.

The presence of positive results when taking tests that detect cytomegalovirus IgG means that the human body has antibodies that block the activity of the virus. This means that this person acts as a carrier of the infection. Having immunity to this type of infection allows you not to be afraid possible complications threatening the patient's life.

In this matter, important role takes into account the quality of the protective functions of the body and the physical health of the patient. Increased attention should be paid if the result of such a test performed during pregnancy is negative. This fact can threaten the child’s health, since the developing body does not have antibodies against this infection.

Cytomegalovirus is one of the most common infections in the world

Cytomegalovirus IgG antibodies detected, what does this mean? To answer this question, we need to consider the research procedure itself. During this procedure, genetic material, submitted for research, is studied to search for specific antibodies to cytomegalovirus. The term Ig in this case is short for the word “immunoglobulin”. This trace element is a protective protein that is synthesized by the immune system to fight various viruses.

Immunity human body produces dozens of types of special antibodies, the purpose of which is to combat various types infections. After puberty ends, internal environment The body contains several dozen types of immunoglobulins. The letter G in the combination in question denotes a class of antibodies that are responsible for fighting certain pathogens. Each of these classes is designated using letters of the Latin alphabet.

It should also be said that if a person has not previously encountered cytomegalovirus, then the internal environment does not contain the antibodies necessary to fight the disease. Based on this, we can say that a positive test result can act as evidence that this type of infection was previously present in the body. In addition, you should pay attention to the fact that immunoglobulins that are part of the same class, but have different purposes, have noticeable differences. Based on this, testing for cytomegalovirus IgG allows you to obtain the most accurate results.

How are analyzes deciphered?

A characteristic feature of cytomegalovirus is that after penetration into the internal environment of the human body, the infection remains in it forever. To date, medicine does not have an answer to the question of how to remove this strain of the virus completely from the body. This type the infection is in an inactive state and is stored in secretions salivary glands, blood composition, as well as in the cells of some organs. It should be noted here that some people are not even aware of the presence of the infection and that they are carriers.

The IgG test for cytomegalovirus itself means searching for specific antibodies to the virus in various samples from the patient’s body

In considering the question of cytomegalovirus IgG positivity, what does that mean, we should take a brief detour and consider some of the differences between antibody classes. The IgM class includes antibodies that are large in size. They are produced by the immune system in order to reduce the activity of a viral infection within a short period of time. This class of antibodies does not have the ability to create immunological memory. This means that after a certain period of time, the reproduced antibodies disappear and the body's defenses are compromised.

Polymer chain reaction studies and a positive response to these studies indicate that the human body has antibodies to cytomegalovirus. If there are antibodies from group M in the blood, one can judge the amount of time that has passed since the moment of infection. The presence of these antibodies is a kind of evidence that this virus is at the peak of its activity and the body is actively fighting the infection. To obtain more detailed information, you should pay attention to additional data.

What to pay attention to

The polymer chain reaction test allows you to detect not only the presence of IgG to cytomegalovirus, but also many other useful information. The data from the tests performed is deciphered by the attending physician, but knowledge of certain terms will allow you to independently familiarize yourself with the information provided. Below is a list of the most common terms:

1. “IgM positive, IgG negative”- means that the immune system is actively producing antibodies, the action of which is aimed at fighting viruses. The presence of this result indicates that the infection occurred recently, and the immune system has not yet had time to produce antibodies from the “G” class.
2. “IgM negative, IgG positive”- the infection is in an inactive state. Infection with citalomegavirus took place a long time ago, and the immune system completely protects the body. If infected again, antibodies will prevent the infection from spreading.
3. "IgM negative, IgM negative"- this result suggests that in the internal environment of the body there are no antibodies that suppress the activity of cytomegalovirus, since this strain of infection is not yet known to the body.
4. "IgM positive, IgG positive"- this status indicates reactivation of the virus and exacerbation of the disease.

The test result “Cytomegalovirus IgG positive” means that the patient with such results has immunity to cytomegalovirus and is its carrier

Sometimes in such results the following line appears: “Anti CMV IgG is increased.” This means that the amount of antibodies necessary to fight the citalomegavirus exceeds the norm. In order to understand what value indicates the norm, let's consider such an indicator as the antibody avidity index:

1. 0 index– means the absence of infection in the body.
2. ≤50% - this result is evidence of primary infection.
3. 50-60% - uncertain data. To obtain this result, you must go through repeat procedure examinations in fifteen days.
4. ≥60% - means that the body has antibodies that protect a person from reactivation of the infection. However, this status may indicate that the disease itself has become chronic.

If you have a strong immune system and the absence of chronic diseases that affect the quality of the immune system, a positive test result for the presence of antibodies should not cause concern for your own health. In most cases, the impact of the immune system on the virus leads to an asymptomatic course of the disease. In more severe cases, cytomegalovirus strong immunity may manifest itself as symptoms such as:

• sore throat;
• slight increase in temperature;
• decreased performance.

Although there may be no signs of active infection, an infected person may acute course illness, you should be in isolation. Experts recommend visiting as little as possible public places and completely avoid close contact with pregnant women and young children. Being in this stage of the disease, a person is active source infection, therefore, in order to shorten the period of acute stage infection, treatment should be started without delay.

Positive results from tests performed during pregnancy

If the test result is positive for the presence of IgM antibodies, several conclusions can be drawn. This result may indicate both primary infection with cytomegalovirus and relapse of the disease. When found of this class immunoglobulins in the first trimester of pregnancy, you need to immediately begin treatment for the disease. Delay in taking the necessary measures may result in the infection having a teratogenic effect on the development of the fetus.

In a situation where the disease relapses during pregnancy, the risk of developing possible complications is significantly reduced. However, as in the previous case, lack of therapy can cause a congenital infectious disease in a newborn. It is also necessary to take into account the risk of infection of the child during passage through the birth canal.

The treatment strategy is determined by the doctor accompanying the process of gestation.

Cytomegalovirus is a herpes virus with a latent course upon penetration into the body

In order to determine the nature of the infection, you should pay attention to the level of immunoglobulins belonging to class “G”. The presence of these bodies is confirmation of immunity to secondary infection. Symptoms characteristic of cytomegalovirus, in this situation, indicate a decrease in the quality of the body’s protective functions. If the result of the PCR procedure is negative, the doctor must regard the damage to the body as primary and accept all necessary measures to reduce the risk of complications for the fetus.

To prescribe a treatment regimen, you will need to analyze the patient’s medical history in detail. Along with this, it is taken into account various factors, including existing chronic diseases. The presence of immunoglobulins from class M is a kind of sign of the danger of the disease. However, it should be noted that such a result as negative Anti cmv IgM, in the absence of antibodies from class G, can pose a certain threat. In this situation, a pregnant woman needs to take all measures that will protect her body from primary infection.

Positive result in infants

The presence of antibodies from class G in a newborn child is a kind of evidence that infection occurred during intrauterine development embryo. In order to obtain unambiguous evidence, you will need to take several samples at intervals of one month. The presence of a congenital infection can be determined by microscopic examination of the blood composition.

In most cases, the development of cytomegalovirus infection occurs latently. However, in similar situation there is a risk of developing serious complications that pose a threat to the baby’s health. Such complications include liver dysfunction, hepatitis and pneumonia. In addition, there is a risk of developing chorioretinitis, which in the future can cause complete loss of vision.

If there is suspicion of cytomegalovirus activity in a newborn, it is necessary to immediately begin treatment in order to avoid possible complications. In the first days after birth, an infected baby must be constantly cared for.

Treatment method

In most cases, antibodies to cytomegalovirus independently eliminate the exacerbation of the disease. However, in some situations, the use of potent medications is required to eliminate the infection. The use of such drugs unnecessarily is highly undesirable, due to high risk development side effects drugs. Among various means drugs used in the treatment of cytomegaloviruses include Ganciclovir, Foscarnet, and Panavir. Despite possible side effects in the form of dysfunction of the kidneys and organs gastrointestinal tract, these drugs for short term eliminate infection activity.

Human infection usually occurs before the age of 12.

In addition, drugs from the interferon group, as well as immunoglobulins obtained from donors who are immune to infection, are used as part of complex treatment. The use of the above medications is permitted only after prior consultation with a specialist. These potent medications have their own characteristics, which only specialists from the field of medicine and pharmacology know about.

In conclusion, it must be said that a positive result of the PCR procedure for the presence of cytomegalovirus infection indicates that the human body contains antibodies that prevent the development of the disease. In order for the immune system to continue to protect the body, it is necessary to pay increased attention to the state of your health.

Data 06 Aug ● Comments 0 ● Views

Doctor   Dmitry Sedykh  

Viruses of the herpes group accompany a person throughout his life. The degree of their danger is directly related to the level of immunity - depending on this indicator, the infection can be dormant or provoke serious illnesses. All this fully applies to cytomegalovirus (CMV). If a blood test shows the presence of IgG antibodies to a given pathogen, this is not a reason to panic, but important information to maintain health in the future.

Cytomegalovirus belongs to the herpesvirus family, otherwise known as human herpes virus type 5. Once it enters the body, it remains in it forever - there is currently no way to get rid of infectious pathogens of this group without a trace.

It is transmitted through body fluids - saliva, blood, semen, vaginal secretions, so infection is possible:

• by airborne droplets;
• when kissing;
• sexual contact;
• using shared utensils and hygiene supplies.

In addition, the virus is transmitted from mother to child during pregnancy (then we can talk about congenital form cytomegalovirus infection), during childbirth or through breast milk.

The disease is widespread - according to research, by the age of 50 years, 90-100% of people are carriers of cytomegalovirus. Primary infection, as a rule, is asymptomatic, however, with a sharp weakening of the immune system, the infection becomes more active and can cause pathologies varying degrees gravity.

Once in the cells of the human body, cytomegalovirus disrupts their division processes, leading to the formation of cytomegaloviruses - huge cells. The disease can affect various organs and systems, manifesting itself in the form of atypical pneumonia, cystitis and urethritis, inflammation of the retina, diseases digestive system. More often external symptoms infection or relapse resemble seasonal colds - acute respiratory infections or acute respiratory viral infections (accompanied by fever, muscle pain, runny nose).

Primary contact with is considered the most dangerous. This can lead to intrauterine infection of the fetus and provoke pronounced deviations in its development.

Cytomegalovirus: pathogen, transmission routes, carriage, re-infection

Diagnostics

Most carriers of cytomegalovirus are not aware of its presence in the body. But if it is not possible to identify the cause of a disease, and treatment does not produce results, tests for CMV are prescribed (antibodies in the blood, DNA in a smear, cytology, etc.). Testing for cytomegalovirus infection is mandatory for pregnant women or women planning to conceive, and for people with immunodeficiency conditions. For them, the virus poses a serious danger.

There are several research methods that are successfully used to diagnose CMV infection. For more exact result It is advisable to use them in combination. Since the pathogen is contained in body fluids, blood, saliva, urine, vaginal secretions and even breast milk can be used as biological material.

Cytomegalovirus in a smear is detected using PCR analysis - polymerase chain reaction. The method makes it possible to detect the DNA of an infectious agent in any biomaterial. A smear for CMV does not necessarily include discharge from the genital organs, it can be a sample of sputum, discharge from the nasopharynx, or saliva. If cytomegalovirus is detected in a smear, this may indicate either latent or active form diseases. Besides, PCR method does not make it possible to determine whether the infection is primary or whether it is a recurrent infection.

If cytomegalovirus DNA is detected in the samples, tests may be prescribed to clarify the status. additional tests. A test for specific immunoglobulins in the blood helps clarify the clinical picture.

Most often, ELISA is used for diagnosis - enzyme-linked immunosorbent assay, or CHLA - chemiluminescent immunoassay. These methods determine the presence of the virus due to the presence of special proteins in the blood - antibodies, or immunoglobulins.

Diagnosis of cytomegalovirus: research methods. Differential diagnosis of cytomegalovirus

Types of antibodies

To fight the virus, the human immune system produces several types of protective proteins that differ in the timing of their appearance, structure and functions. In medicine they are designated special letter code. The common part in their names is Ig, which stands for Immunoglobulin, and the last letter indicates a specific class. Antibodies that detect and classify cytomegalovirus: IgG, IgM and IgA.

IgM

The largest immunoglobulins in size, “group rapid response" During primary infection or when a “dormant” cytomegalovirus is activated in the body, IgM is produced first. They have the ability to detect and destroy the virus in the blood and intercellular space.

The presence and amount of IgM in a blood test is an important indicator. Their concentration is highest at the beginning of the disease, in the acute phase. Then, if viral activity can be suppressed, the titer of class M immunoglobulins gradually decreases, and after about 1.5 - 3 months they completely disappear. If a low concentration of IgM remains in the blood for a long time, this indicates chronic inflammation.

Thus, a high IgM titer indicates the presence of active pathological process(recent infection or exacerbation of CMV), low - about the final stage of the disease or its chronic course. If negative, this indicates a latent form of infection or its absence in the body.

IgG

Class G antibodies appear in the blood later - 10-14 days after infection. They also have the ability to bind and destroy viral agents, but unlike IgM, they continue to be produced in the body of an infected person throughout life. They are usually coded "Anti-cmv-IgG" in test results.

IgG “remembers” the structure of the virus, and when pathogens re-enter the body, they quickly destroy them. Therefore, it is almost impossible to become infected with cytomegalovirus a second time; the only danger is a recurrence of a “dormant” infection with a decrease in immunity.

If the test for IgG antibodies to cytomegalovirus is positive, the body is already “familiar” with this infection and has developed lifelong immunity to it.

IgA

Since the virus mainly attaches and multiplies on the mucous membranes, the body produces special antibodies - IgA - to protect them. Like IgM, they cease to be produced soon after the activity of the virus is suppressed, and 1-2 months after the end of the acute stage of the disease they are no longer detected in blood tests.

The combination of IgM and IgG class antibodies in the test results is of fundamental importance for diagnosing the status of cytomegalovirus.

Avidity of immunoglobulins

One more important characteristic IgG antibodies - avidity. This indicator is measured as a percentage and indicates the strength of the bond between the antibody (immunoglobulin) and the antigen - the causative virus. The higher the value, the more effectively the immune system fights the infectious agent.

The level of IgG avidity is quite low during primary infection; it increases with each subsequent activation of the virus in the body. Testing antibodies for avidity helps distinguish primary infection from recurrent disease. This information is important for prescribing adequate therapy.

Cytomegalovirus Igg and Igm. ELISA and PCR for cytomegalovirus, avidity for cytomegalovirus

What does positive IgG mean?

A positive test result for IgG to CMV means that the person has already been infected with cytomegalovirus before and has long-term, stable immunity to it. This indicator does not indicate a serious threat and the need for urgent treatment. The “sleeping” virus is not dangerous and does not interfere with leading a normal lifestyle - most of humanity coexists safely with it.

Exceptions are people who are weakened, with immunodeficiency conditions, cancer patients and those who have had cancer, pregnant women. For these categories of patients, the presence of the virus in the body can pose a threat.

IgG to cytomegalovirus positive

High titer of IgG in the blood

In addition to the data whether IgG is positive or negative, the analysis indicates the so-called titer of immunoglobulins of each type. This is not the result of a “piecemeal” calculation, but rather a coefficient that gives an idea of ​​the activity of the immune response. Quantitative determination of antibody concentration is carried out by repeated dilution of blood serum. The titer shows the maximum dilution factor at which the sample remains positive.

The value may vary depending on the reagents used, the characteristics of the laboratory research. If the Anti-cmv IgG titer is significantly increased, this can be caused by either reactivation of the virus or a number of other reasons. A more accurate diagnosis will require a number of additional tests.

A titer that goes beyond the reference values ​​does not always indicate a threat. To determine whether there is a need for urgent treatment, it is necessary to consider the data from all studies as a whole, in in some cases It is better to do the analysis again. Reason: high toxicity antiviral drugs, which are used to suppress the activity of cytomegalovirus.

The infection status can be more accurately diagnosed by comparing the presence of IgG with the presence and amount of “primary” antibodies in the blood - IgM. Based on this combination, as well as the immunoglobulin avidity index, the doctor will diagnose accurate diagnosis and will give recommendations for the treatment or prevention of cytomegalovirus infection. The decoding instructions will help you independently evaluate the test results.

Decoding the analysis results

If antibodies to cytomegalovirus are detected in the blood, it means there is an infection in the body. The interpretation of the examination results and the prescription of therapy (if necessary) should be entrusted to the attending physician, however, to understand the processes occurring in the body, you can use the following diagram:

1. Anti-CMV IgM negative, Anti-CMV IgG negative: the absence of immunoglobulins shows that the person has never been infected with cytomegalovirus, and he has no immunity to this infection.
2. Anti-CMV IgM positive, Anti-CMV IgG negative: this combination indicates recent infection and an acute form of the disease. At this time, the body is already actively fighting the infection, but the production of IgG immunoglobulins with “long-term memory” has not yet begun.
3. Anti-CMV IgM negative, Anti-CMV IgG positive: in this case we can talk about a hidden, inactive infection. The infection occurred a long time ago, the acute phase has passed, and the carrier has developed a strong immunity to cytomegalovirus.
4. Anti-CMV IgM positive, Anti-CMV IgG positive: indicators indicate either a recurrence of infection against the background favorable conditions, or about recent infection and the acute stage of the disease - during this period, primary antibodies to cytomegalovirus have not yet disappeared, and IgG immunoglobulins have already begun to be produced. The number of antibodies (titers) and additional studies will help the doctor understand more accurately.

There are many nuances in assessing ELISA results that only a specialist can understand. Therefore, in no case should you diagnose yourself; you should entrust the explanation and prescription of therapy to a doctor.

What to do if IgG to CMV is positive

The answer to this question depends on several factors. IgG antibodies to cytomegalovirus found in the blood indicate a previous infection with CMV infection. To define an algorithm further actions, it is necessary to consider the diagnostic results as a whole.

Cytomegalovirus detected - what to do?

If the totality of data obtained during the examination indicates the active phase of the disease, the doctor will prescribe a special course of treatment. Since it is impossible to completely get rid of the virus, therapy has the following goals:

• protect internal organs and systems from damage;
• shorten the acute phase of the disease;
• if possible, strengthen the body's immune response;
• reduce the activity of infection, achieve stable long-term remission;
• prevent the development of complications.

The choice of methods and drugs is based on individual clinical picture and characteristics of the body.

If the cytomegalovirus is in a hidden, latent state (only IgG is found in the blood), then it is enough to monitor your health and maintain immunity. The recommendations in this case are traditional:

• complete healthy nutrition;
• refusal bad habits;
• timely treatment of emerging diseases;
• physical activity, hardening;
• refusal of unprotected sexual intercourse.

These same preventive measures are relevant if no antibodies to CMV have been detected, that is, primary infection has not yet occurred. Then, when the virus enters the body, the immune system will be able to suppress the development of infection and prevent serious illnesses.

A positive test result for antibodies to cytomegalovirus IgG is not a death sentence; the presence of a latent infection in an adult healthy person does not affect quality of life. However, in order to prevent the activation of the virus and the development of complications, it is necessary to make efforts to preserve physical health- avoid overwork and stress, eat rationally and maintain a high level of immunity. In this case, the body’s own defenses will suppress the activity of the cytomegalovirus, and it will not be able to harm the carrier.

Also read with this

Cytomegalovirus (CMV, cytomegalovirus, CMV) is a type 5 herpesvirus. To identify the stage of an infectious disease and its chronicity, 2 research methods are used - PCR (polymerase chain reaction) and ELISA (enzyme-linked immunosorbent assay). They are prescribed when symptoms appear and infection with cytomegalovirus infection is suspected. If the blood test results show cytomegalovirus igg positive– what does this mean, and what danger does it pose to humans?

Antibodies IgM and IgG to cytomegalovirus - what are they?

When testing for infections, use different immunoglobulins, they all play a certain role and perform their functions. Some fight viruses, others fight bacteria, and others neutralize excess immunoglobulins.

To diagnose cytomegaly (cytomegalovirus infection), 2 classes of immunoglobulins are distinguished from 5 existing ones (A, D, E, M, G):

1. Immunoglobulin class M (IgM). It is produced immediately upon penetration of a foreign agent. Normally it contains approximately 10% of total number immunoglobulins. Antibodies of this class are the largest; during pregnancy they are present exclusively in the blood of the expectant mother, and are unable to reach the fetus.
2. Immunoglobulin class G (IgG). It is the main class, its content in the blood is 70-75%. Has 4 subclasses and each of them is endowed special functions. It is largely responsible for the secondary immune response. The production begins a few days after immunoglobulin M. It remains in the body for a long time, thereby preventing the possibility of relapse past infection. Neutralizes harmful toxic microorganisms. It is small in size, which facilitates penetration to the fetus during pregnancy through the “baby spot”.

Immunoglobulins of the igg and igm classes help identify CMV carriers

Cytomegalovirus igg positive - interpretation of results

The titres, which may differ depending on the laboratory, help decipher the test results. Classification into “negative/positive” is carried out using indicators for the concentration of immunoglobulin G:

• over 1.1 honey/ml (international units in millimeters) – positive;
• below 0.9 honey/ml – negative.

Table: “Antibodies to cytomegalovirus”

ELISA determines the avidity of immunoglobulins to cytomegalovirus

Positive IgG antibodies indicate a past encounter between the body and the virus, or a previous cytomegalovirus infection.

Komarovsky about positive IgG in children

At the birth of a child, in maternity ward blood is immediately taken for analysis. Doctors will immediately determine the presence of cytomegalovirus infection in a newborn.

If cytomegaly is acquired, then parents will not be able to distinguish the disease from a viral infection, since their symptoms are identical ( elevated temperature body, signs of respiratory diseases and intoxication). The disease itself lasts up to 7 weeks, and incubation period– up to 9 weeks.

In this case, it all depends on the child’s immunity:

1. With a strong immune system, the body will fight back the virus and will not be able to continue its development, but the same ones will remain in the blood positive antibodies IgG.
2. In case of weakened immunity, other antibodies will join the analysis, and a disease with a sluggish head start will give complications to the liver, spleen, kidneys and adrenal glands.

During this period, it is important for parents to monitor drinking regime baby and don’t forget to give vitamins.

Maintaining immunity - effective fight with type 5 virus

High igg avidity during pregnancy

During pregnancy special meaning has immunoglobulin G avidity.

1. With low IgG avidity, we are talking about primary infection.
2. IgG antibodies have high avidity (CMV IgG) - this indicates that expectant mother I have already had CMV before.

The table shows possible options positive immunoglobulin G in combination with IgM during pregnancy, their significance and consequences.

IgG in a pregnant woman	IgM in a pregnant woman	Interpretation of the result, consequences
+ – (doubtful)	+	If IgG (+/-) is doubtful, then a repeat test is prescribed after 2 weeks. Since the acute form of IgG is negative for a pregnant woman, it is most dangerous. The severity of complications depends on the timing: the earlier the infection occurs, the more dangerous it is for the fetus. In the first trimester, the fetus freezes or leads to the development of its anomalies. For II and III trimester the risk of danger is lower: pathologies are noted internal organs in the fetus, the possibility premature birth, or complications during labor.
+	+	Repeated form of CMV. If we are talking about the chronic course of the disease, even during an exacerbation, the risk of complications is minimal.
+	–	Chronic form of CMV, after which immune protection remains. The likelihood that antibodies will penetrate to the fetus is very low. Treatment is not required.

CMV is dangerous during pregnancy with primary infection

When planning a pregnancy, it is necessary to undergo tests to detect CMV in order to avoid unpleasant consequences during pregnancy. Normal indicators IgG (-) and IgM (-) are considered.

Do I need treatment?

Whether treatment is necessary or not depends directly on the stage of the disease. Goal of therapy: transfer of the virus from active stage to inactive.

In the chronic course of the disease, there is no need to prescribe medications. It is enough to support the immune system with vitamins, healthy food, giving up bad habits, walking on fresh air and timely fight against other diseases.

If positive immunoglobulin class G indicates a recurrent (exacerbation of infection in a chronic course) or acute form of the disease, then it is important for the patient to undergo a course of treatment, which includes:

• antiviral agents;
• immunoglobulins;
• immunomodulators.

In general, high avidity of immunoglobulin G is most dangerous for children infected in the womb, pregnant women and those with immunodeficiency. But as practice shows, for the most part it is enough to stick to preventive measures For successful fight with a pathogen. Exclusively when the body’s defenses are reduced, it is required complex treatment drugs.