What is cytomegalovirus in women. Prevention and management of patients with CMV. The main symptoms of cytomegalovirus infection

Something between a virus and a bacterium. It develops in the cells of the body, parasitizing in them and, until a certain point, being in a state of "hibernation". CMV begins to multiply actively only when the favorable conditions in the form of a sharp drop in the level of immunity. The symptoms of the disease are sluggish, the diagnosis is difficult. The fact is that the signs of CMV intersect with some colds, so the detection of the virus takes a long time and requires a series of studies, some of which are very complex. By what signs can cytomegalovirus be detected and what are the consequences of this disease?

Signs of CMV differ in representatives of different sexes and ages. This is explained by the difference in metabolism and the structure of the genital organs, as well as the features hormonal background in groups of patients. In the case of the fairer sex, the symptoms are very similar to those of respiratory diseases, so it is difficult to detect the virus even in the later stages without additional tests.

The disease begins with latent stage. There are no symptoms in 95% of cases, the microorganism "sleeps" in the cells, multiplying moderately. In this situation, the woman is a hidden carrier, but she herself does not suffer yet. As soon as the body ceases to cope with CMV on its own (by immune means), the disease begins to develop. At this point, the first signs appear:

inflammation and enlargement lymph nodes(basic first sign);
weakness;
chills;
chronic fatigue;
irritability.

Sometimes this is accompanied by pain in the joints and aching muscles. There are no sexual characteristics yet, they will appear later. The subtlety of this period lies in the fact that treatment at this time is usually the most effective and fastest, but rare woman goes to the hospital for comprehensive survey when such symptoms occur. So it turns out that therapy begins only when CMV enters the active phase.

Further signs of the disease are rarely detected by the patient herself, they are detected by gynecological examination:

vaginitis;
endometritis;
oophoritis;
cervical erosion.

The patient, of course, can herself identify these ailments, which are a consequence of CMV, but only by indirect signs such as vaginal discharge and pain during urination and intercourse. The diseases considered cannot be called full-fledged signs of “our” virus, these are more consequences, but cytomegalovirus can be detected from them.

Diagnostics

The use of one diagnostic method is unlikely to bring a completely reliable result - there are many varieties of CMV, each of them has its own characteristic features DNA. For diagnosis, it is necessary to use the patient's biomaterial, a simple collection of anamnesis does not bring results. As a sample, doctors use:

saliva
urine;
blood;
breast milk;
discharge from the genitals;
lung secret.

In some cases, tissue obtained from a biopsy is used. It is done rarely and only in cases where there is a suspicion of oncology. In other situations, a biopsy is excluded because of its danger to the patient's body.

Blood smear microscopy is available to every patient, it is inexpensive and can be done quickly. But the accuracy of this method does not exceed 70%, so it is impossible to be limited only to these data in the diagnosis of CMV.

The first thing the doctor advises the patient to do:

Get tested for antibodies to CMV. Moreover, if IgG antibodies are detected, then the person is infected with the virus, but active phase no illness is observed, the microorganism sits quietly in its cell, not manifesting itself in any way. It cannot be said that this is good, but almost half of the world's population is carriers of this microbe, and the presence of antibodies indicates that the body is fighting, and successfully, it has immunity to CMV.
CMV diagnostic titer (IgG value), at which the patient can be considered sick, is 1:100. If the value is less than 60, then doctors do not attach any importance to it, such an indicator can only testify to a previously transferred disease. If the titer value exceeds 200, then we can talk about clinically developing form sickness is a bad sign. But there is no need to declare a panic, the presence of an infection in the blood does not always pose a danger to a woman, much depends on her state of health and the chosen therapeutic strategy.

In addition to the study of antibodies to CMV, doctors use the following ways diagnostics:

PCR. Allows you to identify the DNA of an infectious agent, but does not differ in high accuracy. However, in most cases, these results are enough to choose the path of treatment.
Bioseeding. In an artificial environment, specialists grow a sample of the virus strain, which is studied in detail. The most accurate, but also the most expensive method.
Virus isolation. Comparable in accuracy with bioseeding, the same amount of time is spent, but it costs somewhat cheaper (not in all clinics).

The sooner the diagnosis is started, the more likely it is to suppress an unpleasant disease.

Treatment

It is impossible to completely “remove” a virus from the body; medicine has not yet developed medicines that can kill the entire, so to speak, colony of microorganisms. Modern drugs can only limit the activity of microbes, reduce their ability to reproduce and transfer the disease to a latent phase. The basis of CMV therapy is the use of antibiotics:

Foxarnet;

(costs from 110 to 3,705 rubles)

Ganciclovir (about 1,700 rubles);
Valganciclovir (about 30,000 rubles).

It is impossible to choose a drug on your own, and even more so, it is impossible to determine the regimen for its administration. AT best case such an approach to treatment simply will not bring results.

In addition to taking antibacterial drugs, the ability of the immune system to resist infection should be increased. For this, doctors prescribe vitamin complexes and immunomodulators:

B vitamins;
magnesium;
antioxidants.

Also, neuroprotectors will not interfere, especially if we are talking on the fight against CMV late stage when the infection affects the central nervous system and other vital important systems organism.

Do not stay away and folk treatment virus. The most commonly used herbal decoctions are:

chamomile;
lemon balm;
juniper;
wild rose;
licorice root.

It is easy to get them, such fees are sold in many pharmacies. These folk remedies not only suppress the activity of the virus, but also strengthen the immune system. Without developed defensive forces the body, the fight against CMV is practically meaningless, because medicines only help in the fight against microbes, but do not provide it with a 100% guarantee, regardless of the patient's lifestyle and general state of health.

Danger and complications of CMV

For women, CMV is especially dangerous. The reason for this lies in the structural features of the reproductive system. Over time, the virus causes an inflammatory process in the uterus, gonads, ovaries, etc. By the way, this provokes odorous vaginal discharge, which is an additional symptom of the disease. If you do not take urgent measures, then the disease will cover the entire body, hitting:

intestines;
heart and blood vessels;
eyes and organs of hearing.

As for the birth of a child, a woman can relax a little. If CMV in men almost inevitably affects the quality of sperm, which can lead to deformities in the unborn baby, then the “contagious” mother transmits the infection to the fetus only in 20-25% of cases. Moreover, if the disease is cured in time, then unpleasant consequences CMV can be easily avoided.

Launched cytomegalovirus can lead to infertility. This happens only in the case of a complete lack of therapy and very weak immunity. Also associated diseases increase the risks, for example, AIDS, oncology and problems with genitourinary system.

Prevention of CMV

Remember, above we talked about the low probability of transmission of infection from mother to fetus? So, if this does happen, the consequences will be disastrous, especially for the unborn child. The conclusion is simple - you need to be regularly examined during pregnancy, and if CMV is detected, do not refuse treatment. But not only the period of bearing a child is dangerous, preventive measures must be carried out constantly:

Avoid unprotected sex;
regularly visit the shower and wash your hands, especially before eating and after contact with contaminated objects and surfaces;
go in for sports;
set the correct daily routine;
add more foods rich in vitamins to the diet, for example, vegetables and fruits (this is necessary to strengthen immunity);
do not use someone else's linen and dirty kitchen utensils.

Compliance with these simple rules can really save from CMV. Those women who do not avoid prevention very rarely encounter the virus.

You can also get acquainted with the opinion of a specialist by watching this video, what is CMV in women, the main causes and symptoms, and what are the methods of treatment.

The definition of "cytomegalovirus" refers to a disease caused by cytomegalovirus infection. Statistics show the widespread prevalence of the disease, which is confirmed by data on 99% of infected patients of both sexes over the age of 50 years. Cytomegalovirus in women is most often detected during a routine examination during pregnancy. Consider the main symptoms of various forms of the disease, as well as whether treatment of cytomegalovirus is always required.

What is cytomegalovirus

Given the rather low contagiousness of cytomegalovirus, infection requires a combination of several contributing factors: prolonged direct contact with the carrier, the presence of damage to the integrity skin and mucous membranes, decreased immunity as a result of overheating, hypothermia or diseases. The disease belongs to anthroponoses, that is, only a person is the source of infection. CMV infection can occur in the following ways:

airborne. The virus is transmitted with saliva, sputum or tears of the patient, and the place of its introduction is the mucous membranes upper division respiratory tract of a healthy person;
contact-household. Transmission is carried out through household items used by the virus carrier, the entrance gate in this case is the skin and mucous membranes;
oral. The path of transmission of the pathogen to the oral mucosa occurs through breast milk, unwashed hands or infected food;
through the placenta. Infection of the child occurs during pregnancy or childbirth, subject to a decrease immune protection mothers;
through the blood of a donor, poorly processed medical instruments, during organ transplantation. Patients who require frequent blood transfusions or organ transplants are very vulnerable to infection due to the body's immunosuppressive state;
sexually. This is the most common route of infection that occurs during traditional or non-traditional unprotected intercourse. Cytomegalovirus is found in semen, vaginal discharge, cervical mucus, rectal mucosa and in the saliva of an infected partner.

How are the symptoms of cytomegalovirus in women

Symptoms of cytomegalovirus in women will appear depending on the form of the disease. The disease begins with an incubation period of 20-60 days. At this time, the pathogen actively multiplies in the cells, and there are no signs of the disease.

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Then begins the period of the acute phase lasting 4-6 weeks. If the woman's immunity is not weakened, then no symptoms of the disease will be observed. In some cases, a woman may be disturbed by signs resembling a flu-like condition: a slight increase in temperature to 37.1 ° C, weakness, slight malaise.

At the end of the acute phase, the disease takes a chronic form, remains for life, and symptoms in women appear only against the background of a decrease in immunity. The formed latent carriage of cytomegalovirus in women is dangerous because future pregnancies can end in miscarriage or stillbirth. Treatment becomes more difficult.

What is accompanied by cytomegalovirus infection in women with reduced immunity

The weakening of the immune system leads to the development infectious process in active form. The disease manifests itself in two variants - generalized and mononucleosis-like, as can be seen in the photo on our website.

The mononucleosis-like form is similar to infectious mononucleosis due to the increase in all groups of lymph nodes up to 0.5-3 cm. The increase in lymph nodes is accompanied by their soreness, but their consistency remains elastic. At first, the cervical group will increase, then the lymph nodes under the lower jaw, in the axillary and inguinal region. In addition to this symptom, the woman is worried about signs of intoxication (weakness, headache), and the examination will reveal an enlarged liver. Data from laboratory blood tests will indicate an increase in the number of leukocytes and the presence of atypical mononuclear cells.

CMV is not accompanied by angina, an increase in the occipital lymph nodes and spleen, which is different from infectious mononucleosis. Also, the Paul-Bunnel reaction will be negative for cytomegalovirus. Cytomegalovirus in a generalized form is rare and severe. The infection affects the liver, lungs, retina, kidneys, salivary glands, reproductive system. The leading symptoms during generalization will be signs of damage to these organs.

Symptoms of cytomegalovirus in women with AIDS

According to statistics, 90% of women with AIDS suffer from cytomegalovirus. Activation of the pathogen occurs when CD-4 lymphocytes decrease below 50 per 1 ml. the disease proceeds in the form of pneumonia or encephalitis.

Cytomegalovirus pneumonia on the background of AIDS is characterized by diffuse bilateral inflammation lung tissue, which often leads to death. Observed lingering course with agonizing fits of coughing and shortness of breath. Encephalitis with cytomegalo viral infection manifested by encephalopathy. Its characteristic features are the development of dementia, accompanied by a deterioration in intelligence, memory and attention.

The immunodeficiency state in cytomegalovirus leads to damage to the liver, kidneys, reproductive system, spinal cord, and organs of vision. Blindness occurs in every fifth patient with AIDS, and about 70% of patients have ophthalmic problems.

Symptoms in women during pregnancy

Pregnancy is a state of increased vulnerability female body to any kind of infection. If at this time there is a primary infection with cytomegalovirus or its activation latent form, then complications can affect both the mother and her child. The result of infection is such problems as polyhydramnios, spontaneous abortion, pathology of the placenta, massive bleeding during childbirth. The most characteristic of CMV are inflammatory diseases genitourinary system - endometritis, cervicitis, vaginitis, oophoritis, cervical erosion.

A characteristic feature of diseases is their chronic or subclinical form. Nonspecific syndromes in CMV infection are joint pain, skin rashes, enlarged submandibular and parotid lymph nodes.

Perhaps the addition of bacterial flora, which makes it difficult to diagnose a pregnant woman. For a child, cytomegalovirus is dangerous because it causes multiple congenital disorders development: micro- and hydrocephalus, deafness, heart defects, dental anomalies, eye diseases.

What research methods can detect cytomegalovirus

Diagnosis of the disease is carried out based on its form. If it is a congenital or acute form of pathology, then the pathogen should be isolated from the cell culture. Chronic form or a period of exacerbation include diagnostics serological method, through which antibodies against CMV can be detected. In the diagnostic arsenal of doctors, a cytological analysis of tissues is also used, which makes it possible to identify changes characteristic of the virus.

Most exact definition the presence of the virus is its isolation from the cell culture. The method takes 2-3 weeks and requires the use of fresh material.

During the polymerase chain reaction(PCR) in the material for the study determine the viral DNA. The advantage of this approach is that even a small amount of the pathogen is enough to detect its presence in the body. For the study, all biological fluids of the body are used, as well as smears from the genital tract and urethra, feces, washings from the mucous membranes.

A serological blood test consists of enzyme immunoassay, which shows the level of antibodies to the virus. In the acute phase of the disease, class M immunoglobulins will be detected in the analysis, and the inactive phase of the infection is accompanied by an increase in the level of immunoglobulins G. When cytological analysis typical giant cells with characteristic inclusions will be found under a microscope. This method is used in the diagnosis of hepatitis and nephritis caused by cytomegalovirus.

How to treat CMV

Treatment of cytomegalovirus in women aims to reduce the effect of the pathogen on the body, because modern medicine has not yet developed methods for destroying the virus. To achieve this goal, the following groups of drugs are used in the treatment of CMV:

antiviral. Do not allow the reproduction of the virus in the cell. These include Ganciclovir, Panavir, Forskanet;
immunoglobulins. Bind and kill viral particles - Megalotect, Cytotect;
interferons. They act directly on viruses and restore the protective properties of the body - Cycloferon, Viferon, Leukinferon;
means for post-syndromic treatment. They are used depending on the nature of systemic lesions;
symptomatic drugs. They are used to alleviate the patient's condition, and cover such groups as vasoconstrictor, painkillers, anti-inflammatory drugs.

You should be aware that treatment of cytomegalovirus is not always required. Therapy (treatment) with drugs is carried out with generalized CMV form, in pregnant women, newborns, as well as in conditions accompanied by immunodeficiency.

Given that inactive CMV is not dangerous to a healthy body, some experts believe that its treatment is inappropriate. The benefit of this approach is supported by the lack of specific therapy and prevention. reinfection virus. From this it follows that the best treatment for a latent form of the disease is to maintain the immune system at a normal level.

Cytomegaly– infection viral genesis, transmitted sexually, transplacental, household, blood transfusion. Symptomatically proceeds in the form of persistent cold. There is weakness, malaise, headaches and joint pain, runny nose, enlargement and inflammation salivary glands, profuse salivation. Often asymptomatic. The severity of the disease is determined general condition immunity. In the generalized form, severe foci of inflammation occur throughout the body. Pregnant cytomegaly is dangerous: it can cause miscarriage, birth defects development, intrauterine fetal death, congenital cytomegaly.

The duration of the mononucleosis-like syndrome is from 9 to 60 days. Then there is usually a full recovery, although for several months may persist residual effects in the form of malaise, weakness, enlarged lymph nodes. Rarely, cytomegalovirus activation causes recurrences of the infection with fever, sweating, hot flashes, and malaise.

Cytomegalovirus infection in immunocompromised individuals

Weakened immunity is observed in individuals suffering from congenital and acquired immunodeficiency syndrome (AIDS), as well as in patients who have undergone a transplant internal organs and tissues: heart, lung, kidney, liver, bone marrow. After organ transplantation, patients are forced to constantly take immunosuppressants, leading to a pronounced suppression of immune responses, which causes the activity of cytomegalovirus in the body.

In patients who have undergone organ transplantation, cytomegalovirus causes damage to donor tissues and organs (hepatitis in liver transplants, pneumonia in lung transplants, etc.). After bone marrow transplantation, in 15-20% of patients, cytomegalovirus can lead to the development of pneumonia with high mortality (84-88%). greatest danger represents a situation where a cytomegalovirus-infected donor material is transplanted to an uninfected recipient.

Cytomegalovirus infects almost all HIV-infected people. At the onset of the disease, malaise, articular and muscle pain, fever, night sweats. In the future, these signs may be accompanied by lesions of the lungs (pneumonia), liver (hepatitis), brain (encephalitis), retina (retinitis), ulcerative lesions and gastrointestinal bleeding.

In men, cytomegalovirus can affect the testicles, prostate, in women - the cervix, the inner layer of the uterus, vagina, ovaries. Complications of cytomegalovirus infection in HIV-infected people can be internal bleeding from the affected organs, loss of vision. Multiple damage to organs by cytomegalovirus can lead to their dysfunction and death of the patient.

Diagnosis of cytomegaly

In order to diagnose cytomegalovirus infection, it is carried out laboratory definition in the blood of specific antibodies to cytomegalovirus - immunoglobulins M and G. The presence of immunoglobulins M may indicate a primary infection with cytomegalovirus or a reactivation of a chronic cytomegalovirus infection. Determination of high titers of IgM in pregnant women may threaten infection of the fetus. An increase in IgM is detected in the blood 4-7 weeks after infection with cytomegalovirus and is observed for 16-20 weeks. An increase in immunoglobulins G develops during the period of attenuation of the activity of cytomegalovirus infection. Their presence in the blood indicates the presence of cytomegalovirus in the body, but does not reflect the activity of the infectious process.

To determine the DNA of cytomegalovirus in blood cells and mucous membranes (in the materials of scrapings from the urethra and cervical canal, in sputum, saliva, etc.) the method of PCR diagnostics (polymerase chain reaction) is used. Especially informative is the quantitative PCR, which gives an idea of the activity of cytomegalovirus and the infectious process it causes. The diagnosis of cytomegalovirus infection is based on the isolation of cytomegalovirus in clinical material or a fourfold increase in antibody titer.

Depending on which organ is affected by cytomegalovirus infection, the patient needs to consult a gynecologist, andrologist, gastroenterologist or other specialists. Additionally, according to indications, ultrasound of the abdominal organs, colposcopy, gastroscopy, MRI of the brain and other examinations are performed.

Treatment of cytomegalovirus infection

Uncomplicated forms of mononuclease-like syndrome do not require specific therapy. Usually, activities are carried out that are identical to the treatment of a common cold. To relieve symptoms of intoxication caused by cytomegalovirus, it is recommended to drink enough liquid.

Treatment of cytomegalovirus infection in individuals at risk is carried out with the antiviral drug ganciclovir. In cases severe course cytomegalovirus ganciclovir is administered intravenously, because the tablet forms of the drug have only a preventive effect against cytomegalovirus. Since ganciclovir has severe side effects (causes hematopoiesis suppression - anemia, neutropenia, thrombocytopenia, skin reactions, gastrointestinal disorders, fever and chills, etc.), its use is limited in pregnant women, children and in people suffering from renal insufficiency (only for vital indications), it is not used in non-immune patients.

For the treatment of cytomegalovirus in HIV-infected people, the most effective drug is foscarnet, which also has a number of side effects. Foscarnet may cause disturbance electrolyte metabolism(decrease in plasma magnesium and potassium), ulceration of the genital organs, impaired urination, nausea, kidney damage. Data adverse reactions require careful use and timely adjustment drug doses.

Prevention

The issue of prevention of cytomegalovirus infection is especially acute in individuals at risk. The most susceptible to infection with cytomegalovirus and the development of the disease are HIV-infected (especially AIDS patients), patients after organ transplantation and persons with immunodeficiency of a different origin.

Non-specific methods of prevention (for example, personal hygiene) are ineffective against cytomegalovirus, since infection with it is possible even by airborne droplets. Specific prophylaxis cytomegalovirus infection is carried out with ganciclovir, acyclovir, foscarnet among patients at risk. Also, to exclude the possibility of infection of recipients with cytomegalovirus during organ and tissue transplantation, careful selection of donors and monitoring of donor material for the presence of cytomegalovirus infection is necessary.

Cytomegalovirus is of particular danger during pregnancy, as it can provoke miscarriage, stillbirth, or cause severe congenital deformities The child has. Therefore, cytomegalovirus, along with herpes, toxoplasmosis and rubella, is one of those infections that women should be examined for prophylactically, even at the stage of pregnancy planning.

Cytomegalovirus (CMV) infection - viral disease associated with human infection with cytomegalovirus. This pathogen is classified as type 5 herpesviruses, it is widely distributed in the population. 50-80% of all people in the world are infected with CMV. Once infected, a person is infected forever, but for healthy people it is not dangerous. The virus increases its activity only if there is a decrease in immunity. This is a common situation with HIV infection or when taking immunosuppressive (immune-lowering) drugs.

If a woman first became infected with a cytomegalovirus infection during pregnancy, this can lead to serious fetal pathology.

Causes and risk factors

Cytomegalovirus is transmitted through close human-to-human physical contact. This can occur through body fluids:

saliva
blood (including blood transfusions and organ transplants)
breast milk
seminal fluid and vaginal secretions.

During pregnancy, infection occurs through the placenta or directly during childbirth.

Infection is possible by kissing or by contact with objects that have particles of the saliva or urine of a sick person. The majority of people become infected in childhood, usually in a nursery or kindergarten, i.e. where there is a lot of contact between children. Less commonly, infection occurs at the age of 10-35 years.

What happens with CMV

The first encounter with the virus is usually asymptomatic. Only in 2% of cases, symptoms similar to SARS are noted (fever, fever, sore throat, pain in the joints and muscles, swollen lymph nodes). In people with normal immunity, the infection usually does not cause serious complications.

Congenital cytomegalovirus infection is much more dangerous. Most often, pregnant women get CMV from sick children. younger age. Various congenital pathologies are diagnosed in 10% of children infected during fetal development. The virus significantly increases the risk of preterm birth, intrauterine growth retardation, and spontaneous abortion.

CMV belongs to the group of so-called TORCH infections, most often associated with fetal abnormalities and pathology of pregnancy. Infection with the virus can occur before pregnancy or directly during the intrauterine development of the child. In the first case, there are no clinical manifestations, and only specific “late” antibodies are detected in the blood. This situation is not dangerous either for the fetus or for the woman, the risk of complications does not exceed 1%.

Primary infection of the mother during pregnancy is associated with a high risk to the fetus (30-50%). As a result, 10-15% of children may have hearing or vision impairments, seizures, intrauterine growth retardation, microcephaly (decrease in brain size). Possible after birth neurological symptoms, mental retardation and physical development, liver damage, which is most often manifested by jaundice, enlarged spleen.

Symptoms of CMV

There are several types of pathologies that cause cytomegalovirus infection. At healthy people the disease may not manifest itself at all, and the person may not even know that he has become infected. Less often, the disease occurs in the form of an acute cytomegalovirus infection, the symptoms resembling infectious mononucleosis:

swollen lymph nodes
body temperature above 38 degrees
weakness, fatigue, lack of appetite
muscle and joint pain
strong pain in the throat, inflammation of the tonsils
headache.

As a rule, recovery occurs within 2 weeks.

AT severe cases possible liver damage, jaundice, pain in chest, cough, shortness of breath, diarrhea, abdominal pain.

In immunocompromised patients, cytomegalovirus infection is more severe, as the virus quickly spreads throughout the body and causes:

damage to the central nervous system with possible convulsions, the occurrence of coma
severe diarrhea
pneumonia, breathing difficulties
retinitis (damage to the retina)
hepatitis (liver damage).

Newborns who become infected with CMV in utero may have:

jaundice
pneumonia
small purplish rash
enlargement of the liver and spleen
low birth weight
small head size.

Diagnosis of CMV

An infection can be suspected general analysis blood, where the level of lymphocytes exceeds 50%, and atypical lymphocytes make up up to a tenth of all these blood cells.

Accurate diagnosis of cytomegalovirus infection is usually carried out using the analysis of biological fluids. PCR method(polymerase chain reaction) or ELISA (enzymatic immunoassay). Other diagnostic methods, such as CMV culture, are almost never used at present. PCR determines the presence of CMV-specific DNA regions in saliva samples, breast milk etc. ELISA allows you to determine antibodies to cytomegalovirus in the blood serum. As a rule, the presence of immunoglobulins - IgG and IgM is assessed. High level IgM (class M immunoglobulins) in the patient's blood usually indicates a primary infection. When the virus is reactivated, the amount of IgM may also increase, but not as much as the first time. If class G immunoglobulins (IgG) are determined, then the body's encounter with CMV is not the first; these antibodies remain for life. Their number can grow when the virus is activated. The interpretation of the test results is carried out by a doctor, since the appearance of specific antibodies to the virus may lag up to 4 weeks after infection.

Cytomegalovirus belongs to the group of herpesviruses, and if the Epstein-Barr virus (also from the herpesvirus family) is present in the body, the result may be false positive.

To diagnose liver damage, determine the level of bilirubin, AST, ALT.

Treatment

Patients with normal immunity specific treatment do not require. The disease goes away on its own, like SARS, within a few weeks.

If you are worried about high fever, severe muscle pain, then anti-inflammatory drugs are used: paracetamol or ibuprofen. It is important to drink plenty of fluids, this will not only reduce the symptoms of the disease, but also avoid dehydration.

Patients with immunodeficiencies are prescribed antiviral drugs. These drugs cannot completely remove CMV from the body and cure the infection, but they can slow the virus from replicating. The treatment regimen for cytomegalovirus infection in patients with a weakened immune system may include:

ganciclovir
valganciclovir
foscarnet
cidofovir (not registered in the Russian Federation).

Antiviral drugs have side effects therefore treatment requires medical supervision. accept antiviral agents at least 14 days.

Newborns with CMV infection are treated in specialized departments of perinatal centers, where antiviral therapy with ganciclovir or valganciclovir is carried out. After discharge, such babies need constant control vision and hearing, observation by a neurologist.

Prevention of CMV

There is no specific prophylaxis for cytomegalovirus infection. efficient and safe vaccine against CMV does not yet exist. The virus is transmitted through sexual contact, kissing, sharing cutlery, toys, toothbrushes. Therefore, compliance general rules hygiene, washing hands with soap before preparing food, after going to the toilet or changing a diaper will help prevent infection. When in contact with biological fluids (semen, urine), rubber gloves must be worn.

Vulnerable patient groups - such as those taking immunosuppressive drugs after an organ transplant or pregnant women - need to be more carefully observed hygiene rules. If possible, you should avoid contact with small children (especially those under 5 years old) and, moreover, do not kiss them, do not eat with them from the same dish.

Before organ transplantation or blood transfusion, a study of the CMV status of a potential donor is carried out.

Complications

Primary infection during pregnancy leads to impaired intrauterine development, microcephaly, damage to the liver, lungs, and central nervous system of the fetus. In newborns with symptoms of damage to organs and systems, in 30% of cases it is possible fatal outcome. 40-90% of them have neurological disorders(mental retardation, hearing loss, visual impairment, epilepsy).

In patients with HIV infection, cytomegalovirus can cause the following complications:

chorioretinitis (combined inflammation choroid and retina)
pancreatitis, hepatitis, colitis
Guillain-Barré syndrome
encephalitis
peripheral nerve damage
viral inflammation of the lungs
heart muscle damage
skin lesion.

Rarely, complications occur in healthy people. Most often it is diarrhea, pain in the abdomen and muscles.

This disease belongs to the so-called. "slow infections", which are risk factors for the development of somatic diseases: vascular atherosclerosis, diabetes, oncological diseases. Cytomegalovirus can long time stay in a latent form without manifestation of the disease. The onset of the disease provokes a weakening of the immune system and other related factors. IgG antibodies to cytomegalovirus can remain in recovered people for about 10 years. How to treat and how to identify the disease, read further in the article.

Symptoms of the development of cytomegalovirus

The acute form of the disease is formed after an incubation period of 20-60 days. Manifestations of symptoms of cytomegalovirus can be observed in the form of:

Acute respiratory disease(ORZ);

Multiple organ damage;

Defects in the development of the fetus;

Inflammatory processes in the organs of the genitourinary system.

Symptoms of the disease in women proceed in a particularly acute form. The disease they manifest inflammatory processes of the genitourinary organs. This variant of the course of the disease suggests that a woman from the organs of the genitourinary system begins to develop inflammatory processes and erosion of the uterine neck (cervicitis), vagina, inner uterine layer (endometritis), and also the ovaries.

Women often complain about having pain and bluish-whitish discharge from the organs of the genitourinary system. The most dangerous is the disease when it occurs during pregnancy. Infection of the fetus leads to a variety of malformations in its development.

Cytomegalovirus in men occurs, most often, without symptoms, or orchitis is likely - an inflammatory process in the testicles. In a number of situations, urethritis can be observed - inflammation of the urinary tract, as well as unpleasant feelings during urination.

SARS and pneumonia as a manifestation of cytomegalovirus

The most common form of manifestation of the disease is acute respiratory infections, with the most obvious signs for this disease:

headache,

high temperature,

weakness.

Quite rarely, the cytomegalovirus virus is able to provoke more significant diseases: arthritis, pneumonia, encephalitis and affect organs. With a similar generalized form of cytomegalovirus, an inflammatory process of the adrenal glands, liver tissue, pancreas, spleen, and kidneys can be observed.

Symptoms of the disease may be accompanied by causeless frequent pneumonia, a small amount of platelets in the blood, damage eye vessels, brain, intestinal walls, peripheral nerves. Growth of the submandibular and parotid salivary glands, skin rash, inflammation of the joints.

Cytomegalovirus has become a particular problem in HIV infected people. In pregnant women with cytomegalovirus dormant infection, fetal damage is not observed every time. An important condition for this, there may be an exacerbation of a dormant infection in the mother with contact with the blood and further infection of the fetus. The possibility of infection of the fetus will be significantly higher if the mother is infected during pregnancy.

The period of incubation of the disease is sometimes unknown, since very often cytomegalovirus infection is latent, and clinically pronounced forms of the disease appear after the influence of a certain debilitating factor.

Types of cytomegalovirus infection and their manifestations

Human herpesvirus type 8 is a new virus from the herpesvirus family that causes Kaposi's sarcoma in HIV-infected people. Epidemiological data and detection of this virus in semen suggest the possibility of its transmission through sexual contact, especially in homosexual and bisexual men. However, other mechanisms of transmission of human herpesvirus type 8 are not excluded.

The hepatitis D virus is an "incomplete" virus, disease-causing only in the presence of the hepatitis B virus. Infection with the hepatitis D virus in a patient with hepatitis B is clinically manifested by an exacerbation chronic hepatitis. Hepatitis D is transmitted through the blood; rarely occurs during sexual intercourse.

Epstein-Barr virus - the causative agent of infectious mononucleosis can be transmitted sexually. However, in most cases, infection with this virus is not associated with sexual contact and occurs through saliva. In HIV-infected people, Epstein-Barr virus reactivation causes hairy leukoplakia of the mouth.

Human T-lymphotropic virus type 1 causes adult T-cell leukemia-lymphoma and spastic paraparesis. The clinical picture of infection caused by human T-lymphotropic virus type 2 has not yet been elucidated. The epidemiology of human T-lymphotropic virus types 1 and 2 is similar to the epidemiology of hepatitis B and C. Injection and transplacental mechanisms are characteristic, as well as sexual transmission of the infection.

Enteroviruses are usually transmitted through sexual contact, in which the fecal-oral mechanism of infection is possible.

Adenovirus type 19 causes acute conjunctivitis in combination with urethritis. Can be sexually transmitted.

Diagnosis of cytomegalovirus

Clinical diagnosis of the disease presents great difficulties. A similar picture can be caused by many diseases, in particular hemolytic disease, congenital toxoplasmosis, listeriosis, syphilis, sepsis, etc. Diagnosis can be confirmed by isolation of the virus from clinical material or a fourfold increase in antibody titers. A single detection of even a high titer of antibodies cannot serve as evidence due to the wide spread of latent infection.

Examination of blood, urine, and genital secretions by culture, antigen determination, or DNA amplification methods is of limited value in the diagnosis of cytomegalovirus. Apply serological studies symptoms of cytomegalovirus. Histological and cytological changes are detected in cytomegalovirus infection that occurs with clinical picture. Interpretation of histological and cytological studies often complex.

Male indicators of the disease at the age of 0-90 years: 0-15 - negative, 16-22 - doubtful, more than 22 - positive;

Female indicators of cytomegalovirus at the age of 0-90 years: 0-15 - negative, 16-22 - doubtful, above 22 years - positive;

Pregnancy 1-40 weeks cytomegalovirus indicators: 0-15 years - negative, 16-22 - doubtful, more than 22 years - positive.

Symptoms of complications and consequences of cytomegalovirus

The disease can affect many cells and nervous tissue. It can cause thrombocytopenia, inflammation of the salivary glands, an increase in the size of the liver, lymph nodes, paralysis facial nerve, limbs, deep damage brain structures, hepatitis with the presence hepatic coma.

Sometimes there is granulomatous hepatitis or a syndrome resembling mononucleosis. Intrauterine infection of a child, usually occurring during primary infection in a pregnant woman, can cause severe systemic diseases and congenital pathology CNS (eg, sensorineural hearing loss). The role of cytomegalovirus in the development of atherosclerosis has not been fully elucidated. In patients with AIDS and in people with severe immunodeficiency of another nature, severe, sometimes life threatening, the course of cytomegalovirus infection (retinitis, pneumonia, esophagitis, colitis, encephalitis).

Like all herpes viruses, cytomegalovirus can cause a latent course of infection and persistence, and sometimes reactivate if the immune system is weakened. Approximately 0.5-2.5% of born children become infected with cytomegalovirus during fetal development. In this case, 10% of them die within a year, some children develop malformations, or miscarriages begin to develop during pregnancy.

During infection in more late dates during pregnancy, the functional mechanisms of tissue and cell differentiation worsen child's body(damage to the kidneys, liver, central nervous system and pancreas). Approximately 10-60% of children become infected while passing through birth canal and in the first six months of life through breast milk. 15-20% of hepatitis are caused by cytomegalovirus. .

Manifestations of cytomegalovirus in men and women

In most situations, the disease in male patients is in the so-called. inactive or persistent phase. Activation of the virus, chronic exacerbations of cytomegalovirus in men can occur at intervals when the body is the least protected, and the immune system is in a certain depletion (colds, stress, overload of the nervous system).

Signs of male cytomegalovirus

Cytomegalovirus in men is manifested by the following clinical signs of cytomegalovirus in men, which to a certain extent resemble acute respiratory infections:

Chills, fever;

Swelling of the mucous membranes of the nasopharynx, runny nose;

Inflammatory process in the lymph nodes;

Muscle and headaches;

Often the occurrence of skin rashes and inflammation of the joints.

Cytomegalovirus appears only after an incubation period of 1-2 months, and the main difference from the common cold is the duration of clinical signs of cytomegalovirus in men. If, with a standard acute respiratory disease, healing occurs within 1-2 weeks, then during the defeat of cytomegalovirus, unpleasant signs of cytomegalovirus in men are observed for more than 4-6 weeks.

From the moment of initial infection, a person is an active carrier of the disease for about three years. Moreover, cytomegalovirus may well affect and urinary organs, causing inflammation in the urinary tract and testicular tissues, and form discomfort during emptying.

More likely in critical situations of immunodeficiency complex manifestations:

Damage to internal organs;

Disorders of the central nervous system;

Pneumonia;

Encephalitis;

Myocarditis.

Symptoms of cytomegalovirus infection in women

Infection with cytomegalovirus during pregnancy of a woman from a sick person who has an acute form of cytomegalovirus infection. In the absence of antibodies in a woman during pregnancy, cytomegalovirus can cross the placenta and infect the fetus. In this article, we will look at how the disease affects the course of pregnancy.

If a woman was infected before conception, and during pregnancy the disease worsened, then the antibodies present contribute to the weakening of the cytomegalovirus, which reduces the likelihood of it negative impact to the fruit.

Cytomegalovirus is able to be present in the human body for life. In this case, the occurrence of the disease, most often, is absent. However, a person has the ability to isolate the virus and be a source of infection. The development of infection is likely during the lowering of the immune system. The clinical signs of this virus are not specific. The disease may be accompanied by an increase in temperature, an increase in lymph nodes, weakness, pain in the muscles. In this case, most often, a diagnosis of acute respiratory infections is established. In case of a more severe course, ulcers of the intestines and stomach, pneumonia, myocarditis, hepatitis can develop.

Cytomegalovirus is one of the main causes of the formation

threats of premature birth and termination of pregnancy,
and besides severe malformations in the development of the eyes,
brain, etc.
intrauterine fetal injury.

The most favorable outcome is likely with infection during pregnancy. In this case, the virus often penetrates close to the fetus.

If the infection took place before pregnancy, antibodies against the virus are already formed in the body at the time of the onset of pregnancy, therefore the risk to the fetus is much less.

AT normal condition the placenta is impermeable to cytomegalovirus, but in many cases it is likely that the virus will enter the placenta and change it so that it begins to allow the virus to enter the fetus. At the end of pregnancy, antibodies spread from the mother to the fetus, so full-term babies are largely protected from the effects of infection.

Rare forms of cytomegalovirus in men and women

Among the rather rare forms of cytomegalovirus in men, occurring in the presence of a complex of infectious diseases, the development of inflammatory processes and paralysis of brain tissues is likely, which can lead to the death of a sick person.

The natural susceptibility of a man to cytomegalovirus is quite high, infection can be characterized by different clinical manifestations However, with a full-fledged immune system, most often, the disease is clinically asymptomatic.

The acute form of cytomegalovirus infection in men and women is formed against the background of immunodeficient physiological conditions, and also in people with acquired or congenital immunodeficiencies. Replication of cytomegalovirus is carried out in the tissues of the reticuloendothelial system, liver, epithelium of the urogenital tract, mucosa of the digestive tract and respiratory tract.

How to treat cytomegalovirus?

Unfortunately, it should be noted that no current method of treating the disease helps to completely get rid of the cytomegalovirus, which remains when it enters the human body for the rest of its life. For this reason, the goal of therapy is to eliminate the symptoms acute form disease and retention of cytomegalovirus in an inactive, passive state.

If the course of cytomegalovirus infection is asymptomatic, and the immune system of the carrier of the virus is normal, then there is no need for CMV therapy.

In such a situation, if cytomegalovirus indicators are found in human blood, it is much more important additional terms direct to the preservation and maintenance of the immune system of the human body. For this purpose, general strengthening, immunomodulatory therapy, as well as vitamin therapy are carried out.

For carriers of cytomegalovirus infection, it is important to follow the right lifestyle, which guarantees a sufficient amount fresh air for a person balanced diet and movement, i.e. all factors that strengthen the immune system. In addition, there are many immunomodulatory agents that can be used to strengthen the immune system.

Treatment of cytomegalovirus with immunomodulators often continues for several weeks, they are prescribed only by a doctor. We repeat that these drugs are more appropriate to use in the case when the course of cytomegalovirus infection is latent, rather as a prevention than a treatment. In the case of an acute form of cytomegalovirus, the effectiveness of immunomodulating agents is questioned by immunologists and venereologists.

Antiherpetic drugs (Acyclovir, Vidabarin), successfully used in other viruses, were ineffective in the treatment of cytomegalovirus. With acquired cytomegalovirus infection in pregnant women, the main task is to prevent the generalization of infection and intrauterine infection of the fetus. For this purpose, general strengthening treatment of cytomegalovirus is carried out. It is also recommended to introduce a normal human immunoglobulin containing specific antibodies, it is administered intramuscularly at 6–12 ml at intervals of 2–3 weeks during the first 3 months of pregnancy. During kidney transplantation, the introduction of Alpha-interferon had a preventive effect.

Long-term treatment with ganciclovir, foscarnet, or cidofovir is often effective for retinitis in immunocompromised individuals. In other forms of cytomegalovirus infection, the effectiveness of such treatment has not been proven. Condoms prevent infection through sexual contact. Prevention of cytomegalovirus in pregnant women (use of condoms, avoidance of casual sex) helps to prevent intrauterine infection of the child. Mass examinations and examination of sexual partners are not shown.

Clinical example of the treatment of cytomegalovirus

The doctor says: a woman came to us with complaints of loss of strength, headaches for several years. Visiting doctors in the clinic and treatment in hospitals did not bring her relief. At the WFD, we detected symptoms of cytomegalovirus in her.

After questioning the patient, we learned that 5 years ago her daughter had a harmless operation that ended with great complications, as a result of which she received a blood transfusion. After leaving the hospital, the daughter felt unwell for a long time, and later, in the tests, CMV and the hepatitis C virus were detected in her. She was treated by doctors and risked bearing and giving birth to a child. The woman came to us at a time when her daughter was already pregnant. Therefore, we did not dare to take on the treatment of our daughter. In the process of communication between mother and daughter, apparently, the mother became infected with cytomegalovirus from her daughter.

We performed resonant-frequency therapy for cytomegalovirus on the mother, prescribed immunomodulatory drugs (TF Advensd according to the scheme developed by us), bioresonance therapy, and body cleansing. The woman felt cheerful, healthy, efficient. During the control VRD, fragments ("fragments") of cytomegalovirus were detected in her only in the brain. Surveillance and preventive treatment courses are ongoing.

Unfortunately, as it turned out later, CMV was also detected in her two-month-old granddaughter. In dynamics during the year, at subsequent examinations, the patient (mother) felt well: cytomegalovirus was not detected either on the WFD or in the laboratory.

How to treat cytomegalovirus folk remedies?

Want to know how to treat cytomegalovirus? There are some folk remedies that are also aimed at maintaining normal immunity, and, as a result, preventing the further development of cytomegalovirus. Among such means, you can use tempering procedures (sauna, bath, dousing cold water), as well as the application medicinal herbs.

Among the plants that strengthen the immune system, it is necessary to name viburnum, calendula, St. John's wort, dogrose, lemon balm. Each such plant is available to everyone, brewed as a tea and drunk. In particular, similar herbal teas can be useful for pregnant women both in a healthy pregnancy and in the event of a threatened miscarriage.

The main focus in the treatment of the disease is not on drugs, but on your immunity. For this purpose, you can use almost any drugs that increase immunity. They can be medicinal herbs (leuzea, ginseng, echinacea, magnolia vine, etc.), biologically active additives(immunal), high-quality nutrition (providing the body with the minerals, vitamins, microelements it needs), constant walks in fresh air and constant physical exercise.

Consider folk remedies for the treatment of cytomegalovirus:

Licorice root, alder cones, kopeck root, leuzea root, chamomile flowers, string grass - in equal amounts. Production and use: two tbsp. spoons of crushed pre-collection pour 0.5 liters boiled water, insist at night in a thermos. For the treatment of cytomegalovirus, take about a third to a quarter three to four times a day.

Currant leaf 3 parts, bird cherry fruit 4 parts, oregano herb 2 parts, raspberry leaf 3 parts, wormwood grass 3 parts, thyme grass 2 parts, coltsfoot leaf 2 parts, plantain leaf 2 parts, licorice root 3 parts. Two st. spoons of crushed pre-collection pour 0.5 liters of boiled water, insist at night in a thermos. For the treatment of cytomegalovirus folk remedies take a third or a quarter three or four times a day.

Fireweed leaf 3 parts, dill fruits 1 part, hop cones 2 parts, chamomile flowers 2 parts, mint leaf 2 parts, oregano herb 2 parts, calamus root 2 parts, meadowsweet flowers 2 parts, cyanosis root 1 part. Two tablespoons of crushed pre-collection are poured into 0.5 liters of boiled water, insisted at night in a thermos. For the treatment of cytomegalovirus folk remedies take a third or a quarter three or four times a day.

Ways of spread and causes of cytomegalovirus infection

Cytomegalovirus is a virus that causes cytomegalovirus infection, a widespread viral infection that is characterized by a variety of manifestations from asymptomatic to most severe. severe forms with damage to the central nervous system and internal organs.

The ways of spreading the disease are diverse, because the virus can be present in saliva, blood, urine, milk, seminal fluid, feces, secretions of the uterine cervix. Possible transmission during blood transfusion, airborne transmission, sexual transmission, probably also intrauterine transplacental infection. Of great importance is infection with cytomegalovirus during childbirth and during breastfeeding by an infected mother. Only man is considered the source and reservoir of the disease.

Antibodies are detected in 10–15% of adolescents. By the age of 35, they are already detected in half of the people. These figures vary widely across regions and different groups population. Superinfection with other strains of cytomegalovirus is possible.

Under the influence of cytomegalovirus, normal cells begin to grow in size. Cytomegalovirus can be categorized as a herpes virus.

The disease has an affinity for the tissue of the salivary glands and, in the presence of localized forms, it can be found only in these glands. The virus lives in the human body for life. In response to the initial penetration, the restructuring of immunity begins to develop. If you have good immunity, then it suppresses the virus, preventing it from manifesting itself. The transition of dormant symptoms of cytomegalovirus into pronounced forms is often caused by some factors that weaken the immune system (for example, diseases, the appointment of cytostatics and other immunosuppressants).

Provocative factors of cytomegalovirus

To arise vivid symptoms cytomegalovirus, that is, in order for the disease to move from a latent form to a clinically pronounced one, specialized provoking factors are needed:

chronic stress;

Hypothermia of the body;

Intercurrent diseases;

Reception of immunosuppressants and cytostatics;

HIV infection;

The presence of other infections and diseases: syphilis, chlamydia, gonorrhea, etc.