ji antibodies. Deciphering the results of the IgM analysis for cytomegalovirus. Serological methods for the diagnosis of cytomegalovirus

Antibodies, or immunoglobulins, are the most important element of the immune system. They react with a pathological object that penetrates into the blood, bind and neutralize it.

Indications for testing

An immunoglobulin test allows a diagnosis to be made with a high degree of accuracy. This virtually eliminates the possibility of diagnostic errors. In addition, the analysis allows us to assume not only an active pathological process, but also the carriage of the pathogen, and in autoimmune pathologies it allows us to judge the severity of the disease.

Usually, when testing for antibodies, both types are determined, then the diagnostic value of the examination is the highest. The method can be used both for complex diagnostics and for monitoring the patient's condition, or as the main means of making a diagnosis.

Indications for analysis are:

• complex diagnostics:
  • urinary infections;
  • viral hepatitis;
  • and AIDS;
• the main diagnosis is the presence of autoimmune antibodies:
  • systemic lupus erythematosus;
  • autoimmune thyroiditis;
  • diabetes;
  • Rhesus conflict in pregnant women.

In all of these diseases, as well as many others, monitoring the level of antibodies allows you to determine the prognosis of the disease. Reducing the level of IgG to normal and the disappearance of IgM is an indicator of recovery. If a certain disease is characterized by non-sterile immunity, then the rate of recovery is a decrease, and then the disappearance of immunoglobulins, which indicates the termination of contact with the pathogen.

In chronic diseases - oncological, allergic and autoimmune lesions, the control of immunoglobulins is vital, its results reflect the effectiveness of treatment and are important when there is a need to adjust the therapy regimen.

Before complex surgical interventions, especially organ transplants, Ig testing is critical. With a high level of protective proteins (primarily IgM), the operation can be canceled, since there is a high risk of developing a transplant rejection reaction - the most formidable complication of any organ transplant.

During pregnancy, serological tests make it possible to notice the development of autoimmune pathologies in time, primarily the Rhesus conflict.

Rh conflict is a pathology that occurs when the Rh factor does not match between the mother and the fetus (negative in the mother, positive in the child).

In this case, the woman's body perceives the fetal Rh factor as a foreign protein and produces antibodies that can lead to miscarriage. If this condition is recognized in time, it can be avoided.

Also, tests for immunoglobulins are prescribed in the diagnosis of infertility in men and women, as well as habitual miscarriage. The causes of this pathology may be autoimmune disorders that are detected by an examination for antibodies. Also, this analysis is prescribed in cases where there are pathologies of the endocrine system, kidneys or skin to identify a possible autoimmune pathology.

Preparation and essence of the study

An antibody test is always prescribed by a doctor if there are indications for an examination. For the patient, the procedure is a blood sampling from a vein. Preparation is quite simple - you need to follow a diet and limit physical activity during the day. If the patient is taking any medications, the doctor should be informed. In some cases, the analysis may be prescribed only after the completion of the course of treatment. Women can donate blood in any phase of the menstrual cycle, but it is advisable not to do this in the first days of menstruation. Blood must be donated on an empty stomach.

The method by which the concentration of antibodies is determined is called. The analysis requires blood from a patient's vein, a purified antigen solution, and a dye. For analysis, a special plate with several wells is used. In one of them, blood and antigen solution are mixed, in the other (control) only blood remains.

The dye is added to both wells.

When an antigen and an antibody interact, immune complexes are formed, and the dye stains them. The blood in the control well retains its color. If the blood in the well with the antigen is stained, the reaction is considered positive, the amount of antibodies can be determined by the intensity of the color (usually indicated by a “+” sign in the form, there can be from one to four). If the blood in both wells has not changed, the reaction is negative, the patient does not have antibodies to the desired disease.

The advantage of the method is that ELISA has a very high sensitivity and absolute specificity. The likelihood of a false positive diagnosis or misdiagnosis of one disease instead of another is minimal. A false negative result is possible in cases where the concentration of Ig is extremely low.

The reaction itself takes less than an hour, but diagnostic laboratories can be very busy, so patients are given 2-3 business days to issue results.

Deciphering the results

There are several test systems for determining immunoglobulins in the blood, so the results of the analysis from different laboratories may vary markedly. Therefore, you need to donate blood in the laboratory recommended by the doctor, if you have to be examined several times, you need to do this in the same laboratory, then the results will be most accurate.

The normal content of IgM in adults is 0.33-2.4 g / l, in women its content is slightly higher than in men. For children older than a year, a high concentration of this type of immunoglobulin is characteristic, especially for girls. In infancy, on the contrary, there is a lack of them, the differences between the norm for boys and girls are minimal. The norm of IgG is from 5.4 to 16.3 g / l, regardless of gender. This concentration is established in children at 2 years of age and persists with slight fluctuations throughout life.

For convenience, in modern forms there is a “norm” column, which indicates the normal value, and the doctor has the opportunity to compare the results. The above norms relate to immunoglobulins to the antigens of pathogens, to which non-sterile immunity is formed. In most helminthic diseases and genitourinary infections, immunity is non-sterile, and the presence of antibodies means the presence of the pathogen. Rh antibodies and autoimmune complexes should not normally be present. Their presence already means a disease.

The detection of IgG and IgM can tell a lot about the patient's immune status. This is one of the most frequent and important types of blood tests, which is prescribed for the diagnosis of a wide range of diseases.

The cost of such a procedure is high for most patients - from 300 to 2000 rubles, depending on the desired antigen. The cheapest analysis is the determination of anti-Rhesus-Ig, the most expensive is a comprehensive examination when planning a pregnancy. Blood sampling is paid separately.

The question of the norm of the content of IgG immunoglobulins to cytomegalovirus in the blood serum worries the majority of women planning a pregnancy or already bearing a child, as well as many young mothers. The increased attention to the virus in recent years is explained by its wide prevalence in the human population and the negative impact on the development of the fetus when the expectant mother is infected during pregnancy. In addition, cytomegalovirus infection (CMVI) is often associated with the development of atypical pneumonia in children, delayed physical and mental development, visual and hearing impairment.

CMVI is also of particular importance in organ transplantation and the treatment of immunocompromised patients.

Determining the level of IgG antibodies in the blood is the most common method for detecting cytomegalovirus infection and determining its status in the body. It is important to understand that the content of class G immunoglobulins in blood serum is expressed in relative units, which may vary depending on the location of the laboratory performing the analysis and the equipment used.

Accordingly, the numerical expression of the norm may look different. It is generally accepted that the very presence of IgG in the body of adults is normal, since more than 90% of the world's population are carriers of the virus. In this case, the production of antibodies indicates a normal reaction of the immune system to infection with a virus.

The detection of IgG antibodies in the blood of a patient has a certain diagnostic value: in itself, this is not an indication for the appointment of treatment, but only indicates the presence of immunity to infection. That is, the body once already encountered a virus and produces (for life) the corresponding antibodies.

What is the norm

The amount of antibodies to cytomegalovirus is usually expressed as a titer. The titer is the highest dilution of the patient's blood serum at which a positive reaction is observed. As a rule, in immunological studies, serum dilutions are prepared in multiples of two (1:2, 1:4, and so on). The titer does not reflect the exact number of immunoglobulin molecules in the blood, but gives an idea of ​​their total activity. This greatly speeds up the delivery of analysis results.

There is no norm for the titer value, since the amount of antibodies synthesized by an individual human body can vary depending on the general condition of the body, lifestyle, immune system activity, the presence or absence of chronic infections, and metabolic characteristics.

To interpret the results of the analysis for antibodies to cytomegalovirus, the concept of "diagnostic titer" is used. This is a certain dilution of blood serum, a positive result in which is considered an indicator of the presence of a virus in the body. For cytomegalovirus infection, the diagnostic titer is a dilution of 1:100.

Currently, the arsenal of immunological laboratories has several dozen test systems for the detection of antibodies to cytomegalovirus. All of them have different sensitivity and consist of different components. General is only the principle of research - enzyme immunoassay (ELISA).

The results of ELISA are taken into account according to the degree of staining (optical density) of the solution to which the patient's serum is added. The optical density (OD) of the analyzed sample is compared with obviously positive and negative samples - controls.

As a rule, to speed up the study, each test system is configured to work with one dilution of blood serum specified in the instructions for the test system. This eliminates the need to prepare multiple dilutions, and the analysis procedure is reduced by several hours.

There is currently no single diagnostic titer for all laboratories. For each test system, the manufacturer specifies the so-called reference values ​​at which the result is considered positive or negative.

That is why in the forms of the results of the analysis for antibodies to cytomegalovirus you can find the following: the norm is 0.3, the result is 0.8 (positive). In this case, the norm means the optical density of the control sample, which does not contain antibodies to the virus.

Learn more about IgG and IgM immunoglobulins

With the penetration of cytomegalovirus into the body, the nonspecific cellular link of immunity is initially activated - phagocytic cells (macrophages and neutrophils). They capture and neutralize the virus. The protein components of the virus envelope appear on the membranes of macrophages. This serves as a signal for a special group of T-lymphocytes - helpers, which secrete specific stimulators of B-lymphocytes. Under the influence of a stimulator, B-lymphocytes begin an active synthesis of immunoglobulins.

Immunoglobulins (antibodies) are soluble proteins that circulate in the blood and interstitial tissue fluid, and are also present on the surface of B-lymphocytes. They provide the most effective and rapid protection against the multiplication of infectious agents in the body, are responsible for lifelong immunity to certain infections and are involved in the development of protective inflammatory and allergic reactions.

There are five classes of antibodies - IgA, IgM, IgG, IgD, IgE. They differ from each other in structure, molecular weight, strength of binding to antigens and types of immune responses in which they take part. In antiviral protection in CMVI, immunoglobulins of classes M and G are of the greatest importance.

IgM is the first to be synthesized when the body is infected with a virus.. They appear in the blood within 1-2 weeks after the initial infection and persist from 8 to 20 weeks. The presence of these antibodies in the blood serum usually indicates a recent infection. Class M immunoglobulins can also appear during reactivation of a long-standing infection, but in much smaller quantities. In this case, it is possible to distinguish the primary infection from the reactivated one by determining the avidity of antibodies, that is, the strength of their binding to viral particles.

Immunoglobulins IgG appear in the blood serum about a month after infection with cytomegalovirus. At the beginning of the immune response, they have low avidity. 12-20 weeks after the onset of infection, avidity becomes high. IgG persist in the body for life and allow the immune system to quickly respond to increased virus activity.

The amount of synthesized immunoglobulins depends on the individual characteristics of the organism, therefore, there are no normal values ​​\u200b\u200bfor this indicator. In most people with normal immune system activity, the amount of IgG to cytomegalovirus rapidly increases during the first 4-6 weeks after the initial infection or reactivation of the infection, then gradually decreases and remains at a constant level.

Deciphering the results of the analysis

In order to independently decipher the results of the analysis for cytomegalovirus, it is necessary to compare the obtained data with the reference values ​​\u200b\u200bspecified in the answer form. These indicators can be expressed in arbitrary units (c.u., IU), optical units (r.u.), optical density indicators (OD), units per milliliter or as a titer. Examples of results and their interpretation are given in the table.

Possible options for the results of determining IgG in blood serum and their interpretation:

If the form does not contain reference values ​​or normal indicators, the laboratory must provide a transcript. Otherwise, the attending physician will not be able to determine the presence or absence of infection.

High titers of IgG do not indicate a danger to the body. Determination of only class G immunoglobulins gives an idea of ​​the possible contact of the organism with cytomegalovirus in the past, but does not allow to establish the activity of the virus. Thus, if IgG is detected in the patient's blood serum, this only indicates the carriage of the virus.

To determine the stage of infection, the level of IgG avidity should be assessed. Low avid antibodies always indicate a fresh primary infection, high avid antibodies circulate in the blood of carriers of the virus all their lives. When reactivating a long-standing chronic infection, highly avid IgGs are also detected.

A complete picture of the picture can be obtained by a combination of immunological and molecular biological diagnostic methods: ELISA for antibodies of classes M and G to cytomegalovirus, IgG avidity, polymerase chain reaction (PCR) for the presence of virus DNA in blood, saliva and urine.

Norm of IgG antibodies to cytomegalovirus in pregnant women

Analysis for the presence of IgG to cytomegalovirus is mandatory when examining pregnant women. It has been proven that the primary infection of a future mother can lead to spontaneous abortion, the development of severe congenital anomalies in the fetus, or long-term complications of the infection.

In this regard, one should not neglect the mandatory analyzes and take them on time. It is advisable to take an analysis for cytomegalovirus before 10-12 weeks of pregnancy. If a re-examination is recommended, it must be completed strictly within the specified time frame.

The ideal option is to determine antibodies to cytomegalovirus when planning pregnancy and in each of its trimesters. This allows you to exclude or detect in time the primary infection or reactivation of a long-standing infection during pregnancy.

If before pregnancy a woman did not have antibodies to cytomegalovirus, she is at risk. When infected with the virus during pregnancy, the probability of intrauterine infection of the fetus reaches 50%. It is recommended to limit contact with children under the age of 6 and carefully observe the rules of personal hygiene.

If class G antibodies with low avidity and / or IgM are detected before pregnancy, the diagnosis is “recent primary infection”. It is recommended to postpone conception for 2-3 months due to the high probability of infection of the fetus.

If antibodies to cytomegalovirus were not detected in a woman before pregnancy, and IgG was detected in the blood during pregnancy, this also indicates a primary infection. It is recommended to consult an infectious disease specialist and carefully monitor the health of the newborn, since the possibility of a congenital infection is not excluded.

In practice, they are most often limited to a single determination of IgG and IgM in the first trimester of pregnancy, when the risk to the fetus is maximum. Analysis of immunoglobulins M is necessary to establish the timing of infection. In the absence of the possibility of its implementation, the determination of IgG avidity is required.

Identification of only class G immunoglobulins does not give a complete picture of the duration of infection and the activity of the infectious process. The most accurate results can be obtained by setting up all three analysis options: the determination of IgG, IgM and IgG avidity.

Interpretation of the results of the analysis for the determination of antibodies to cytomegalovirus in pregnant women and the prognosis for the child:

When obtaining questionable results or in the case of immunodeficiency conditions, confirmation of the diagnosis by PCR (polymerase chain reaction) is recommended.

The possibility of superinfection in the presence of class G immunoglobulins in the blood

As a rule, the immune system of adults and children over 5-6 years of age effectively suppresses the activity of cytomegalovirus in the body, and the infection proceeds without clinical manifestations.

However, this virus is characterized by great genetic variability, which leads to frequent changes in the structure of its proteins. The human immune system has a high specificity, that is, in response to the introduction of the virus, antibodies are formed that have an affinity for a certain structure of its components. With a significant modification of viral proteins, the strength of the immune response decreases, therefore, in rare cases, carriers of cytomegalovirus may have a primary infection caused by an altered version of the virus.

It should be remembered that with a positive result for cytomegalovirus, you should not immediately sound the alarm. Asymptomatic infection does not pose a threat to the adult body and does not require treatment. Pregnant women and women planning a pregnancy, as well as persons with clinical manifestations of CMVI, should consult an infectious disease specialist.

Doctor's explanations about IgG and IgM to cytomegalovirus

Antibodies are called a special type of proteins - immunoglobulins (international name - Ig). They are divided into five classes and are designated by Latin letters (IgM, IgG, IgA, IgE, IgD). Each class of antibodies refers to a different stage and dynamics of the disease, which is an important factor in the diagnosis and treatment of various diseases. Given these factors, the doctor can predict risks, prescribe diagnostic tests and treat.

Definition

Quantity IgM antibodies may increase from the onset of the disease and peak around the end of 1-4 weeks, depending on the nature of the infection, and then begin to decline over several months. In some infections, the presence of a large number of IgM antibodies may increase. In such cases, an analysis of the avidity of these antibodies is prescribed. The rapid appearance of IgM antibodies most often indicates the onset of an acute illness.

IgG antibodies appear in the body somewhat later (about two weeks after the onset of the disease), their increase in levels is slower than in the case of IgM, and their gradual decline is also much slower (in some infections, they may even persist throughout life). An increase in IgG antibodies indicates that the person is already familiar with this infection.

Comparison

An analysis for the avidity of antibodies is carried out before pregnancy planning, as well as in certain diseases to exclude infection. Avidity is a measure of the strength of the bonds between an antigen and an antibody.

Low-avid antibodies are most often observed during the initial infection with an infection, high-avid antibodies appear in the case of a past infection or reinfection.

Findings site

1. Antibodies IgG and IgM belong to a different class of immunoglobulins and are responsible for the presence of infection in the human body. Their various indicators together show a specific stage and severity of the process.
2. An increase in IgM antibodies in the body indicates the onset of an acute illness. An increase in IgG antibodies in the body indicates that this infection is already familiar to him.

(CMV) is one of the causative agents of herpes infection. Detection of immunoglobulins (Ig) in the blood allows you to determine the stage of development of the disease, the severity of the infectious process and the state of immunity. The class of immunoglobulins G indicates immunological memory - the penetration of cytomegalovirus into the body, the carriage of infection, the formation of stable immunity. For the correct diagnosis of the disease, it is carried out in parallel with the indicators of the concentration in the blood of Ig M and the avidity index. Next, we will consider in detail what this means - cytomegalovirus Ig G is positive.

When infectious agents, including viruses, enter the body, the immune system produces protective protein substances - antibodies or immunoglobulins. They bind to pathogenic agents, block their reproduction, cause death, and remove them from the body. For each bacterium or virus, specific immunoglobulins are synthesized that are active against only these pathogens. CMV, when it enters the body, penetrates the cells of the nervous and immune systems, the cells of the salivary glands and remains in them in a latent state. This is the carrier phase of the virus. With a significant decrease in immunity, an exacerbation of the infection occurs.

Antibodies come in different classes: A, M, D, E, G. When cytomegalovirus infection is detected, immunoglobulins of class M and G (Ig M, Ig G) are of diagnostic value.

Antibodies come in different classes: A, M, D, E, G. When cytomegalovirus infection is detected, immunoglobulins of class M and G (Ig M, Ig G) are of diagnostic value. Immunoglobulins M are produced from the first days of infection penetration into the body and during exacerbation of the disease. Ig M have large sizes of protein molecules, neutralize viruses, lead to recovery. Ig G are smaller in size, are synthesized 7-14 days after the onset of the disease and are produced in small quantities throughout a person's life. These antibodies are an indicator of immunological memory for CMV and keep the virus under control, preventing it from multiplying and infecting new host cells. With re-infection or exacerbation of the infection, they are involved in the rapid neutralization of viruses.

Evaluation of the results of the analysis for the detection of class G immunoglobulins

Antibodies in the blood are detected using immunological laboratory diagnostics - enzyme immunoassay (ELISA). To determine the stage of the disease and the level of immunity to cytomegalovirus, the presence of Ig G, Ig M, in the blood or other biological fluid is assessed. The analysis only for the content of class G immunoglobulins does not have sufficient diagnostic value and is not prescribed separately.

The structure of the immunoglobulin G (Ig G) molecule.

Possible results of ELISA for the determination of antibodies to CMV.

1. Ig M - negative, Ig G - negative. It means that the body has never encountered, there is no stable immunity, there is a high probability of infection with CMV.
2. Ig M is positive, Ig G is negative. It means that the primary penetration of the infection into the body, the acute phase of the disease, stable immunity has not yet been developed.
3. Ig M - positive, Ig G - positive. It means an exacerbation of the disease against the background of a chronic course or carriage, which is associated with a sharp inhibition of the body's defenses.
4. Ig M - negative, Ig G - positive. It means the phase of recovery after a primary infection or exacerbation of the disease, the period of the chronic course of the disease, carriage, a strong immunity to CMV has been developed.

For the correct interpretation of the stage of the disease, the presence of Ig G and Ig M in the blood is carried out along with the determination of the value of the Ig G avidity index - the ability of antibodies to bind to the virus. At the beginning of the disease, this indicator is low, as the infectious process develops, the avidity index increases.

Evaluation of the results of the Ig G avidity index.

1. Avidity index less than 50% - low ability to bind class G immunoglobulins with cytomegalovirus, early phase of the acute period of the disease.
2. An avidity index of 50-60% is a questionable result, the analysis must be repeated after 10-14 days.
3. Avidity index over 60% - high ability to bind class G immunoglobulins to the virus, late phase of the acute period, recovery, carriage, chronic course of the disease.
4. Avidity index 0% - there is no cytomegalovirus infection in the body.

When determining Ig G in blood or other biological fluid, the avidity index cannot be equal to 0%.

The role of the determination of class G immunoglobulins

Primary infection and carriage of CMV at a normal level of immunity is asymptomatic without appreciable harm to health. Sometimes, during infection and exacerbation of the infection, a mononucleosis syndrome occurs, the clinical signs of which are similar to the manifestations of a cold: weakness, headache, subfebrile temperature (37-37.6), tonsillitis, enlargement of regional lymph nodes. In most cases, cytomegalovirus infection goes unnoticed, diagnostics for the detection of antibodies is not carried out.

For a contingent of people who are at risk for developing severe forms of the disease, the detection of Ig G in the blood is of great importance. In these patients, CMV affects the brain (meningoencephalitis), liver (hepatitis), kidneys (nephritis), eyes (retinitis), lungs (pneumonia), which can be fatal. During pregnancy, infection or exacerbation of infection leads to intrauterine death of the fetus, the formation of malformations, prenatal cytomegalovirus infection. An assessment of the level of class G antibodies is carried out to prescribe antiviral therapy and determine the prognosis of the disease.

At-risk groups:

• congenital immunodeficiencies;
• acquired immunodeficiencies;
• artificial immunodeficiencies (glucocorticoids, chemotherapy, radiation therapy);
• transplantation of internal organs;
• severe chronic diseases;
• intrauterine development of the fetus.

An analysis for the determination of Ig G and Ig M in blood or other biological fluids is prescribed regularly for early detection of primary infection and exacerbation of the disease.

Risk group - patients with immunodeficiency conditions

A sharp decrease in the body's defenses in immunodeficiencies leads to a decrease in the synthesis of class G immunoglobulins, which occurs constantly after the primary infection with CMV. Against this background, the virus passes from a latent ("sleeping") state into an active phase of life - it destroys the cells of the salivary glands, the nervous and immune systems, multiplies, affects the tissues of the brain and internal organs. When the immune system is depressed, severe forms of the disease develop.

To control the activity of cytomegalovirus in the body, patients with immunodeficiency conditions are prescribed routine blood tests for Ig G, Ig G, Ig M avidity index. Patients receiving immunosuppressive therapy - cancer treatment, autoimmune diseases, after organ transplantation, immunological diagnostics are carried out for timely appointment of antiviral drugs and prevention of disease progression.

Risk group - fetus during fetal development

At the stage of pregnancy planning, in the first and second half of gestation, a woman needs to take a blood test for the content of antibodies to CMV. Assessment of immunological memory to cytomegalovirus infection determines the risks of intrauterine infection and fetal death.

The main risk group is people with immunodeficiency conditions (HIV, AIDS, the effects of chemotherapy).

1. Ig G is positive, avidity index is more than 60%, Ig M is negative. Means that . The mother's body has developed immunity to cytomegalovirus infection. Exacerbation of the disease is unlikely, in most cases it is safe for the fetus.
2. Ig G is negative, avidity index is 0%, Ig M is negative. Means that there is no immunity to CMV in the mother's body. There is a risk of primary infection with cytomegalovirus infection during pregnancy. A woman needs to adhere to preventive measures to prevent infection and donate blood for antibodies to CMV.
3. Ig G - positive, avidity index over 60%, Ig M - positive. It means that against the background of a decrease in immunity, an exacerbation of the infection occurred. It is necessary to monitor the development of the disease and the condition of the fetus. In most cases, the intrauterine development of the child proceeds normally, since the mother has an immunological memory for cytomegalovirus.
4. Ig G is negative, avidity index is less than 50%, Ig M is positive. The result of the analysis means a high risk of intrauterine infection of the fetus and the absence of immunity in the mother. When infected in the first 12 weeks of pregnancy, malformations are formed or intrauterine death of the child occurs. In the second half of pregnancy, prenatal cytomegalovirus infection of the fetus develops. Depending on the severity of the infection, observation, antiviral therapy, medical abortion, or premature delivery are prescribed.

The evaluation of the diagnostic results for the detection of antibodies to CMV is carried out by a doctor. When establishing the severity of the course of the disease and for prescribing therapy, the clinical picture, anamnesis of the disease, the presence of concomitant pathology, and the results of other diagnostic methods are taken into account.

The presence of class G immunoglobulins in the blood and other biological fluids indicates a past cytomegalovirus infection and the formation of stable immunity. In people with a healthy immune system, this is an indicator of protection against re-infection and exacerbation of the disease.

More on this topic:

If the blood test results say that the test for class g antibodies is positive, then misunderstanding often arises. What does this mean and what are the next steps? ? What is herpes type 1 and 2? Is it possible to get rid of it? To answer these questions, you need to delve a little into the essence of the terms and understand what kind of ailment it is.

What is herpes virus type 1 and 2?

It is one of the most common human infections. There are 8 types of herpes in total. Types 1 and 2 are the most common and are called herpes simplex viruses (HSV). In medicine, the name is used, which is an abbreviation of the English term Herpes Simplex Virus 1 and 2: HSV-1 and HSV-2. The degree of infection of humanity with the virus of the first type is up to 85%, antibodies to HSV of the second type are found in approximately 20% of the world's population. Not all infected people show symptoms.

Infection with herpes simplex is possible in several ways: HSV-1 is transmitted by airborne droplets and contact (through the skin, especially when in contact with blisters) ways, you can become infected with HSV-2 through sexual contact with an infected partner. Also, the virus can be transmitted from mother to child (during gestation and childbirth).

Herpes HSV-1 usually manifests itself on the surface of the skin and mucous membranes in the mouth and nose, most often on the border of the lips. Symptoms vary. In adults, this type of herpes is manifested by blistering rashes, sometimes it can be a single vesicle on the lip, but usually there are several of them, while they are combined into a continuous focus, sometimes several such foci appear.

Bubbles burst as they develop, forming wounds. The whole process is accompanied by itching and irritation. In the people, this type of virus is often called the "cold". HSV-2 is most often localized on the skin in the genital area and has the appearance of rashes similar to type 1, such localization determines its name - genital herpes.

Once in the body, the herpes virus can exist in a latent form for a long time; in an adult, it lives in the nerve nodes without damaging the cells. Stress, exhaustion, diseases that cause a decrease in immunity can activate the virus. Among the factors contributing to the development of herpes, a special place is occupied by organ transplantation, because the immunity of the recipient in these cases is suppressed in the process of engraftment of the organ.

In most cases, herpes simplex is not very dangerous to health, but it can cause serious diseases, such as encephalitis.

Men with HSV-2 infection may develop prostatitis or herpetic urethritis. Women are at risk of developing vulvovaginitis or cervicitis.

What immunoglobulins are being tested?

Diagnosis of herpes is important in the following cases:

• pregnancy planning (doctors recommend that both partners undergo diagnostics);
• state of immune deficiency;
• examination before organ transplantation;
• if there are signs of intrauterine infection or fetoplacental insufficiency;
• study of various risk groups;
• differential diagnosis for suspected urogenital infections;
• detection of any blisters on the skin (to exclude dangerous pathologies).

After this infection enters the body, the immune system produces antibodies to the herpes virus, this is a special type of protein in blood cells, they are called immunoglobulins and are denoted by Latin letters ig. There are 5 types (or classes) of immunoglobulins: IgM, IgG, IgA, IgE, IgD. Each of them in a special way characterizes the disease.

The IgA class usually make up about 15% of all immunoglobulins, they are produced in the mucous membranes, are present in breast milk and saliva. These antibodies are the first to take over the protection of the body when exposed to viruses, toxins and other pathogenic factors.

Immunoglobulins IgD are produced in the fetus during gestation, only minor traces are found in adults, this class has no clinical significance. The IgE type is present in the blood in very small amounts and may indicate a tendency to allergies. The most important in the diagnosis of herpes simplex are 2 classes: IgG (anti hsv IgG), these are the most numerous antibodies (about 75%), and IgM (anti hsv IgM), they are about 10%.

IgM is the first to appear in the blood after infection, after a few days IgG is detected. Normal (reference) values ​​for anti hsv types 1 and 2 are usually indicated on the form, while we must not forget that reference values ​​\u200b\u200bare different in different laboratories.

If the level of antibodies is below the threshold value, then they speak of a negative result (seronegativity), if it is higher, a positive result (seropositivity).

An increase in IgM antibodies in the body indicates the onset of an acute illness. After recovery, a certain amount of IgG remains in a person forever (IgG is elevated), the presence of these antibodies does not guarantee protection against re-infection. If the analysis shows that IgG antibodies are elevated, then this infection is already familiar to the body, that is, IgG serves as a marker of infection of the body with the herpes simplex virus. Immunoglobulins IgM can be considered a marker of the primary penetration of infection into the body.

Diagnostic methods

Venous or capillary blood can be used as a material for research. possible in two different ways:

• ELISA - enzyme immunoassay;
• PCR - polymerase chain reaction.

The difference between these methods is that ELISA allows you to detect antibodies to the virus, and PCR - the virus itself (its DNA). At the same time, PCR finds the pathogen only in those tissues that were provided for analysis, i.e., it determines the defeat of only a specific organ. The ELISA method allows you to determine the prevalence of infection throughout the body, because immunoglobulins, together with blood, are present in all organs and tissues.

To detect the herpes simplex virus, it is preferable to use the ELISA method. When the description of the test results contains the phrases - IgG positive, we can confidently say that the study was carried out by ELISA. At the same time, PCR is also very actively used; it can be used to determine a specific type of virus (1 or 2) in cases where it is not possible to establish the type by localization.

Interpretation of the received data

Analysis data is not always 100% reliable interpretation. For example, immediately after infection, a sufficient amount of antibodies does not have time to develop, the result in this case may turn out to be false negative. If you want to get the most reliable conclusions, it is recommended to take an additional test for IgM and repeat the analysis for IgG (two types) after a few weeks.

In the blood of the vast majority of the world's population, IgG antibodies to the herpes simplex virus are found. Recent primary infection, as well as viral reactivation, is defined by an observed increase in lgG of approximately 30% over a two-week period of samples. When usually high levels of IgG are detected, a decrease in the number of antibodies indicates a positive trend.

Principles of treatment of viral manifestations

Before starting treatment for a herpes virus infection, you need to know:

• it is impossible to achieve complete destruction of the virus;
• there are no preventive medications;
• with the help of antibiotics, viral infections cannot be cured, viruses are immune to them;
• medical treatment of mild manifestations of the herpes virus type 1 is unjustified.

Immunity to the virus in infected individuals is temporary and incomplete, with reduced immunity usually relapsing. The herpes virus itself is capable of lowering immunity, since the increased synthesis of IgG antibodies suppresses the production of special lymphocytes that can fight pathogens. The state of human immunity significantly affects the frequency and strength of relapses.

Acyclovir is most effective in the treatment of the herpes virus. Due to the similarity of the structure of the drug with the amino acid elements of the virus, Acyclovir enters its DNA, inhibits its activity and blocks the synthesis of new chains. At the same time, the substance acts strictly selectively, suppressing only viral DNA; its effect practically does not extend to the replication of human cell DNA.

The use of the drug in accordance with the instructions allows you to speed up recovery by reducing the duration of clinical manifestations. Among the precautions for treatment with Acyclovir:

• pregnancy (during lactation, special care should be taken);
• hypersensitivity to the components of the drug;
• when a child is under 3 years old, you should stop taking pills;
• in case of renal insufficiency, you must first consult with your doctor, you may have to reduce the dosage;
• in the elderly, oral treatment must necessarily be accompanied by abundant fluid intake;
• avoid getting the drug on the mucous membranes of the eyes.

The course of the disease when infected with a type 2 virus is characterized by more severe symptoms. This type of herpes in pregnant women can cause miscarriage and increase the chance of miscarriage. A dramatic consequence of HSV-2 infection during pregnancy can be neonatal herpes. In men, type 2 virus is a very common cause of infertility.

Identification of this type of HSV requires a broader treatment regimen, which includes various immunomodulators. It is important to strengthen the immune system and the body's defenses, so vitamins and biostimulants are additionally prescribed. Sometimes injections of saline are indicated, so the concentration of the virus in the blood can be reduced.

The occurrence of relapses

After suppression of the active stage, the virus remains in the nerve ganglia, where it exists latently, while it can not give itself away for a very long time, new viruses are not produced at this phase. The causes of relapses are not exactly established, but there are known triggers:

• changes in the immune system of women before menstruation sometimes provoke a relapse of HSV;
• ARVI infection, influenza and other diseases accompanied by high fever can also cause relapses;
• local lesions in the lips or eyes;
• side effects of radiation therapy;
• strong, cold wind;
• exposure to ultraviolet radiation.

Immunity to the virus is permanent, and the severity of relapses decreases over time.