Update: December 2018 Cytomegalovirus (CMV, cytomegaly, virus
salivary glands, CMV virus) widely distributed (in 50-80%
adults and 10-15% of children) DNA-genomic virus of the family Herpesviridae
Cytomegalovirus hominis, which can infect absolutely
everyone. Cytomegaly is called the “disease of civilization.” In this article
it will be about cytomegalovirus, the symptoms and treatment of this
diseases in pregnancy, in children and in adults. Frequency
clinical manifestations of this virus over the past decade sharply
increased with the number of people with various immunodeficiency
conditions (see whether HIV infection is a myth or a reality).
The reservoir and source of the CMV virus is a person with a present
acute or latent viral form of CMV.
Most people do not know about the disease, as its symptoms are not
specific and extremely rare. However during pregnancy
and in immunodeficient states, CMV is the reason for
After being infected with a virus, the infection persists in the body for life.
In a healthy person, CMV remains dormant.
Cytomegalovirus is spread through physiological fluids.
organism: blood, saliva, urine, feces, semen and breast milk. People
со слабым иммунитетом имеют больший риск заболеть, случае
cytomegalovirus infection of a pregnant woman and development
active infection may be infected with a child’s virus.
There are several forms of the disease. Among them prevails
subclinical manifestation and latent virus carriage.
Clinical manifestations of infection occur on the background of weakening
What is the danger of the virus? Modern treatment methods
cytomegalovirus does not completely eliminate the infection.
The consolation to this is only that the disease is dangerous only in
in some cases: in pathological conditions of the immune system and
during pregnancy (dangerous to the fetus).
Classification of CMV infection
Cytomegalovirus infection is:
- Congenital: acute, chronic
- Acquired: latent, acute, mononucleosis,
How is CMV infection transmitted?
Ways of transmitting a viral infection:
- Contact (through household items or directly from
- During transplantation of donor organs and blood transfusion
- Through breast milk.
Diagnosis of cytomegalovirus infection
Detection of the virus in humans is possible through blood tests,
urine, saliva, smear and scraping of the genitals. Usually people
leaning towards the option of donating blood. Detected specific
cytomegalovirus antibodies indicate the presence of
In the well-known laboratory INVITRO spend several
antibody detection tests:
|Anti-CMV Igg||+||a positive response is an indicator of an illness|
|Anti-CMV Igm||+||indicates the presence of infection and the acute form
|When combined analyzes are possible the following options
|–||–||there is no virus in the body, specific immunity
|±||+||primary infection in active stage|
|+||±||re-active form usually proceeds
|+||–||cytomegalovirus infection (remission), inactive
The presence of antibodies to cytomegalovirus in the blood (igg
positive) – a sign of persistent immunity, such a condition
does not require treatment. Overwhelmingly, this is
asymptomaticе пассивное вирусоносительство.
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In case of a negative answer (option 1), pregnant women are recommended
repeat tests every trimester of pregnancy since this
The category is at risk. Lack of antibodies to the virus
increases the chance of infection and poses a threat to normal
carrying a child.
Children born to a sick mother with an acute form of CMV infection,
Be sure to check for antibodies in the first days of life.
Antibodies detected in a newborn in the first three months of life
Igg не являются явным признаком врожденной цитомегалии. When hidden
the mother’s mother’s carriage, the child receives the finished antibodies,
which disappear on their own by three months. But specific
антитела Igm – прямое доказательство острой фазы цитомегаловирусной
Cytomegalovirus during pregnancy
Cytomegalovirus infection along with rubella, herpes and
toxoplasmosis during pregnancy is very dangerous. Basically
infection occurs before pregnancy and only 6% of women have CMV
enters the body for the first time. Therefore, experts recommend
be tested for CMV infection before conception.
Infection of the fetus during primary infection of the mother is observed in
50% of cases due to the lack of specific immunity that
allows �”Strong” virus to pass through the placental barrier
or fetal membranes and enter the baby’s body.
ATыявленные у беременной пациентки Igg означают присутствие
latent low-hazard form of the disease with already developed immune
antibodies. The probability of transmission to the child
(1-2%). The complete absence of cytomegalovirus antigens and
specific immunoglobulins is dangerous by primary infection.
Against the background of pregnancy often decreases immunity and the body
become more susceptible to various infections. therefore
pregnant women should take care of precautions. Should
restrict public stay
personal hygiene and avoid close contact with potential
Infection of the child can occur during conception (through
sperm). Children most often become infected at birth during
passing through the birth canal. CMV virus is present in the thoracic
milk from an infected mother, so breastfeeding is another
way of infection of the newborn.
It is important to note that intrauterine infection is more dangerous.
its effects, rather than during childbirth and through milk.
When a pregnant woman becomes infected with a virus in the early stages
pregnancy (up to 12 weeks) there are often sudden abortions,
stillbirth and miscarriage. If a child
survives or infection occurs in the later stages
pregnancy, the child in most cases is born with congenital
CMV infection. The disease makes itself felt immediately after birth or
After some time.
Symptoms of cytomegalovirus in women during pregnancy may
manifest fever, malaise, headache
pain, weakness, or completely absent.
Congenital CMV infection in children
ATрожденная форма вирусного diseases – это последствие
intrauterine infection of the fetus. The diagnosis is set to
first months of life. More than 2% of newborns are infected.
cytomegalovirus. Of these, most are born healthy or
are virus carriers. In 17% of cases of congenital
cytomegalovirus symptoms in children appear during
newborn or maximum to 2-5 years.
About congenital cytomegalovirus infection in infants
testifies results of analyzes with an interval in a month with
повышением в четыре раза титра антител Igg.
Baby in the womb, infected in the first trimester
pregnancy often die before birth. However, if this is not
happens, the degree of damage caused by the virus is very high.
Symptoms in infants manifest in the form of malformations –
underdeveloped brain, congenital deformities, dropsy of the head
brain, pathology of the heart, liver, enlargement of the spleen. Is possible
deafness, epilepsy, mental retardation, cerebral
paralysis, muscle weakness. Often this leads to a lethal
to the end
Zheltushka in a newborn baby
Symptoms of congenital cytomegaly in newborns:
- bluish spots on the body
- neurological disorders
- enlarged liver and spleen
У 15,7% детей вирус необратимо поражает мозг –
meningoencephalitis, dropsy (brain hydrocephalus),
structural changes. Visible damage to the brain vessels
(expansion), medulla (necrotization, hemorrhage) and
productive changes in the meninges.
Children with congenital CMV are born weak, with low weight and
reduced muscle tone, bad breastfeeding. Observed
depression of reflexes, muscular dystonia, tremor, vomiting, lag in
mental and physical development, convulsions in conjunction with
malformations of the eyes and internal organs.
In some cases, symptoms appear by 2-3 months. Child
sleeping badly, eating, gaining weight. There are convulsive seizures,
which over time become more frequent and more difficult. Often happen
респираторные diseases, бронхопневмонии. Slows down
psychomotor development. Nervous system disorders are accompanied
severe lesions of various organs.
Congenital cytomegaly manifested not immediately, but by 2-5 years
provokes speech inhibition, deafness, blindness, mental
backlog, impaired psychomotor reactions.
Cytomegalovirus in children requires treatment in case of
symptoms of the disease. The basis of therapy is antiviral
Having infiltrated a child’s CMV can cause an acute condition
or immediately go into the latent form without symptoms.
When immunity is weakened (hypothermia, stress, operative
intervention) possible relapse and chronic process.
Signs of cytomegalovirus infection
Acquired cytomegaly mainly occurs in early childhood
или подростковом возрасте в силу несовершенства immune system. AT
90% людей ЦМAT протекает asymptomatic.
Средний инкубационный период ЦМAT – 20-60 дней. When hit in
the body does not immediately make itself felt. Первоначально ЦМAT селиться
in the cells of the salivary glands, where for its reproduction the most
When the virus spreads throughout the body, a short-term
viremia in the form of mononucleosis syndrome: inflammation and increase
salivary glands and regional lymph nodes, increased salivation,
raid on the tongue. Severe intoxication provokes headache
fever, weakness and general malaise.
ЦМAT внедряется в лейкоциты и мононуклеарные фагоциты, где
replication occurs. Infected cells increase. AT их ядрах
visible viral inclusions. ЦМAT может долго и латентно пребывать в
body, especially in the lymphoid organs, and not succumb
exposure to antibodies and interferon. Simultaneously, being in
T lymphocytes, the virus suppresses cellular immunity.
Тяжелая гененрализованная форма ЦМAT возникает при
immunosuppressive conditions (AIDS, oncological diseases). Direct
cytomegalovirus exposure worsens, may occur
reactivation and hematogenous generalization. Infection spread by
throughout the body and affects various organs. ATозможно воспаление
легких, гепатит, jaundice, энцефалит, ретинит, дисфункция различных
parts of the digestive tract, endocrine glands, brain pathologies and
Neotsitotekt for the treatment of newborns and pregnant women
Симптомы diseases в острой фазе или во время реактивации
virus in children and adults often manifest as colds,
influenza manifestations. The disease lasts from two to six weeks and
ends with recovery.
Symptoms of cytomegalovirus:
- Puffiness of the throat
- Weakness and fatigue
- Swollen lymph nodes
- ATозможны боли в горле, кашель
Symptoms of cytomegalovirus in men except for cold symptoms
may manifest in the form of inflammation of the genitourinary system
(localized form). Affected urethra and tissue
testicles, painful and unpleasant when urinating
In women, cytomegalovirus can cause erosion and inflammation of the cervix.
uterus, vagina, ovaries. ATозможны боли внизу живота и
bluish-bluish vaginal discharge.
Treatment of cytomegaly in adults and children
ATозможности современной медицины позволяют только подавить ЦМAT,
complete neutralization is not yet possible. Therapy is determined
the degree of damage to the body and is carried out in a complex.
- Medication measures include taking antiviral drugs.
immunomodulatory and vitamin preparations. In addition, held
симптоматическое treatment с целью облегчить острое состояние
- ATажно помнить: бесконтрольное самоtreatment цитомегаловирусной
infection is unacceptable and fraught with consequences.
- AT первую очередь пациентам показано полноценное питание и
- The use of antiviral drugs is justified in the case of
тяжелого течения болезни с целью «загнать» ЦМAT в пассивную –
- Пациентам назначают Ганцикловир, ATалацикловир, Фамцикловир.
The duration of the use of drugs is determined by the doctor. AT среднем
Antiviral therapy lasts 10-21 days.
- Used interferons, normal human immunoglobulin (25
ml. 2800-3000 rub.), Specific anticytomegalovirus
иммуноглобулин (НеоЦитотект 10 ml.), который содержит антитела к
ЦМAT. The course of treatment is 10 days.
- Therapy with multivitamin complexes is indicated at any age.
regardless of the form of the disease and the patient’s condition.
Laboratory detected cytomegalovirus during pregnancy
requires treatment in case of reactivation of a latent infection and
primary infection in the acute phase. Apply antiviral
drugs and immunotherapy. Conduct three treatments
human normal immunoglobulin in I, II and III
Самым безопасным и эффективным противовирусным средством при ЦМAT
infections today are glycyrrhizic acid, extracted from
licorice root. ATыявление высокой антивирусной активности природного
component – the latest achievement of scientific research. On
today is a preparation based on glycyrrhizic acid
exists for topical use only – Epigen intim (gel 500
rub, spray 600-1200 rub), as well as Epigen labial cream.
Clinical trials of the vaccine with recombinant gene
cytomegalovirus that have already proven their effectiveness on
practice. ATведение сыворотки беременным и новорожденным поможет
to resist the virus through the formation of artificial immunity,
that will soften the course of the disease.
AT случае asymptomaticго течения ЦМAT treatment препаратами с
antiviral activity is not necessary, however
immunodeficiency and pregnancy.