Cytomegalovirus igg (cytomenalovirus infection) ranks first in prevalence among the population. The causative agent of the infection is cytomegalovirus (DNA-containing), which belongs to the group of herpes viruses. Once it enters the human body, it remains there forever.

With strong immunity, it is not dangerous, since its reproduction is suppressed by antibodies. But when weakening protective functions the virus is activated and can affect internal organs and vital systems of the body. The infectious agent poses a particular danger to a pregnant woman and the developing fetus.

Almost 80% of the world's inhabitants are infected with cytomegalovirus. At the same time, an infected person may not suspect for a long time that he poses a danger to others, since characteristic symptoms there is no disease. The virus can be detected accidentally during a laboratory test (determination of antibodies to cytomegalovirus in the blood).

Cytomegalovirus infection ( cmv) is transmitted only from person to person. The source of infection becomes a patient who is a carrier of the virus, but is unaware of his illness. The virus multiplies and is released in biological fluids - blood, saliva, urine, breast milk, semen, vaginal secretions. Main routes of transmission:

1. airborne;
2. contact-household;
3. sexual

That is, a healthy person can easily become infected during contact with a sick person, when sharing household items with him, through a kiss, or sexual contact.

In progress medical manipulations Cytomegalovirus is transmitted during transfusion of contaminated blood and its components. Infection of a child is possible in the womb (as the virus passes through the placental barrier), during childbirth and breastfeeding.

The herpes virus cytomegalovirus poses a particular danger to patients with HIV infection, cancer patients and people who have undergone organ transplantation.

Symptoms of infection

U healthy people With strong immunity, even after cmv infection , there are no visible symptoms. For the rest, after expiration incubation period(which can reach 60 days), manifestations similar to infectious mononucleosis, which often makes diagnosis difficult.

The patient complains of prolonged fever (for 4-6 weeks), sore throat, weakness, joint and muscle pain, loose stools. But more often the infection is asymptomatic and manifests itself only during a period of weakened immunity, which may be associated with pregnancy in women, severe chronic diseases or old age.

Severe forms of cytomegalovirus infection are accompanied by the following symptoms:

• the appearance of a rash;
• enlargement and pain of lymph nodes (submandibular, cervical, parotid);
• sore throat (pharyngitis).

Further progression of the infection provokes damage internal organs(liver, lungs, heart), nervous, genitourinary, reproductive system person. Women experience gynecological problems (colpitis, vulvovaginitis, inflammation and erosion of the cervix and uterine body). In men, the inflammatory process involves the urethra and spreads to the testicles.

At the same time, the body’s immune system tries to fight the virus in the blood, produces antibodies and gradually “drives” the pathogen into salivary glands and kidney tissue, where it is in a latent (sleeping) state until favorable conditions arise for its activation.

When asked whether cytomegalovvirus infection can be cured, experts answer negatively. Once the virus enters the body, it remains there for life. It may not manifest itself in any way if the immune system is strong, but this means that it is only in a latent state and, under favorable conditions, can “awaken” at any moment and begin its destructive activities.

At the current stage of medical development, getting rid of cytomegalovirus existing methods is impossible, since the pathogen persists inside cells and multiplies using DNA replication.

Cytomegalovirus during pregnancy

During pregnancy, the risk of complications increases depending on the type of cytomegalovirus present in the body. With primary infection, the consequences of the disease are much more severe than with cmv reactivation. Women during pregnancy constitute a special risk group.

During this period, they are especially vulnerable due to a physiological decline in immunity. Cytomegalovirus can provoke obstetric pathologies. So, if infection occurs in the first trimester of pregnancy, then 15% of women experience spontaneous miscarriage.

During primary infection, infection of the fetus occurs in 40-50% of cases, since the virus accumulates in placental tissues and penetrates through the placenta to the embryo. This can lead to various anomalies and deviations in fetal development. With intrauterine infection, the following external manifestations are noted;

1. enlarged liver and spleen;
2. disproportionate small head;
3. accumulation of fluid in the abdominal and chest cavity.

If a woman has antibodies to cytomegalovirus, you should not plan a pregnancy until the course of conservative drug therapy is completed and laboratory tests will not confirm normalization of antibody titres.

Cytomegalovirus igg in children

Congenital cytomegalovirus infection in children develops in the prenatal period, when the virus is transmitted from the carrier mother. On early stages this type of infection usually does not manifest itself in life severe symptoms, but can subsequently lead to serious complications:

• hearing problems (hard of hearing, deafness);
• the occurrence of seizures;
• impairment of intelligence, speech, mental retardation;
• damage to the organs of vision and complete blindness.

Acquired CMV (cytomegalovirus infection) becomes a consequence of infection of the child from the mother during childbirth and breastfeeding, through contact with a carrier from among medical personnel.

The risk of infection in children increases sharply with age, especially during periods when the child joins the children's group and begins to attend kindergarten and school. In children, manifestations of cytomegalovirus look like an acute form of acute respiratory viral infection, since it is accompanied by the following symptoms:

• a runny nose appears;
• temperature rises;
• cervical lymph nodes enlarge;
• noted profuse salivation and swelling of the salivary glands;
• the child complains of weakness, muscle pain, chills, headache;
• there are stool disorders (alternating constipation and diarrhea);
• the liver and spleen increase in size.

Based on such a clinical picture, it is impossible to make a correct diagnosis. To identify the pathogen, laboratory research methods are needed that can detect antibodies to the virus and the virus itself in the blood.

What tests need to be taken for the presence of infection?

The human immune system begins to produce antibodies to the virus immediately after it enters the body. Row laboratory tests allows you to immunologically determine these antibodies and thus understand whether infection has occurred or not.

After infection, specific antibodies are produced in a certain concentration (titers). So-called IgM antibodies are formed approximately 7 weeks after infection during the period of the most intensive reproduction of the virus. But over time, they disappear; moreover, these antibodies are also detected during infection with other types of viruses (for example, toxoplasmosis).

IgM antibodies are fast immunoglobulins; they are large in size, but are not able to retain immunological memory, therefore, after their death, protection against the virus disappears after a few months.

A more accurate result is obtained by testing for Igg antibodies, which do not disappear after infection, but accumulate throughout life, which suggests the presence of a cytomegalovirus infection. They appear in the blood within 1 - 2 weeks after infection and are able to maintain immunity against a certain type of virus throughout life.

In addition, there are several other methods used to detect cytomegalovirus:

1. The ELISA method is an immunological study in which traces of cytomegalovirus are detected in biological material.
2. The PCR method allows you to determine the causative agent of infection in the DNA of the virus. Considered one of the most accurate analyzes, allowing you to quickly obtain the most reliable results.

To determine CMV infection, they often resort to the virological method, which is based on the determination of IgG antibodies in blood serum.

The norm of cytomegaloviruses in the blood and interpretation of the analysis

Normal levels of the virus in the blood depend on the gender of the patient. So, for women the norm is 0.7-2.8 g/l, for men - 0.6-2.5 g/l. The rate of cytomegalovirus in the child’s blood is determined taking into account the amount of immunoglobulins to the virus when diluted in the blood serum. Normal indicator a level of less than 0.5 g/l is considered. If the indicators are higher, then the analysis is considered positive.

1. Cytomegalovirus igg positive- what does it mean? A positive result indicates that this infection is present in the body. If the test result for determining IgM antibodies is also positive, this indicates an acute stage of the disease. But if the IgM test is negative, this is evidence that the body has developed immunity to the virus.
2. A negative test for cytomegalovirus igg and IgM indicates that the person has never encountered such an infection and has no immunity to the virus. But if the test for igg is negative, and for IgM is positive, it’s time to sound the alarm, since such a result is evidence of recent infection and the onset of the development of the disease.

The avidity of igg antibodies to the virus is determined during laboratory testing of the patient’s biological material. It is this indicator that gives specialists an idea of ​​the degree of infection of the patient’s body. The breakdown of the analysis is as follows:

1. In case of primary infection that occurred recently, the number of detected antibodies does not exceed 50% (low avidity).
2. At rates from 50 to 60% (average avidity), a repeat test is required laboratory examination to clarify the diagnosis, which is carried out several weeks after the first.
3. A chronic form of cytomegalovirus infection, accompanied by active production of antibodies, is indicated by an indicator of more than 60% (high avidity).

Only a specialist can decipher the test results. When analyzing the data obtained as a result of the study, the doctor takes into account certain nuances (age and gender of the patient), after which he gives the necessary recommendations and, if necessary, prescribes a course of treatment.

Treatment

Latent cytomegalovirus infection does not require therapeutic measures. In other cases, the course of therapy is based on the use antiviral agents and immunomodulators. All appointments must be made by a specialist.

Specific immunoglobulins used in the treatment process contain up to 60% antibodies to cytomegalovirus. The drugs are administered intravenously, in exceptional cases It is possible to administer immunoglobulin intramuscularly, but this significantly reduces the effectiveness of therapy.

Nonspecific immunoglobulins are usually prescribed for the prevention of CMV infection in persons with immunodeficiency conditions. During pregnancy, immunoglobulin is also the drug of choice, and the risk of damage to the fetus in this case directly depends on the amount of antibodies to the virus in the woman’s blood.

Since it is impossible to completely get rid of cytomegalovirus, the task complex treatment is to restore the body's defenses. Therapy is complemented by good nutrition, taking vitamins and a healthy lifestyle.

Watch the video where Malysheva talks in detail about the treatment and prevention of Cytomegalovirus:

Cytomegalovirus (abbreviated CMV or CMV) is a causative agent of an infectious disease belonging to the herpesvirus family. Once it enters the human body, it remains there forever. Antibodies produced immune system in response to the penetration of the virus, are the main diagnostic sign for identifying infection.

Cytomegalovirus infection can occur either asymptomatically or with multiple lesions of internal organs and systems. IN damaged tissues normal cells turn into giant ones, which is why this disease got its name (cytomegaly: from the Greek cytos - “cell”, megalos - “big”).

IN active stage the development of infection, cytomegaloviruses cause significant changes in immunity:

• dysfunction of macrophages that destroy bacteria and viruses;
• suppression of the production of interleukins that regulate the activity of immune cells;
• inhibition of the synthesis of interferon, which provides antiviral immunity.

Antibodies to cytomegalovirus, determined using laboratory methods, serve as the main markers of CMV. Their detection in blood serum makes it possible to diagnose the disease at early stages and also monitor the course of the disease.

Types of antibodies to CMV and their features

When foreign bodies enter the body, a response occurs from the immune system. Special proteins are produced - antibodies, which contribute to the development of protective inflammatory reactions.

The following types of antibodies to CMV are distinguished, differing in structure and role in the formation of immunity:

• IgA, the main function of which is to protect the mucous membranes from infections. They are found in saliva, tear fluid, breast milk, and are also present on the mucous membranes of the gastrointestinal tract, respiratory tract and genitourinary tract. Antibodies of this type bind to microbes and prevent them from adhering to and penetrating the body through the epithelium. Immunoglobulins circulating in the blood provide local immunity. Their lifespan is only a few days, so periodic examination is necessary.
• IgG, making up the bulk of antibodies in human serum. They can be transmitted from a pregnant woman to the fetus through the placenta, ensuring the formation of its passive immunity.
• IgM, which are the most close-up view antibodies. They occur during primary infection in response to the penetration of previously unknown foreign substances. Their main function is receptor function - transmitting a signal into the cell when a molecule of a certain chemical substance is attached to the antibody.

By the ratio of IgG and IgM, it is possible to determine at what stage the disease is - acute (primary infection), latent (latent) or active (reactivation of a “dormant” infection in its carrier).

If infection occurs for the first time, then the amount of IgM, IgA and IgG antibodies increases rapidly during the first 2-3 weeks.

From the second month from the onset of infection, their level begins to decline. IgM and IgA can be detected in the body within 6-12 weeks. These types of antibodies are taken into account not only for the diagnosis of CMV, but also for the detection of other infections.

igg antibodies

IgG antibodies are produced by the body late stage, sometimes only 1 month after infection, but they persist throughout life, providing lifelong immunity. If there is a risk of re-infection with another strain of the virus, their production increases sharply.

Upon contact with the same culture of microorganisms, the formation protective immunity occurs in a shorter time - up to 1-2 weeks. A feature of cytomegalovirus infection is that the pathogen can avoid the action of immune forces by creating other varieties of the virus. Therefore, infection with modified microbes proceeds as during primary contact.

Antibodies to cytomegalovirus. Photo courtesy of igg Antibodies.

However, the human body also produces group-specific immunoglobulins, which prevent their active reproduction. Antibodies to class G cytomegalovirus are more often detected among the urban population. This is due to the high concentration of people in small areas or more weak immunity than that of rural residents.

In families with low level In life, CMV infection among children is observed in 40-60% of cases even before they reach 5 years of age, and by adulthood, antibodies are detected in 80%.

Antibodies igm

IgM antibodies act as the first line of defense. Immediately after the introduction of microorganisms into the body, their concentration increases sharply, and its peak is observed in the interval from 1 to 4 weeks. Therefore, they serve as a marker of recent infection, or the acute stage of CMV infection. In blood serum they persist for up to 20 weeks, in rare cases - up to 3 months or more.

The latter phenomenon is observed in patients with impaired immunity. A decrease in IgM levels in subsequent months occurs even if no treatment is given. However, their absence is not a sufficient basis for a negative result, since the infection can occur in a chronic form. During reactivation they also appear, but in smaller quantities.

IgA

IgA antibodies are detected in the blood 1-2 weeks after infection. If treatment is carried out and it is effective, then their level decreases after 2-4 months. With repeated infection with CMV, their level also increases. Stable high concentration antibodies of this class are a sign of a chronic form of the disease.

In people with weakened immune systems, IgM is not formed even in the acute phase. For such patients, as well as for those who have undergone organ transplantation, positive result IgA analysis helps to recognize the form of the disease.

Avidity of immunoglobulins

Avidity refers to the ability of antibodies to bind to viruses. IN initial period the disease is minimal, but gradually increases and reaches a maximum by 2-3 weeks. During the immune response, immunoglobulins evolve, the efficiency of their binding increases, due to which the “neutralization” of microorganisms occurs.

Laboratory diagnostics of this parameter are performed to estimate the time of infection. Yes, for acute infection characterized by the detection of IgM and IgG with low avidity. Over time they become highly avid. Low-avidity antibodies disappear from the blood after 1-5 months (in rare cases, longer), while high-avidity antibodies remain until the end of life.

Such a study is important when diagnosing pregnant women. This category of patients is characterized by frequent false-positive results. If high-avidity IgG antibodies are detected in the blood, this will eliminate an acute primary infection that is dangerous for the fetus.

The degree of avidity depends on the concentration of viruses, as well as on individual differences in mutations at the molecular level. In older people, the evolution of antibodies occurs more slowly, so after 60 years of age, resistance to infections and the effect of vaccination decreases.

Norms for CMV levels in the blood

The numerical value of the “normal” antibody content in biological fluids does not exist.

The concept of counting IgG and other types of immunoglobulins has its own characteristics:

• Antibody concentration is determined by titration. Blood serum is gradually diluted with a special solvent (1:2, 1:6 and other concentrations that are multiples of two). The result is considered positive if the reaction to the presence of the test substance remains during titration. For cytomegalovirus infection, a positive result is detected at a dilution of 1:100 (threshold titer).
• Titers represent an individual reaction of the body, which depends on the general condition, lifestyle, immune activity and metabolic processes, age, presence of other pathologies.
• Titers give an idea of ​​the total activity of antibodies of classes A, G, M.
• Each laboratory can use its own test systems to detect antibodies with a certain sensitivity, therefore, they must produce a final interpretation of the results, in which reference (boundary) values ​​and units of measurement are indicated.

Avidity is assessed as follows (units of measurement – ​​%):

• <30% – low-avidity antibodies, primary infection that occurred about 3 months ago;
• 30-50% – it is not possible to accurately determine the result, the analysis must be repeated after 2 weeks;
• >50% – high-avidity antibodies, infection occurred a long time ago.

In adults

The results for all groups of patients are deciphered in the manner indicated in the table below.

Table:

IgG value	IgM value	Interpretation
positive	positive	Secondary reinfection. Treatment is required
negative	positive	Primary infection. Treatment required
positive	negative	Immunity has been formed. A person is a carrier of the virus. Exacerbation of the disease is possible with decreased immunity
negative	negative	There is no immunity. There was no CMV infection. There is a risk of primary infection

Antibodies to cytomegalovirus can be at low levels for several years, and when reinfected with other strains, the amount of IgG increases rapidly. To obtain an accurate diagnostic picture, the level of IgG and IgM is determined simultaneously, and a repeat analysis is carried out after 2 weeks.

In children

Children during the neonatal period and breastfeeding may have IgG in their blood that they received in utero from their mother. Their level begins to gradually decline after a few months due to the lack of permanent source. IgM antibodies often give false-positive or false-negative results. In this regard, diagnosis at this age causes difficulties.

Considering the general clinical picture, immunological tests interpreted as follows:

Repeated testing allows you to determine the time of infection:

• after birth– increasing titer;
• intrauterine– constant level

During pregnancy

Diagnosis of CMV in pregnant women is carried out according to the same principle. If in the first trimester it is discovered that IgG is positive and IgM is negative, then it is necessary to take a PCR test to confirm the absence of reactivation of the infection. In this case, the fetus will receive maternal antibodies that will protect it from the disease.

Doctor antenatal clinic must issue directions for monitoring the IgG titer also in the 2nd and 3rd trimesters.

If detected at 12-16 weeks low index avidity, then infection could have occurred before pregnancy, and the probability of infection of the fetus is almost 100%. At 20-23 weeks this risk decreases to 60%. Determining the time of infection during pregnancy is of great importance, since transmission of the virus to the fetus leads to the development of severe pathologies.

To whom and why is a test for antibodies to CMV prescribed?

The analysis is indicated for those individuals who are at risk of developing infection:

In healthy people with strong immunity, primary infection is often asymptomatic and without complications. But CMV in active form is dangerous in case of immunodeficiency and pregnancy, as it causes numerous complications. Therefore, doctors recommend undergoing examination before the planned conception of a child.

Methods for detecting the virus and deciphering research results

All research methods for determining CMV can be divided into 2 groups:

• Direct– cultural, cytological. Their principle is to grow a culture of viruses or study the characteristic changes that occur in cells and tissues under the influence of a microorganism.
• Indirect– serological (ELISA, fluorescent antibody method), molecular biological (PCR). They serve to detect the immune response to infection.

The standard for diagnosing this disease is to use at least 2 of the methods listed above.

Test for antibodies to cytomegalovirus (ELISA - enzyme-linked immunosorbent assay)

The ELISA method is the most common due to its simplicity, low cost, high accuracy and the possibility of automation, eliminating laboratory technician errors. The analysis can be completed in 2 hours. Antibodies IgG classes, IgA, IgM are detected in the blood.

Determination of immunoglobulins to cytomegalovirus is carried out as follows:

1. The patient’s blood serum, control positive, negative and “threshold” samples are placed in several wells. The titer of the latter is 1:100. The plate containing the wells is made of polystyrene. Purified CMV antigens are pre-precipitated on it. When reacting with antibodies, specific immune complexes are formed.
2. The plate with samples is placed in a thermostat, where it is kept for 30-60 minutes.
3. The wells are washed with a special solution and a conjugate is added to them - a substance with antibodies labeled with an enzyme, then again placed in a thermostat.
4. The wells are washed and an indicator solution is added to them and kept in a thermostat.
5. A stop reagent is added to stop the reaction.
6. The results of the analysis are recorded in a spectrophotometer - the optical density of the patient's serum is measured in two modes and compared with the values ​​for control and threshold samples. To determine the titer, a calibration graph is constructed.

If the test sample contains antibodies to CMV, then under the influence of the indicator its color (optical density) changes, which is recorded by a spectrophotometer. The disadvantages of ELISA include the risk of false-positive results due to cross reactions with normal antibodies. The sensitivity of the method is 70-75%.

The avidity index is determined similarly. A solution is added to the patient's serum samples to remove low-avidity antibodies. Then the conjugate is introduced and organic matter with dye, absorbance is measured and compared with control wells.

Polymerase chain reaction (PCR) method for diagnosing cytomegalovirus

The essence of PCR is to detect fragments of DNA or RNA of the virus.

After preliminary cleaning of the sample, the results are recorded using one of 2 methods:

• Electrophoretic, in which viral DNA molecules move in electric field, and a special dye makes them fluoresce (glow) under the influence of ultraviolet rays.
• Hybridization. Artificially synthesized sections of DNA labeled with a dye bind to the viral DNA in the sample. Next, they are fixed.

The PCR method is more sensitive (95%) compared to ELISA. The duration of the study is 1 day. Not only blood serum, but also amniotic or cerebrospinal fluid, saliva, urine, secretion from the cervical canal.

Currently, this method is the most informative. If viral DNA is found in blood leukocytes, this is a sign of primary infection.

Isolation of cell culture (seeding) for the diagnosis of CMV

Despite the high sensitivity (80-100%), seeding of cell cultures is rarely performed, since the following restrictions exist:

• The method is very labor intensive, the analysis time takes 5-10 days;
• the need for highly qualified medical personnel;
• the accuracy of the study strongly depends on the quality of the collection of biological material and the time between the analysis and culture;
• a large number of false negative results, especially when diagnostics are carried out later than 2 days.

Just as with PCR analysis, it is possible to determine the specific type of pathogen. The essence of the study is that samples taken from the patient are placed in a special nutrient medium in which microbes grow and are subsequently studied.

Cytology for the diagnosis of cytomegalovirus

Cytological examination refers to primary species diagnostics Its essence lies in the study of cytomegal cells under a microscope, the presence of which indicates a typical change in CMV. Saliva and urine are usually taken for analysis. This method cannot serve as the only reliable method for diagnosing cytomegalovirus infection.

What to do if IgG to CMV is positive?

Antibodies to cytomegalovirus found in blood and other biological fluids may indicate three possible states: primary or re-infection, recovery and carriage of the virus. The test results require a comprehensive assessment.

If IgG is positive, then to determine the acute phase, which is the most dangerous to health, you need to contact an infectious disease doctor and conduct additional research ELISA for IgM, IgA, avidity or PCR analysis.

If IgG is detected in a child under 1 year of age, it is recommended that the mother also undergo this examination. If approximately identical antibody titers are detected, then high probability there was a simple transfer of immunoglobulins during pregnancy, and not infection.

It should be taken into account that small quantity IgM can be detected for 2 or more years. Therefore, their presence in the blood does not always indicate recent infection. In addition, the accuracy of even the best test systems can produce both false positive and false negative results.

What does it mean if Anti-CMV IgG is detected?

If antibodies to CMV are re-detected and there are no other signs of acute infection, test results indicate that the person is a lifelong carrier of the virus. In itself, this condition is not dangerous. However, before planning pregnancy, as well as in case of immunodeficiency, it is necessary to periodically monitor the level of immunoglobulins.

In healthy people, this disease occurs silently, sometimes with flu-like symptoms. Recovery indicates that the body has successfully coped with the infection, and lifelong immunity has been developed.

To monitor the dynamics of the disease, tests are prescribed every 2 weeks. If the IgM level gradually decreases, the patient recovers, otherwise the disease progresses.

Is it necessary to treat cytomegalovirus?

It is impossible to completely get rid of cytomegalovirus. If a person is a carrier of this infection, but there are no symptoms, then treatment is not required. Prevention of CMV, which is aimed at strengthening the immune system, is of great importance. This allows you to keep the virus in a “dormant” state and avoid exacerbation.

The same tactics are used against pregnant women and children. In people with severe immunodeficiency, cytomegalovirus infection may develop complications such as pneumonia, inflammation of the colon and retina. To treat this category of people, strong antiviral drugs are prescribed.

How to treat cytomegalovirus

CMV therapy is carried out in stages:

Depending on which organs are affected by the virus, the doctor prescribes additional medications.

In severe cases, the following treatment methods are used:

• for detoxification of the body - droppers with saline solution, acesol, di- and trisol;
• to reduce swelling and inflammation in case of damage to the central nervous system - corticosteroid drugs (Prednisolone);
• in case of secondary bacterial infection, antibiotics (Ceftriaxone, Cefepime, Ciprofloxacin and others).

During pregnancy

Pregnant women with CMV are treated with one of the following agents listed in the table below:

Name	Release form	Daily dosage	Average price, rub.
Acute phase, primary infection
Cytotect (human anticytomegalovirus immunoglobulin)		2 ml per 1 kg of weight every 2 days	21,000/10 ml
Interferon recombinant alpha 2b (Viferon, Genferon, Giaferon)	Rectal suppositories	1 suppository 150,000 IU 2 times a day (every other day). At 35-40 weeks of pregnancy - 500,000 IU 2 times a day daily. Course duration – 10 days	250/ 10 pcs. (150,000 IU)
Reactivation or reinfection
Cymevene (ganciclovir)	Solution for intravenous administration	5 mg/kg 2 times a day, course – 2-3 weeks.	1600/ 500 mg
Valganciclovir	Oral tablets	900 mg 2 times a day, 3 weeks.	15,000/60 pcs.
Panavir	Intravenous solution or rectal suppositories	5 ml, 3 injections with an interval of 2 days between them. Candles – 1 pc. at night, 3 times, every 48 hours.	1500/ 5 ampoules; 1600/ 5 candles

Drugs

The basis of treatment for CMV is antiviral drugs:

The doctor may prescribe the following as immunomodulatory agents:

• Cycloferon;
• Amiksin;
• Lavomax;
• Galavit;
• Tiloron and other drugs.

Immunomodulators used in the remission phase can also be used during relapse. After the end of the acute phase of the disease, restorative and physiotherapeutic treatment is also indicated; it is necessary to eliminate chronic inflammatory and infectious foci.

Folk remedies

IN folk medicine There are several recipes for the treatment of CMV infection:

• Grind fresh wormwood herb and squeeze the juice out of it. Heat 1 liter of dry wine over a fire to approximately 70° C (at this point a whitish haze will begin to rise), add 7 tbsp. l. honey, mix. Pour 3 tbsp. l. wormwood juice, turn off the heat, stir. Take 1 glass of “wormwood wine” every other day.
• Wormwood, tansy flowers, crushed elecampane roots are mixed in equal proportions. 1 tsp. pour 0.5 liters of boiling water into the mixture. This amount is drunk in equal portions 3 times a day half an hour before meals. The duration of treatment with the collection is 2 weeks.
• Crushed alder, aspen and willow bark are mixed in equal proportions. 1 tbsp. l. collection, brew 0.5 liters of boiling water and take it in the same way as in the previous recipe.

Prognosis and complications

Cytomegalovirus infection most often occurs benignly, and its symptoms are confused with ARVI, since patients experience the same symptoms - elevated temperature, headaches and muscle pain, general weakness, chills.

In severe cases, infection can lead to the following complications:

This infection is most dangerous in the early stages of pregnancy, as fetal death and miscarriage often occur.

The surviving child may have the following congenital abnormalities:

• reduction in brain size or dropsy;
• malformations of the heart, lungs and other organs;
• liver damage - hepatitis, cirrhosis, bile duct obstruction;
• hemolytic disease of newborns - hemorrhagic rash, hemorrhages in the mucous membranes, stool and vomiting with blood, bleeding from the umbilical wound;
• strabismus;
• muscle disorders - cramps, hypertonicity, asymmetry of the facial muscles and others.

There may be a delay later mental development. IgG antibodies detected in the blood are not a sign that there is an active CMV infection in the body. A person may already have lifelong immunity to cytomegalovirus. It is most difficult to determine the diagnostic picture in newborns. The disease in its passive form does not require treatment.

Article format: Lozinsky Oleg

Video about antibodies to cytomegalovirus

Cytomegalovirus Igg and Igm. ELISA and PCR for cytomegalovirus:

When they really wait for us, we return even from the other world

Cytomegalovirus: Igg positive - what does it mean

Today, cytomegalovirus is a very common infection, affecting approximately 70% of the population. Infected people may not even be aware of their illness for many years until characteristic symptoms begin to appear or appropriate antibodies are detected during laboratory testing of biological material. Infection with cytomegalovirus can occur through any contact with a patient:

• during sexual intercourse;
• when kissing;
• during blood transfusion;
• during organ transplantation;
• during intrauterine development(from mother to fetus, through the placenta);
• in case of any contact with biological material of a patient with cytomegalovirus.

Antibodies to CMV

When conducting a laboratory study of the biological material of a patient who is suspected of having cytomegalovirus, antibodies may be detected that indicate the presence of this infection in his body. They are tightly folded protein molecules that are large in size. By appearance these molecules look like balls because they have an identical shape. The main task of antibodies is to eliminate particles of a specific type of virus that enter the human body.

The danger of CMV infection and its features

Cytomegalovirus is special kind a virus that, after infection, lives in the cells of the human body, no matter what age category they belong to. If a person is infected with CMV, he will have this infection in his body for the rest of his life.

If the immunity of infected people fully performs its assigned functions, the virus will be under control, so its cells will not multiply. Otherwise, cytomegalovirus under the influence of any external factor becomes active and multiplies very quickly. Penetrating into the cells of the human body, the virus begins to progress, against the background of which they rapidly begin to increase in size.

After cytomegalovirus enters the human body, it begins an incubation period, the duration of which can reach 60 days. After this, the infection can begin its active manifestation, accompanied by characteristic symptoms.

People infected with cytomegalovirus in most cases experience general malaise, they may have a fever and all the signs of a respiratory disease. Over time, this category of patients begins to become inflamed. lymph nodes, appears pain syndrome in the joints, observed skin rashes etc.

Cytomegalovirus can cause serious consequences and complications, therefore it is extremely important to begin complex drug treatment in a timely manner.

Indications for testing

Cytomegalovirus poses a great danger to the following categories of citizens (those with a weakened immune system):

• for pregnant women;
• for people who have had a transplant;
• for HIV-infected patients;
• for people suffering from cancer.

During the appointment of each patient, the specialist collects an anamnesis of the disease. In most cases, a laboratory examination is prescribed to establish the correct diagnosis. Indications for testing for cytomegalovirus are the following factors:

• feverish conditions;
• neoplastic diseases;
• the patient is taking drugs that are part of the group of cytostatics;
• pregnancy planning (every woman, even before conceiving a child, must undergo a comprehensive examination with her partner in order to exclude any troubles in the future);
• signs of infection of the fetus through the placenta;
• pneumonia, the course of which is non-standard;
• spontaneous abortions at any stage of pregnancy;
• exposure respiratory diseases etc.

Preparing for the study

Before conducting a laboratory examination, the purpose of which is to detect cytomegalovirus in the blood, the patient must undergo preparation. Firstly, this analysis is not taken from women during the period menstrual cycle. Secondly, men who plan to donate biological material from the urethra should not urinate for several hours before the analysis. A referral to the laboratory is issued by a gynecologist or urologist, who must give the patient all the necessary recommendations.

Igg antibodies detected - what does this mean?

If Igg antibodies were detected during a laboratory examination of the patient, this means that the human body has long been infected with cytomegalovirus. After a person has had cytomegalovirus, his body produces antibodies, indicating stable and lifelong immunity. This result will be considered favorable for all categories of patients with cytomegalovirus, except for people with immunodeficiency.

Avidity of igg antibodies to the virus

The avidity of igg antibodies to cytomegalovirus is determined during laboratory testing of the patient’s biological material. This indicator (along with immunoglobulins) will allow specialists to determine the degree of infection of the human body. Based on the results of a laboratory examination, the following indicators can be obtained:

Types of tests for CMV

Currently, when conducting a laboratory examination of patients (blood and urine is taken, a smear is made, etc.) for cytomegalovirus infection, specialists use various techniques detection of this virus:

1. Immunological. This method (ELISA) of laboratory examination is carried out using a microscope, thanks to which it is possible to examine traces of cytomegalovirus in biological material.
2. Molecular Biology. PCR diagnostics involves searching for the causative agent of cytomegalovirus infection in the DNA of the virus. It is believed that this diagnostic method makes it possible to determine the maximum accurate results, available just a few days after laboratory testing of the patient’s biological material.
3. Cytological. This technique used in cases where you need to quickly get a result: whether there is a virus or not. Its main disadvantage is its low information content.
4. Virological. This method involves taking biological material from the patient and placing it in a favorable environment. Once a colony of microorganisms has grown, it will be possible to identify them.

Antibody levels in blood

Experts use generally accepted antibody standards to determine at what stage a cytomegalovirus infection is.

Igg positive: what does it mean?

If a patient has been diagnosed with a positive cytomegalovirus Igg, then this infection is present in his body. The result of the laboratory examination will have the following titer indicator: 0.5 lgM and higher.

Igg negative: what does it mean?

If a patient is diagnosed with a negative cytomegalovirus Igg (titers less than 0.5 lgM), then the result may indicate that his body has not been infected with this type of virus. So that the human immune system can continue to cope with cytomegalovirus infection, it is recommended that he maintain hygiene and take preventive measures.

Norms of igg antibodies during pregnancy

During pregnancy, women should undergo regular laboratory testing. It is especially important to do this for those expectant mothers who have been diagnosed with cytomegalovirus. Positive value of Igg titers in in this case will indicate that the fetus has been infected with this virus. The results of laboratory tests of a pregnant woman’s biological material will be carefully studied by her attending physician, after which he will be able to choose the safest and most effective treatment method. During the first 12 weeks, the doctor must take all necessary measures for eradication of cytomegalovirus infection. This is due to the fact that at this stage the risk of teratogenic effects of the virus on developing fetus. At the time of remission, the likelihood of infection of the fetus from the mother through the placenta will significantly decrease.

Norms of igg antibodies in children

When conducting a laboratory examination of young children, specialists can obtain the following indicators:

Antibody norms in people with immunodeficiency (HIV)

For people with immunodeficiency, the detection of positive cytomegalovirus IgG in biological material (determined at the acute stage) entails a serious danger. This category of patients may face major complications:

• the development of pneumonia, which is often fatal;
• inflammation of the gastrointestinal tract;
• development of hepatitis;
• problems with the organs of vision;
• diseases nervous system, in particular encephalitis, etc.

Interpretation of tests for CMV

Results of laboratory examination of the patient	Decoding
Anti-CMV IgM— Anti-CMV IgG—	During a laboratory examination, no cytomegalovirus infection was detected in the patient's body. Such an analysis result can also be obtained in the case when the collection of biological material for research was carried out several days after infection.
Anti-CMV IgM+	The result of a laboratory test with this indicator can be obtained in the category that has a primary cytomegalovirus infection. Those infected people who experience malfunctions of the immune system need to pay attention to their health.
Anti-CMV IgM+	This result of a laboratory examination may occur in those patients who have already developed immunity to cytomegalovirus infection.
Anti-CMV IgM-	Having such an analysis result, patients do not have to worry about the progression of cytomegalovirus infection. A relapse can only happen if there are serious disruptions in the functioning of the immune system.

Analysis of IgG and IgM antibodies to cytomegalovirus helps to timely understand the cause of many diseases caused by the virus. Cytomegalovirus is a virus related to herpesvirus that causes infectious disease cytomegaly. This disease affects most of the world's population and is predominantly asymptomatic.

Is the virus dangerous?

Although the virus, related to human herpes virus type 5, does not cause serious health problems, CMV can worsen some chronic diseases. CMV is especially dangerous for women during pregnancy, as it can negatively affect the development of the fetus in the prenatal period and the baby after birth. For timely detection of the disease and provision of proper therapy, it is recommended to conduct a blood test for cytomegalovirus during pregnancy planning and during it, as well as for people who have problems with the immune system. Early diagnosis allows you to effectively and quickly stop the development of the virus in the body, preventing it from causing special harm health.

Blood test for CMV - what is it?

As diagnostic method To detect CMV in the blood, several types of tests can be used, but the most effective and common is enzyme-linked immunosorbent assay (ELISA). This type of diagnosis makes it possible to evaluate the quantitative and characteristic antibodies specific to cytomegalovirus (immunoglobulins), and based on the data obtained, conclusions can be drawn about the presence or absence of immunity to the pathogenic pathogen in the body. Enzyme immunoassay is accurate, fast and publicly available.

Antibodies to CVM

When active restructuring of the immune system begins. The duration of the incubation period is 15-90 days, depending on the initial state of the person’s immunity. This infection does not leave the body, that is, it remains in it forever. The virus makes the body’s immunity unstable, reducing it, and this can only mean one thing – negative impact on general condition human health and the likelihood of secondary infection with viruses or other types of infections. As a result defensive reaction The immune system responds to the effects of CMV by producing specific immunoglobulins of two classes, IgG and IgM.

Antibodies in the blood to cytomegalovirus are active proteins that bind and neutralize virus particles.

Immunoglobulins of the igg type to cytomegalovirus in the patient’s blood may indicate ongoing or past CMV infection. IgM antibodies to CMV are produced by the infected organism 4-7 weeks after infection and remain in the blood for the next 4-5 months. If these components are found in the blood (the test answer is “positive”), it means that an infection is currently occurring in the body or there has been a recent, primary infection. As the virus develops in the body, IgM indicators decrease, which means the condition is normal and the disease enters the latent period, but at the same time, IgG immunoglobulin indicators with positive value rises.

At long-term development viral infection of the human body, immunoglobulins of the igg class gradually decrease, but do not disappear completely, and antibodies to CMV proteins remain active throughout life. When the virus is reactivated, which can occur due to a significant decrease in immunity, IgG levels increase again, but do not reach high values, as in the case of primary infection.

What is the difference between IgG and IgM tests?

When receiving answers as a result of an ELISA test for cytomegalovirus, it is necessary to know the differences between the two classes of antibodies IgG and IgM.

So, IgM is a fast immunoglobulin, which has a significant size and is produced by the body in order to react to the development of the virus in the body in the shortest possible period of time. But at the same time, IgM is not able to form the memory of the immune system to the virus and this means that after 4-5 months active protection disappears from cytomegalovirus.

IgG antibodies appear when CMV activity decreases and are cloned by the body to provide lifelong immunity to the virus. They are smaller in size compared to class M immunoglobulins and are produced later than them, as a rule, after the active phase of suppression of cytomegaly, as exemplified by the igg antibodies themselves. This means that if there are immunoglobulins of a specific type IgM in the blood, then the body has been affected by the virus relatively recently and the infection may be currently occurring in acute form. To clarify the answer, it is necessary to conduct additional studies of CMV infection using other methods.

Cytomegalovirus IgG positive

If the igg result for CMV is positive, we can safely say that the body has already had the infection and has developed a special immunity to it in the form of immunoglobulins, which protect the person for life from re-infection.

To put it simply, for people who do not suffer from immunodeficiency, such results are the most acceptable of all possible, since a negative answer in this case means that the person does not have immunity to CMV and can become infected with the disease at any time. This shows that a positive ELISA response to cytomegalovirus igg indicates successful previous infection at least a month ago.

A positive result can be considered favorable if there are no special conditions of the patient and abnormalities in the functioning of the immune system. For example, for women planning pregnancy or who are pregnant, people planning to undergo organ transplant surgery or undergo chemotherapy, a positive cytomegalovirus igg in the blood can trigger the re-development of cytomegaly in the body and lead to a number of undesirable consequences for the patient in terms of his health.

Results of analysis for cytomegalovirus decoding

To decipher the enzyme immunoassay, the reference values ​​adopted to determine the amount of antibodies in each individual laboratory are taken into account. As a rule, they must be indicated on the answer forms of all studies, so that the attending physician can decipher the final data.

Specific immunoglobulins of the IgM type identified as a result of diagnosis indicate an ongoing infection in the acute period of primary infection, or its recent completion.

In the absence of concomitant symptoms, we can assume that the body has easily tolerated cytomegaly, and CMV no longer poses a danger to the body.

Titers (indicators of the amount of antibodies in the blood) igg with high levels, for example, igg results to CMV is more than 250 or igg is detected above 140, then this means that no dangerous condition for the body. If during diagnosis exclusively immunoglobulins of the igg class are determined, this indicates the likelihood of the body’s contact with CMV in the past and the absence of an acute course in the present time. From this we can judge that single igg indicators indicate that a person is a carrier of cytomegalovirus.

In order to accurately determine the stage of CMV, it is necessary to assess the level of avidity of immunoglobulins of the igg class. If the indicators give low-avidity indicators, this means primary infection, while high-avidity indicators are in the carrier’s blood throughout his entire life. During the reactivation of chronic cytomegalovirus in the body, immunoglobulins G also have high avidity levels.

Avidity of antibodies to cytomegalovirus

Antibody avidity is an indicator of the ability of immunoglobulins to bind to free proteins of the virus to further suppress it, that is, it is the strength of their connection with each other.

In the initial stages of cytomegaly, IgG antibodies have low avidity, that is, little connection with viral proteins. With the development of CMV and the immune system response, igg avidity levels increase and the indicator becomes positive.

The connection of the protein with antibodies during the study is assessed using calculated indicators - the avidity index, which is the ratio of the results of the concentration of immunoglobulin G with treatment with special active solutions to the result of the concentration of the same immunoglobulin igg without treatment.

Cytomegalovirus IgG positive during pregnancy

Results with a “positive” indicator require separate coverage. enzyme immunoassay for the presence of antibodies to. At the same time, the timing of pregnancy during which these studies were carried out is of particular importance.

If, at a period of more than 4 weeks of pregnancy, a woman’s analysis shows a positive result with high-avidity indicators, then such an answer can be interpreted ambiguously and require additional, more specific research. After all, the infection could have taken place either a year ago or a few weeks ago, which in the latter case is fraught with serious consequences for the fetus. negative consequences. But at the same time, if the titer is high with a positive response to CMV, then this result may indicate a suppressed infection in the body and the absence of danger to the fetus and unborn baby.

Patients are wondering if antibodies are detected with cytomegalovirus igg, what does this mean? Nowadays, there are a number of diseases that do not manifest themselves in any way, and their presence in the body is detected only using laboratory methods, sometimes completely by accident. One such infection is cytomegalovirus. What does it mean if cytomegalovirus iG antibodies are detected?

What are antibodies to cytomegalovirus?

Testing for IgG antibodies to cytomegalovirus allows one to detect the presence of this infection.

Cytomegalovirus (abbreviated CMV) is a member of the herpesvirus family that causes cytomegaly in humans. Cytomegaly is viral disease, which is transmitted from person to person. It is characterized by the fact that the virus attaches to healthy cells of human tissues and changes them internal structure, as a result, huge cells, the so-called cytomegales, are formed in the tissues.

This virus has a very special feature for many years live in human body and not show yourself in any way. When the immune balance in the body is disturbed, the virus is activated, and the disease begins to progress very quickly. As a rule, cytomegalovirus is localized in the salivary glands, since its structure is close to this species fabrics.

in the human body are excreted independently. According to official data, antibodies to this virus have been found in children adolescence in 10–15% of cases, and in adults - in 40%.

Cytomegalovirus is spread:

• by airborne droplets, for example, through saliva;
• transplacental, i.e. from mother to fetus through the placenta, as well as during the passage of the child through the birth canal;
• nutritional, i.e. through the mouth when eating or drinking, as well as through dirty hands;
• sexually - in contact, for example, with the mucous membrane of the vagina, contact of mucous membranes with sperm;
• during blood transfusion;
• during lactation through mother's milk.

The incubation period of CMV lasts from 20 to 60 days, the acute period of the disease passes within 2–6 weeks. In the acute phase of the disease, a person experiences the following manifestations:

After the acute stage of the disease has passed, the immune system is activated and antibodies are produced. If the immune system is weak due to previous diseases and poor lifestyle, the disease develops into chronic stage and affects tissues, and often internal organs of a person.

For example, CMV provokes the development wet macular degeneration, i.e. diseases of the eye cells responsible for transmitting nerve impulses from the organ of vision to the brain.

The disease manifests itself as:

• ARVI, in some cases pneumonia;
• generalized form, namely, damage to internal organs, for example, inflammation of the liver, pancreas and other glands, as well as tissues of the intestinal walls;
• organ problems genitourinary system, manifested in the form of periodically recurring inflammations.

You need to be especially concerned if a pregnant woman becomes infected with cytomegalovirus. In this case, fetal pathology develops when viruses in the mother’s blood are transmitted to it through the placenta. Pregnancy ends in miscarriage, or the child’s brain is damaged, as a result of which he suffers from diseases of both a physical and mental nature.

It is necessary to pay great attention to the diagnosis of the disease in utero form. It is especially important to establish how the pregnant woman became infected. If before conception the body has already suffered from a disease, and during pregnancy a second infection occurs, this fact means a higher chance of having a healthy baby. Cytomegalovirus provokes diseases that have high risk severe complications for life.

How is the disease diagnosed? The methods used in diagnosing CMV are as follows:

• immunofluorescence method, which makes it possible to detect the virus in biological fluids of the body;
• chemiluminescence immunoassay (CHLA) method, based on an immunoassay;
• polymerase chain reaction (PCR) is a molecular biology method that allows you to detect viral DNA in human biological fluids;
• cell culture seeding;
• enzyme-linked immunosorbent assay (ELISA), which determines whether there are antibodies to CMV in the blood.

What does it mean if Anti-CMV IgG is detected?

The listed types of tests are aimed at identifying specific antibodies called immunoglobulins. This in turn makes it possible to determine at what stage of development the disease is. The most effective and frequently used of them are ELISA and CLLA tests.

There are 2 classes of immunoglobulins that appear in CMV. The analysis reveals their quantitative indicator, which goes beyond the reference values, i.e., exceeds the norm.

Immunoglobulins M, which quickly respond to viral infections. These antibodies have the international abbreviation ANTI-CMV IgM, which stands for antibodies generated against class M cytomegalovirus.

These antibodies do not form immune memory and are destroyed in the body within six months.

At increased quantity Cytomegalovirus IgM is diagnosed in the acute stage of the disease.

Immunoglobulins G, which are formed throughout life and are activated after the infection is suppressed. ANTI-CMV IgG is the abbreviated name for these antibodies, according to international classification, which means class G antibodies. IgG antibodies to cytomegalovirus indicate that the virus is developing in the body. Laboratory research able to determine the approximate time of infection. This is indicated by an indicator called titer. For example, a titer of cytomegalovirus igg 250 indicates that the infection has entered the body over several months. The lower the indicator, the longer the duration of infection.

When assessing the likelihood of infection, an analysis of the ratio of antibodies of the IgG class and the IgM class is used. The interpretation of the relationship is:

It is especially important to conduct these studies in women of reproductive age. If a positive result for cytomegalovirus IgG is obtained with a negative IgM before conception, this means that during pregnancy there will be no primary infection (the most dangerous for the fetus).

With a positive IgM pregnancy It is worth postponing and consulting with your doctor. And if the result for cytomegalovirus IgG and IgM is negative, then there is no virus in the body, and there is a possibility of primary infection.

What should I do if I test positive for IgG antibodies?

Treatment for CMV is usually aimed at strengthening the immune system in order to bring the cytomegalovirus into a latent form that can be controlled by the human immune system.

Therapy is also based on taking antiviral drugs with antiherpes action. Concomitant diseases, developing along with CMV, are treated with antibiotics.

To prevent CMV, a special vaccine has been developed, aimed primarily at protecting pregnant women. According to studies, the vaccine currently has an effectiveness rate of approximately 50%.

The results revealing a positive cytomegalovirus iGG should not be taken as a death sentence. The CMV virus is present in the body of the vast majority of people. Timely analysis, prevention and adequate treatment can minimize the risks of the disease provoked by this infection.