Cmv lgg positive. Cytomegalovirus igg positive

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 the 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 any particular harm to health.

Blood test for CMV - what is it?

Several types of tests can be used as a diagnostic method for detecting CMV in the blood, but the most effective and common is enzyme-linked immunosorbent assay (ELISA). This type of diagnosis allows you to evaluate the quantitative and characteristic characteristics of cytomegalovirus specific antibodies(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 begins immune system. 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 – a negative impact on a person’s overall health and the likelihood of secondary infection with viruses or other types of infections. As a result of the protective reaction of the immune system to the actions of CMV, specific immunoglobulins of two classes, IgG and IgM, are produced.

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 response is “positive”), it means that an infection is currently occurring in the body or there was a recent, primary infection. As the virus develops in the body, IgM levels decrease, which means the condition is normal and the disease enters a latent period, but at the same time, IgG immunoglobulin levels with a positive value increase.

With the long-term development of viral damage to 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 against cytomegalovirus disappears.

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 is affected by the virus relatively recently and possibly in this moment the infection occurs in an 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 igg for cytomegalovirus indicates a successful infection at least a month ago.

A positive result can be considered favorable in the absence of 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 transplantation or undergo chemotherapy, a positive cytomegalovirus igg level in the blood can provoke re-development cytomegaly in the body and lead to a number of undesirable consequences for the patient from 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 a current infection in acute period primary infection, or its recent completion.

With absence accompanying 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 for CMV are more than 250 or igg are detected above 140, this means that there is 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 initial stages 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

Separate coverage requires results with a “positive” indicator of an 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 occurred either a year ago or several weeks ago, which in the latter case is fraught with serious negative consequences for the fetus. 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.

Cytomegalovirus IgG positive occurs in patients who are immune to CMV, but are also its carrier.

It is worth noting that cytomegalovirus IgG antibodies are positive in 90% of the population. The IgG indicator means that the person has been infected and the body has suppressed the infection, i.e. Antibodies have been developed that support the body against this virus, preventing it from entering the active stage. During primary infection with CMV or during relapse of the disease, IgM antibodies are produced.

In a latent state, CMV may not manifest itself in any way. For most people, this virus never becomes active and does not cause any negative consequences for good health.

A positive cytomegalovirus IgG cannot be completely cured. Treatment with medications only increases the period of remission or has an effect on relapse of the disease.

When the virus is activated, timely consultation with a doctor and subsequent use of various anti-inflammatory drugs allows for for long years keep the virus in a “dormant” state.

How to treat cytomegalovirus IgG positive?

It should be noted that drugs used to treat CMV IgG positive have side effects, therefore, it is appropriate to prescribe them only during exacerbation of the disease. Activation of the virus mainly occurs during the period of weakening of human immunity.

It is recommended to treat cytomegalovirus with the following drugs:

• Ganciclovir - blocks the reproduction of the virus (side effect - digestive disorders and problems with hematopoiesis);
• Panavir (injections) – also blocks the reproduction of CMV, not recommended during pregnancy;
• Foscarnet;
• Immunoglobulins, which are obtained from immunocomplete donors;
• Interferon, etc.

It is advisable to carry out complex treatment of cytomegalovirus. In addition to antiviral, it is also important to carry out immune therapy. After a course of treatment, CMV IgG ceases to be released from human biological fluids (saliva, breast milk, blood), and the infection enters a latent (dormant) phase. High-quality and timely immunotherapy improves defense mechanism the body, allowing you to control the recurrence of the disease, preventing the virus from moving from a “dormant” state to an active one.

Interpretation of the results of IgM analysis for cytomegalovirus

Cytomegalovirus is a herpetic type microorganism that is opportunistic and latently lives in the bodies of 90% of people. When the immune system is weakened, it begins to actively multiply and leads to the development of infection. To diagnose the disease, an enzyme immunoassay for cytomegalovirus IgM is predominantly used - determining the presence of antibodies to the infectious agent in the blood.

Indications for the study

As a rule, cytomegalovirus does not pose a danger to a person with normal immunity and is asymptomatic; Sometimes mild symptoms of general intoxication of the body appear, which do not lead to the development of complications. However, for pregnant women and people with immunodeficiency, acute infection can be dangerous.

An enzyme immunoassay for antibodies to CMV is performed if the following symptoms are observed:

• increased body temperature;
• rhinitis;
• a sore throat;
• enlarged lymph nodes;
• inflammation and swelling of the salivary glands, in which the virus is concentrated;
• inflammation of the genital organs.

Most often, cytomegalovirus is difficult to distinguish from ordinary acute respiratory disease. It is worth noting that a pronounced manifestation of symptoms indicates a weakened immune system, so in this case you should additionally check for immunodeficiency.

The easiest way to distinguish cytomegalovirus from a cold is by the timing of the disease. Symptoms of acute respiratory infections disappear within a week, herpetic infection may remain in acute form for 1–1.5 months.

Thus, the indications for prescribing the analysis are as follows:

1. Pregnancy.
2. Immunodeficiency (caused by HIV infection, taking immunosuppressants, or congenital).
3. The presence of the above symptoms in a person with normal immunity (the disease must first be differentiated from the Epstein-Barr virus).
4. Suspicion of CMV in a newborn child.

Given the possible asymptomatic course of the disease, during pregnancy the test should be performed not only in the presence of symptoms, but also for screening.

Differences between IgM and IgG tests

The immune system first responds to the entry of any foreign microorganisms into the blood by producing antibodies. Antibodies are immunoglobulins, large protein molecules with a complex structure that are able to bind to proteins that make up the shell of viruses and bacteria (they are called antigens). All immunoglobulins are divided into several classes (IgA, IgM, IgG, etc.), each of which performs its own function in the body’s natural defense system.

IgM class immunoglobulins are antibodies that are the first protective barrier against any infection. They are produced urgently when the CMV virus enters the body, do not have a specification and have a short lifespan - up to 4–5 months (although residual proteins that have a low coefficient of binding to antigens may remain 1–2 years after infection).

Thus, an analysis for IgM immunoglobulins allows you to determine:

• primary infection with cytomegalovirus (in this case, the concentration of antibodies in the blood is maximum);
• exacerbation of the disease - the concentration of IgM increases in response to a sharp increase in the number of viral microorganisms;
• reinfection - infection with a new strain of the virus.

Based on the remnants of IgM molecules, over time, IgG immunoglobulins are formed, which have a specification - they “remember” the structure of a particular virus, persist throughout life and do not allow the infection to develop unless the overall strength of the immune system is reduced. Unlike IgM, IgG antibodies against different viruses have clear differences, so analysis for them gives a more accurate result - they can be used to determine which virus has infected the body, while analysis for IgM only provides confirmation of the presence of infection in a general sense.

IgG antibodies are very important in the fight against cytomegalovirus, since it is impossible to completely destroy it with the help of medications. After the exacerbation of the infection ends, a small number of microorganisms remain in the salivary glands, mucous membranes, and internal organs, which is why they can be detected in samples of biological fluids using polymerase chain reaction(PCR). The virus population is controlled precisely by IgG immunoglobulins, which prevent cytomegaly from becoming acute.

Decoding the results

Thus, enzyme immunoassay makes it possible to accurately determine not only the presence of cytomegalovirus, but also the period elapsed since infection. It is important to evaluate the presence of both major types of immunoglobulins, so IgM and IgG antibodies are considered together.

The results of the study are interpreted as follows:

Particular attention should be paid to a positive IgM antibody result in pregnant women. If IgG immunoglobulins are present, there is nothing to worry about; acute infection poses a danger to the development of the fetus. Complications in this case occur in 75% of cases.

In addition to the actual presence of antibodies, enzyme immunoassay evaluates the avidity coefficient of proteins - their ability to bind to antigens, which decreases as they are destroyed.

The results of the avidity study are deciphered as follows:

• >60% - immunity to cytomegalovirus is developed, infectious agents are present in the body, that is, the disease occurs in a chronic form;
• 30–60% - relapse of the disease, an immune response to the activation of a virus that was previously in a latent form;

For women planning a pregnancy or already carrying a child, it is very important to know about a past infection with cytomegalovirus, as this can affect the development of the fetus. An enzyme immunoassay for antibodies comes to the rescue with this.

Test results during pregnancy are assessed differently. The safest option is positive IgG and negative IgM - there is nothing to worry about, since the woman has immunity against the virus, which will be passed on to the child, and there will be no complications. The risk is also small if positive IgM is detected - this indicates a secondary infection that the body is able to fight, and there will be no serious complications for the fetus.

If no antibodies of either class are detected, the pregnant woman should be very careful. It is important to follow measures to prevent infection with cytomegalovirus:

• avoid sexual intercourse without using contraception;
• avoid sharing saliva with other people - do not kiss, do not share dishes, toothbrushes, etc.;
• maintain hygiene, especially when playing with children, who, if they are infected with cytomegalovirus, are almost always carriers of the virus, since their immunity is not yet fully formed;
• See a doctor and get tested for IgM for any manifestations of cytomegalovirus.

It is important to remember that it is much easier to become infected with the virus during pregnancy due to the fact that a woman’s immunity naturally weakens during pregnancy. This is a mechanism of protection against rejection of the embryo by the body. Like other latent viruses, old cytomegalovirus can become active during pregnancy; this, however, only in 2% of cases leads to infection of the fetus.

If the result for IgM antibodies is positive and for IgG antibodies is negative, the situation is most dangerous during pregnancy. The virus can enter the fetus and infect it, after which the development of the infection may vary depending on the individual characteristics of the child. Sometimes the disease is asymptomatic, and permanent immunity against CMV develops after birth; in 10% of cases the complication is various pathologies development of the nervous or excretory system.

Particularly dangerous is infection with cytomegalovirus during pregnancy of less than 12 weeks - an underdeveloped fetus cannot resist the disease, which leads to miscarriage in 15% of cases.

An IgM antibody test only helps determine the presence of the disease; The risk to the child is assessed through additional tests. Based on a number of factors, appropriate pregnancy management tactics are developed to help minimize the likelihood of complications and congenital defects in the child.

Positive result in a child

An embryo can become infected with cytomegalovirus in several ways:

• through sperm during fertilization of the egg;
• through the placenta;
• through the amniotic membrane;
• during childbirth.

If the mother has IgG antibodies, then the child will also have them until about 1 year of age - initially they are there, since during pregnancy the fetus shares a common circulatory system with the mother, then it is supplied with breast milk. As breastfeeding stops, the immune system weakens and the child becomes susceptible to infection from adults.

Positive IgM in a newborn indicates that the child was infected after birth, but the mother does not have antibodies to the infection. If CVM is suspected, not only an enzyme-linked immunosorbent assay is performed, but also PCR.

If the child’s body’s own defenses are not enough to fight the infection, complications may develop:

• slowdown in physical development;
• jaundice;
• hypertrophy internal organs;
• various inflammations (pneumonia, hepatitis);
• lesions of the central nervous system - mental retardation, hydrocephalus, encephalitis, problems with hearing and vision.

Thus, the child should be treated if IgM antibodies are detected in the absence of IgG immunoglobulins inherited from the mother. Otherwise, the body of a newborn with normal immunity will cope with the infection on its own. Exceptions are children with serious oncological or immunological diseases, the course of which may affect the functioning of the immune system.

What to do if the result is positive?

A person’s body with a healthy immune system is able to cope with the infection on its own, so if an immune response to cytomegalovirus infection is detected, nothing can be done. Treatment of a virus that does not manifest itself in any way will only lead to a weakening of the immune system. Medicines are prescribed only if the infectious agent has begun to actively develop due to an insufficient reaction of the body.

Treatment is also not necessary during pregnancy if there are IgG antibodies. If only the IgM test is positive, medication is necessary, but it is intended to contain acute infection and transfer of cytomegalovirus into a latent form. It should be remembered that medications for CMV are also unsafe for the body, so they can only be used if prescribed by a doctor - self-medication will lead to various adverse consequences.

Thus, positive IgM indicates an active stage of CMV infection. It should be considered in conjunction with other test results. Particular attention to the test indications should be paid to pregnant women and people with weakened immune systems.

Cytomegalovirus - symptoms, causes and treatment

Cytomegalovirus is a virus widespread throughout the world among adults and children, belonging to the group of herpes viruses. Since this virus was discovered relatively recently, in 1956, it is considered not yet sufficiently studied, and in scientific world is still the subject of active debate.

Cytomegalovirus is quite common; antibodies to this virus are found in 10-15% of adolescents and young adults. In people aged 35 years or more, it is found in 50% of cases. Cytomegalovirus is found in biological tissues - semen, saliva, urine, tears. When the virus enters the body, it does not disappear, but continues to live with its host.

What it is?

Cytomegalovirus (another name is CMV infection) is an infectious disease that belongs to the herpesvirus family. This virus affects humans both in utero and in other ways. Thus, cytomegalovirus can be transmitted sexually or through airborne alimentary routes.

How is the virus transmitted?

The transmission routes for cytomegalovirus are varied, since the virus can be found in blood, saliva, milk, urine, feces, seminal fluid, and cervical secretions. Possible airborne transmission, transmission through blood transfusion, sexual intercourse, and possible transplacental intrauterine infection. An important place is occupied by infection during childbirth and when breastfeeding a sick mother.

There are often cases when the carrier of the virus does not even suspect it, especially in situations where symptoms hardly appear. Therefore, you should not consider every carrier of cytomegalovirus to be sick, since existing in the body, it may never manifest itself in its entire life.

However, hypothermia and a subsequent decrease in immunity become factors that provoke cytomegalovirus. Symptoms of the disease also appear due to stress.

Cytomegalovirus igg antibodies detected - what does this mean?

IgM are antibodies that the immune system begins to produce 4-7 weeks after a person is first infected with cytomegalovirus. Antibodies of this type are also produced every time the cytomegalovirus remaining in the human body after a previous infection begins to actively multiply again.

Accordingly, if you have been found to have a positive (increased) titer of IgM antibodies against cytomegalovirus, this means:

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

A positive titer of IgM antibodies can persist in a person's blood for at least 4-12 months after infection. Over time, IgM antibodies disappear from the blood of a person infected with cytomegalovirus.

Development of the disease

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

Even after completing a course of treatment, the virus lives in the body for life, maintaining the risk of relapse, so doctors cannot guarantee the safety of pregnancy and full gestation even if a stable and long-term remission occurs.

Symptoms of cytomegalovirus

Many people who carry cytomegalovirus do not show any symptoms. Signs of cytomegalovirus may appear as a result of disturbances in the functioning of the immune system.

Sometimes in people with normal immunity this virus causes the so-called mononucleosis-like syndrome. It occurs 20-60 days after infection and lasts 2-6 weeks. He appears high temperature, chills, cough, fatigue, malaise and headache. Subsequently, under the influence of the virus, a restructuring of the body’s immune system occurs, preparing to repel the attack. However, in case of lack of strength, the acute phase passes into a calmer form, when vascular-vegetative disorders often appear, and damage to internal organs also occurs.

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

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

Particular attention should be paid to CMV infection in the fetus (intrauterine cytomegalovirus infection), in newborns and young children. An important factor is the gestational period of infection, as well as the fact whether the pregnant woman was infected for the first time or the infection was reactivated - in the second case, the likelihood of infection of the fetus and the development of severe complications is significantly lower.

Also, if a pregnant woman is infected, fetal pathology is possible when the fetus becomes infected with CMV entering the blood from outside, which leads to miscarriage (one of the most common causes). It is also possible to activate the latent form of the virus, which infects the fetus through the mother’s blood. Infection leads either to the death of the child in the womb/after birth, or to damage to the nervous system and brain, which manifests itself in various psychological and physical diseases.

Cytomegalovirus infection during pregnancy

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

The patient notes complaints about:

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

If the fetus is infected during pregnancy (but not during childbirth), congenital cytomegalo may develop viral infection The child has. The latter leads to severe diseases and damage to the central nervous system (mental retardation, hearing loss). In 20-30% of cases the child dies. Congenital cytomegalovirus infection is observed almost exclusively in children whose mothers become infected with cytomegalovirus for the first time during pregnancy.

Treatment of cytomegalovirus during pregnancy includes antiviral therapy based on intravenous injection of acyclovir; the use of drugs to correct immunity (cytotect, intravenous immunoglobulin), as well as carrying out control tests after completing a course of therapy.

Cytomegalovirus in children

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

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

Manifestation is also possible in adulthood, when the child is 3-5 years old, and usually looks like an acute respiratory infection (fever, sore throat, runny nose).

Diagnostics

Cytomegalovirus is diagnosed using the following methods:

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

Consequences

With a critical decrease in immunity and the body’s inability to produce an adequate immune response, cytomegalovirus infection becomes a generalized form and causes inflammation of many internal organs:

• adrenal glands;
• liver tissue;
• pancreas;
• kidney;
• spleen;
• peripheral nervous tissue and central nervous system.

Today, WHO puts the generalized form of cytomegalovirus infection in second place in the number of deaths worldwide after acute respiratory infections and influenza.

Treatment of cytomegalovirus

If the virus becomes active, you should under no circumstances carry out any self-medication - this is simply unacceptable! You should definitely consult a doctor so that he can prescribe the correct therapy, which will include immunomodulatory drugs.

Most often, complex treatment for cytomegalovirus is used, aimed at strengthening the immune system. It includes antiviral (valaciclovir) and restorative therapy. Antibiotic treatment is also prescribed concomitant diseases. All this allows the virus to be transferred to a latent (inactive) form, when its activity is controlled by the human immune system. However, there is no 100% method that would permanently eradicate the herpes virus from the body.

For example, according to serological tests, 90.8% of people in the group 80 years of age and older are seropositive (that is, have a positive level of IgG antibodies).

Prevention

Cytomegalovirus is especially dangerous during pregnancy, as it can cause miscarriage, stillbirth, or cause severe congenital deformities in the child.

Therefore, cytomegalovirus, along with herpes, toxoplasmosis and rubella, is one of those infections for which women should be screened prophylactically, even at the stage of pregnancy planning.

Which doctor should I contact?

Often, the diagnosis of CMV infection is dealt with by a gynecologist who observes expectant mother. If treatment of the disease is necessary, consultation with an infectious disease specialist is indicated. A newborn child with a congenital infection is treated by a neonatologist, then a pediatrician, and observed by a neurologist, ophthalmologist, and ENT doctor.

In adults, when CMV infection is activated, consultation with an immunologist (often this is one of the signs of AIDS), a pulmonologist and other specialized specialists is necessary.

Cytomegalovirus IgG 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 with 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?

If the analysis for the determination of IgG antibodies to cytomegalovirus infection is positive, what conclusion is drawn?

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 happens 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. The lymphatic system is affected - The 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 the mother's birth canal or breast milk during 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.

• 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 its 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 cytomegalovirus infection. They are characterized by bilateral pneumonia and 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 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.

If the results are “IgM positive” and “IgG negative”, this indicates an acute recent infection and the absence of permanent immunity against CMV. Aggravation chronic infection indicators are characteristic 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 has a healthy immune system, then he can cope with cytomegalovirus infection on his own. You don't have to 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.

With a positive test for IgM, to transfer the acute condition into a 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.

Cytomegalovirus in children

Cytomegalovirus infection (CMV) is a widespread infectious disease. The causative agent of cytomegalovirus infection belongs to the herpes family. Once in the human body, the virus multiplies inside the cell and significantly increases its size. The result of the multiplication of cytomegalovirus can be infection of any tissues and internal organs. The fetus during pregnancy, newborns and children of the first 3-5 years of life are especially sensitive to cytomegalovirus.

Cytomegalovirus in children - causes

Cytomegalovirus in a child can be either congenital or acquired.

Congenital cytomegalovirus infection develops in a child when infected from a mother who is a carrier of the virus through the placenta during the prenatal period. If a woman catches cytomegalovirus for the first time during pregnancy, the infection can enter the child’s body through the placenta. Congenital cytomegalovirus in most cases does not manifest itself in the early stages of a child’s life, but has the most pronounced complications later (hearing loss, decreased intelligence, speech impairment). The extent of this manifestation depends on the timing of infection of the fetus during pregnancy.

Acquired cytomegalovirus infection. Infection of a child can also occur directly during childbirth when the fetus passes through the mother’s infected birth canal or in the first days of life through contact with an infected mother or medical personnel. A newborn can also be infected through breast milk. With acquired cytomegaly, unlike congenital cytomegaly, the spread of infection occurs extremely rarely.

In preschool and school age Cytomegalovirus enters the body through household contact or by airborne droplets, when in a small space it enters the body of other children from one virus carrier or a sick child. You can become infected with cytomegalovirus from the first days of life, and infection increases sharply with age. The virus can live and multiply for a long time in leukocytes and other cells of the human immune system and cause chronic carriage.

Cytomegalovirus in children - symptoms

Typically, cytomegalovirus infection in children is mild and hidden (asymptomatic) and doesn’t show itself at all. And only one in ten cases of infection will have clinical manifestations, especially if the immune system is weakened. Therefore, the symptoms of CMV depend not only on the state of the child’s immune system, but also on his age, the presence of immunity against cytomegalovirus, and the presence of concomitant diseases of the child.

Most often, cytomegalovirus in children manifests itself as an acute respiratory viral infection (ARVI).

The incubation period ranges from 15 to 60 days. During the acute phase of cytomegalovirus infection, the child develops the following symptoms:

• increased body temperature (sometimes periodically and irregularly to febrile levels for three or more weeks);
• runny nose, inflammation and enlargement of the salivary glands, with copious saliva;
• enlarged cervical lymph nodes;
• chills, weakness, fatigue, headache, muscle pain;
• the spleen (splenomegaly) and liver enlarge;
• bowel movements may be disrupted, such as constipation or diarrhea;
• in the child’s blood the number of platelets decreases, the absolute and relative content of monocytes increases;
• frequent “causeless” pneumonia, bronchitis;

Due to the lack of specific symptoms of cytomegalovirus, it is impossible to make a diagnosis based only on clinical manifestations.

Laboratory methods are used to identify the pathogen and the specific immune response. The diagnosis of cytomegalomirus infection is confirmed by the presence of the virus itself in the blood and tissues, as well as the detection of antibodies to the virus in the blood. In sick people, cytomegalovirus is detected in sediments of urine, saliva, and sputum.

Antibodies to cytomegalovirus

Antibodies to cytomegalovirus begin to be produced immediately after the virus enters the human body. It is antibodies that fight viral infection, preventing cytomegalovirus from developing and causing the disease to be asymptomatic. There are several classes of antibodies - IgG, IgM, IgA, etc., each of which is responsible for certain functions of the immune system. However, for the diagnosis of cytomegalovirus infection, those that can detect antibodies belonging to the IgM and IgG classes are truly useful.

Antibodies to cytomegalovirus - IgG and IgM are detected when laboratory analysis blood.

Availability IgM antibodies usually appear in the blood first and indicates a fresh infection or reactivation of a latent (latent) infection. However, an increase in IgM antibodies may not be detected during the first 4 weeks after the onset of the disease. At the same time, titers may remain high for up to a year after recovery. In this regard, a single determination of the level of IgM antibodies is useless in assessing the severity of infection. It is important to monitor changes in the level of IgM antibodies (increase or decrease in their level).

After one to two weeks from the moment of infection with cytomegalovirus, IgG antibodies. These immunoglobulins help the doctor determine whether the baby was previously infected with cytomegalovirus, as well as a blood test for these antibodies is given to diagnose acute cytomegalovirus infection. IgG antibodies during primary infection increase in the first weeks and then may remain tall in years. IgG antibodies appear during the recovery period and can persist for up to 10 years in those who have recovered, so the frequency of detection of IgG antibodies can reach 100% among various groups population.

A single determination of the antibody titer does not allow one to distinguish a current infection from a past one, since cytomegalovirus is always present in the body of the virus carrier, as are antibodies to it.

Antibodies to cytomegalovirus - IgG positive

If IgG class immunoglobulins are detected as single marker, then this indicates either infection with cytomegalovirus or the presence of immunity to this infection. The detection of antibodies to cytomegalovirus IgG in children in the first six months of life in the absence of other markers of this infection indicates their maternal origin.

The simultaneous detection of specific antibodies of the IgM and IgG classes in the blood serum of children indicates a disease with cytomegalovirus.

Antibodies to cytomegalovirus, which belongs to the group of herpes viruses (type 5), are detected using enzyme-linked immunosorbent assay (ELISA), immunochemiluminescent blood tests, and the polymerase chain reaction method. Based on the results of the study, both the presence or absence of herpesvirus in the blood and the type (primary or secondary) of infection of the patient are determined.

Test for antibodies to cytomegalovirus

For the qualitative determination of antibodies (immunoglobulins) during diagnosis, serological ELISA is used, based on the interaction of blood serum antibodies with antigens. Antigens of suspected pathogens are added to the sample and the formation of immune (antigen-antibody) complexes is monitored.

In IHLA, phosphors glowing in ultraviolet are added to the immunological reaction, the level of luminescence of which is measured by instruments.

PCR is a reaction that enlarges the test part of the sample and allows one to detect the presence or absence of infection in the body.

Decoding the results

In humans, two types of antibodies are produced against cytomegalovirus (CMV), belonging to the G- and M-class. Activation of cytomegalovirus infection is indicated by a more than 4-fold increase in the diagnostic IgG titer. This type of antibody indicates a primary or worsened infection; to clarify, an IgM test is performed.

The results of the enzyme immunoassay and immunochemiluminescence test are interpreted as follows:

• immunoglobulins of the IgG and IgM types are absent - there is no immunity to cytomegalovirus, there is a risk of primary infection;
• Anti-CMV is present (type G) - immunity is present, which does not exclude the transition to the acute phase of the infection;
• the presence of type M in the blood plasma means that a primary infection has entered the body that requires treatment;
• antibodies to cytomegalovirus IgG and IgM were detected - a secondary exacerbation of the viral infection occurred.

The value of the positivity rate (antibody concentration in the sample) detected during testing is indicated on the form in milliliters (ml), nanograms (ng) or ng/ml. The reference value of the study is used as a reference point, representing the average value of the indicator being determined and used as the norm for a given test system.

If the result is weakly positive, the ELISA test is repeated a week later. If the level of type M antibodies decreases, the virus is suppressed by the body; an increase in the number of markers means the progression of the disease. If questionable results are obtained, the analysis is performed several times.

When analyzed using the polymerase reaction method, the result indicates the presence or absence of viral DNA in the sample. If the result is negative, there remains a high probability of infection with cytomegalovirus.

Avidity of antibodies to cytomegalovirus

Avidity characterizes the level of pathogenicity of the virus, depending on the strength of binding of antigens to antibodies, which is determined by the degree of activity by the avidity index:

• high (over 60%) avidity indicates that the body has overcome the infection and developed immunity;
• with low avidity (less than 50%), we are talking about primary infection.

In terms of ease of diagnosis, IgG serological markers are more often studied.

Peculiarities

In adults

The level of immunoglobulin concentration varies depending on age and gender; normally its parameters are within the following limits:

• 0.5-2.5 units. IgM - in men;
• 0.7-2.9 IgM - in women;
• from 16.0 IgG.

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, the quality of work plays an important role. protective functions body and physical health 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, the genetic material submitted for research is studied in order 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.

The human body’s immune system produces dozens of types of special antibodies, the purpose of which is to combat various types infections. At the end of puberty, several dozen types of immunoglobulins are present in the internal environment of the body. 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 of infection is in an inactive state and is stored in the secretions of the salivary glands, the composition of the blood, and also 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.

Myself IgG test for cytomegalovirus 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 slight detour and look at some of the differences between antibody classes. The IgM class includes antibodies that have big 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 a lot of 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. If you receive this result, you must undergo a repeat examination procedure fifteen days later.
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 with strong immunity can manifest itself in the form of symptoms such as:

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

Despite the fact that there may be no signs of infection activity, an infected person during the acute course of the disease should be in isolation. Experts recommend visiting public places as little as possible and completely avoiding close contact with pregnant women and young children. Being at this stage of the disease, a person is an active source of infection, therefore, in order to shorten the period 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. If this class of immunoglobulins is detected in the first trimester of pregnancy, treatment for the disease must be started immediately. 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, various factors are taken into account, 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 a result such as negative Anti cmv ​​IgM in the absence of antibodies from class G may 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 the infection occurred during the intrauterine development of the 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 such a 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 may later cause total loss 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 drugs is required to eliminate the infection. medications. The use of such drugs unnecessarily is highly undesirable, due to high risk development of side effects of drugs. Among various means drugs used in the treatment of cytomegaloviruses include Ganciclovir, Foscarnet, and Panavir. Despite possible side effects in the form of disruption of the kidneys and gastrointestinal tract, these drugs are 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. Using the above medicines allowed only after preliminary 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.

In contact with

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 by the immune system in response to the penetration of the virus are the main diagnostic sign for detecting 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 the active stage of infection, cytomegaloviruses cause significant changes in the immune system:

• 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.

Based on 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 of protective immunity occurs in a shorter period of 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 had an organ transplant, a positive IgA test result helps to recognize the form of the disease.

Avidity of immunoglobulins

Avidity refers to the ability of antibodies to bind to viruses. In the initial period of the disease it 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. Thus, acute infection is 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 exclude 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

There is no numerical value for the “normal” level of antibodies in biological fluids.

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, activity of the immune system and metabolic processes, age, and the 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, so they must produce a final interpretation of the results, which indicates reference (borderline) values ​​and units of measurement.

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 interpreted 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 a constant 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 a low avidity index is detected at a period of 12-16 weeks, 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:

U 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 of the IgG, IgA, IgM classes 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. 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. The conjugate and organic dye are then injected, the 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 limitations 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 acute phase, the most dangerous to health, you need to consult an infectious disease doctor and conduct additional ELISA tests 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 the same antibody titers are detected, then it is highly likely that simple transfer of immunoglobulins occurred during pregnancy, and not infection.

It should be taken into account that small amounts of 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. Great importance has CMV prevention, which is aimed at strengthening the immune system. 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

In pregnant women with CMV, treatment is carried out with one of the following means 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 - fever, headaches and muscle pain, general weakness, chills

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

This infection is most dangerous on early stages pregnancy, as this often results in fetal death and miscarriage.

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.

Subsequently, mental retardation may become apparent. 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: