Cytomegalovirus - what is it, symptoms and treatment. What is dangerous CMV for children. Interesting facts about cytomegalovirus infection

Before starting treatment for cytomegalovirus, it is necessary to accurately diagnose the disease and determine whether treatment for CMVI is necessary in your case. Since it is not always required, you need to be aware of it. In addition, to diagnose the presence of cytomegalo viral infection It is not easy and CMV is easily confused with other diseases. Below we will talk about how to cure cytomegalovirus and how it is treated, as well as in what cases it is necessary.

Cytomegalovirus infection should be treated only when the disease is an undeniable danger to the human body. Such cases are clearly identified only by a specialist, after visiting a sick clinic to diagnose the disease. If the body has symptoms of a generalized cytomegalovirus infection, then it is extremely important to contact the clinic. The treatment regimen for cytomegalovirus can only be drawn up after a personal examination of the patient.

A person who has been ill with cytomegalovirus and has undergone an infectious disease without any serious consequences acquires a fairly strong immunity. In the vast majority of cases, cytomegalovirus infection, having struck the human body, does not cause any symptoms. The virus itself in the body takes a sleep mode, remaining in a person forever. And it manifests itself, causing relapses, accompanied by all kinds of complications, only with a strong weakening immune system.

In all cases, treatment cytomegalovirus infection aims to significantly mitigate negative impact viral infection on the human body. Most often, after infection, a person with a sufficiently strong immune system easily endures the primary outbreak of an infectious disease, so there is no need for a person with cytomegalovirus to go to the hospital. In such people, after a short manifestation, the set of symptoms that have been created ceases without a trace. As a result, the disease mostly goes unnoticed.

When is cytomegalovirus treatment really necessary?

The specific circumstances under which the attending physician determines the course of treatment of cytomegalovirus infection in adults or in children include such manifestations as:

• The presence of acquired or congenital immunodeficiency in a patient of any age.
• Generalized stage - the widespread spread of the virus is accompanied by a very painful inflammatory process throughout the body or in a specific organ against the background of the presence of other infections that weaken the main protective functions human body.
• Complicated or exacerbated course of cytomegalovirus or preparation for treatment with allogeneic organ transplantation, pneumonia, encephalitis, oncological diseases - when using therapy that severely suppresses the immune system.
• During the first trimester of pregnancy, immunocompromised women may develop primary cytomegalovirus, which can potentially cause extremely severe damage to the fetus, and may also cause miscarriage.

The generalized stage or symptomatic exacerbation of a cytomegalovirus infection is often characterized by the fact that most patients, and even sometimes some doctors, confuse this viral disease due to its similarity with the symptoms of influenza-like diseases or SARS. As well as other infectious diseases. Often this leads to erroneous treatment and high risk development of severe complications.

With absolutely accurate differential diagnosis, treatment for cytomegalovirus will be prescribed to the patient as adequate as possible. And the medicines are prescribed for the right purpose.

Drugs and vitamins for the treatment of cytomegalovirus infection

Let's look at how to treat cytomegalovirus with medicines. Main medical preparations from cytomegalovirus infection and their treatment are divided into several small groups:

• Symptomatic remedies- provide relief, anesthetize, eliminate inflammation, constrict blood vessels (drops in the nose, eye drops, painkillers, anti-inflammatory, folk remedies).
• Antiviral drugs- inhibit the activity of the infection (Ganciclovir, Panavir, Cidofovir, Foscarnet).
• Posyndromic drugs- restore damaged organs and tissues in case of complications (capsules, suppositories, tablets, injections, gels, ointments, drops).
• Immunomodulators- strengthen and stimulate the immune system (Leukinferon, Roferon A, Neovir, Genferon, Viferon).
• Immunoglobulins- bind and destroy viral particles (Neocytotect, Cytotect, Megalotect).
• Vitamin and mineral complex- to support the immune system.

In men, cytomegalovirus is treated with antiviral drugs - Foscarnet, Ganciclovir, Viferon. And immunoglobulins - Cytotect, Megalotect.

In women, cytomegalovirus is treated with antiviral drugs - Acyclovir, Viferon, Genferon, Cycloferon.

List of drugs

1. Foscarnet is an antiviral drug. Infectious cytomegalovirus is treated quite successfully with Foscarnet. It is applied when severe cases diseases and in complex forms of possible exacerbations that can be caused by other diseases. It is advisable to use this drug with a weakened immune system in a patient. When the drug enters the diseased cell, the elongation of the viral chain is disrupted, that is, the drug slows down, and then completely stops the active reproduction of the virus.
2. Ganciclovir is an antiviral drug. The drug is one of the most effective, rather difficult in practical use. The remedy is prescribed during the course of the disease - cytomegalovirus infection, especially complicated severe pathologies organs, quite extensive inflammation. It is also used to prevent viral infection, congenital CMV infection. Release form - tablets and crystalline powder from the group of polar hydrophilic solvents. For ophthalmic gel or injection, the drug is available as a lyophilisate. The use of Ganciclovir is advisable in the treatment of cytomegalovirus - a herpes infection.
3. Cytotect - immunoglobulin. For many patients, Cytotect seems to be one of the most optimal means for the treatment of cytomegaluvirus. The drug combines a fairly effective efficiency and an almost complete absence of general toxicity and relative contraindications. Prescribed for prophylaxis in patients with suppressed immune system drugs. Prevents mass manifestations of the disease after infection with CMVI. When applied, it can create: headaches; nausea and vomiting; chills and fever; joint pain and mild pain in back; sometimes a decrease in blood pressure.
4. Neovir is an immunostimulant. Solution for injection, used as an immunostimulating drug for the treatment and prevention of cytomegalovirus infection in people with immunodeficiency.
5. Viferon is an immunomodulator. Candles with antiviral action. It is used for complications of infectious diseases, for primary inflammation, as well as for recurrence of cytomegalovirus infection of a localized form. The drug is applied rectally. When applied, it can cause an allergic reaction in the form of a skin rash.
6. Bischofite is an anti-inflammatory drug. Produced in the form of a balm (gel) in a tube or in a glass container in the form of a brine. It is applied topically as therapeutic mud or mineral water.

List of vitamins

1. C - Antioxidant a wide range actions. Stimulates the work of cells that eat bacteria and viruses in the blood. Increases the resistance of the human body various infections with the help of cell resistance to the penetration of infectious agents.
2. B9 - for the powerful maintenance of the production factory (bone marrow) of the human body's immune system.

The general rules for the treatment of cytomegalovirus include hospitalization of the patient in cases where it is absolutely necessary. Since during the treatment period the patient seems to be a very active source of viral infection for others, the patient must significantly limit any contact with people. Ensure maximum peace of mind. Provide the best necessary microclimate conditions. Observe strict rules of personal hygiene. Use a therapeutic and preventive diet.

With strict adherence to these rules and all the recommendations of the attending physician, you can rely on a fairly quick and most effective way to get rid of the infection and prevent complications and relapses.

Treatment with folk remedies

If a person heard that people were treated for cytomegalovirus by home medicine, then this is an erroneous idea that, thanks to traditional medicine, it is possible to cope with such a difficult task. Treatment of such an infection and all sorts of complications should not occur on its own without the supervision of a specialist. But support the immune system folk remedies quite expedient.

Many patients after the tests are perplexed: cytomegalovirus - what is it, where did it get into the body and what to do now. Don't get so upset and discouraged. Cytomegalovirus does not cause much harm if the immune system is in in perfect order. A certain danger can exist only during the period of gestation. To date, does not exist specific treatment cytomegalovirus. Therefore, in most cases, to your question about how to treat cytomegalovirus, the doctor will only advise you to strengthen your health.

First descriptions cytomegalovirus disease appeared in 1882. German pathologists, studying the bodies of those who died from severe infections, noticed that under a microscope their cells look huge and resemble an “owl's eye” in shape.

By such a preface, we in no way wanted to scare our readers. Now cytomegalovirus can be easily identified and cured.

Cytomegalovirus virus

This is the herpes virus type 5. In fact, the cytomegalovirus virus is a striking infection. In terms of prevalence, it is in first place worldwide among all currently existing infections. And this despite the fact that the virus appeared in Russia quite recently: around the 1940s.

Cytomegalovirus infection

Cytomegalovirus infection has manifested itself in full height after they began to actively engage in transplantology (organ transplantation) in medicine. Also, the number of patients increased when patients began to prescribe cytostatics ( anticancer drugs) and drugs that suppress the immune system.

Recently, there are more and more patients with rheumatoid arthritis and connective tissue diseases. The fact is that with these ailments, the human immune system begins to fight with healthy cells of the body. Therefore, too "zealous" immunity has to be restrained with the help of drugs. But at the same time, the patient develops immunodeficiency, and he becomes highly susceptible to various diseases. And it is after such therapy that it turns out that the patient was diagnosed with cytomegalovirus.

How is cytomegalovirus transmitted?

Consider how cytomegalovirus is transmitted. Sick people are the source of infection. You can get infected through a variety of secrets: blood, saliva, urine, tears, feces, semen, vaginal contents, breast milk. You can also catch the virus through airborne droplets.

How do you get infected with cytomegalovirus?

It is impossible to unequivocally answer the question of how they become infected with cytomegalovirus. Cytomegalovirus is called the "youth" infection, as it is sexually transmitted, it is also called the "kissing" virus. But it would be much more accurate to call it a “mother and child” disease, because when a mother kisses a child, they infect each other. Once sick, the patient remains a carrier of the virus for life.

Cytomegalovirus infection

According to some researchers, 80% of the population is already infected with cytomegalovirus, and antibodies have formed in their blood. It turns out that only 20% of people on Earth are not protected from this infection. Cytomegalovirus infection usually goes unnoticed.

Cytomegalovirus in pregnant women

Newborns are most often infected; patients receiving blood transfusions and organ transplants; persons leading a promiscuous sexual life; people with a weakened immune system (they can get sick even if they have antibodies in their blood).

The greatest danger is cytomegalovirus in pregnant women. In the first trimester, the virus is found in the urine in 2-3% of pregnant women, in the second, 7% are infected, in the third trimester - 12%, and by the time of delivery, cytomegalovirus is already found in 35% of women. Most mothers have children born with antibodies to cytomegalovirus infection.

What does cytomegalovirus mean?

What does cytomegalovirus mean for a newborn baby and its development? An infant's health is at risk if the mother is exposed to cytomegalovirus infection in early pregnancy. Then the baby develops congenital cytomegaly.

This happens if the mother did not have antibodies in the blood or if there were any placental disorders, because of which antibodies did not get to the child. For example, a woman could have had any viral infection in the early stages, even directly with cytomegalovirus, and because of this, placental insufficiency has formed. What does cytomegalovirus mean for a baby is difficult to say. Most likely, the infection will go into a chronic form of carriage and will not give severe symptoms.

How is congenital cytomegaly manifested? it serious disease, which begins from the very first days of life. The child has a fever, changes in the brain appear, hearing loss, vision loss, development of myocarditis, endocarditis, heart disease, gothic palate, inguinal hernia, jaundice are possible. The baby's spleen and lymph nodes are enlarged.

Unlike other diseases with cytomegalovirus, the lymph nodes are not hard, but soft. The prognosis in the first days of a child's life is extremely unfavorable.

It's okay if cytomegalovirus infects a woman in late pregnancy, when the placenta and general circle circulation has already been established.

If future mom will get sick with the virus before the baby is conceived, which is generally excellent - she will pass on the antibodies to the child, and he will no longer get sick.

Symptoms of cytomegalovirus

Let's say a kidney was transplanted to a person from a person who had cytomegalovirus. The incubation period of the disease lasts approximately 8-12 weeks. Sometimes it lengthens up to 2 years after an organ transplant. After that, symptoms of cytomegalovirus occur.

The disease manifests itself acutely and proceeds severely, with intoxication, high temperature weakness, muscle and joint pain. But it is difficult to confuse cytomegalovirus with another infection, since the patient has an enlarged spleen, all lymph nodes, and jaundice appears.

Why is cytomegalovirus dangerous?

There is a possibility of developing cytomegalovirus sepsis (blood poisoning), cytomegalovirus meningoencephalitis. If you don't see a doctor quickly, it's possible fatal outcome. This is what cytomegalovirus is more dangerous for.

Cyomegalovirus Definition

The definition of cytomegalovirus is carried out in the laboratory. Diagnosis is quite simple: a simple blood test under a special fluorescent microscope is sufficient. Large viruses are clearly visible, not without reason that the word “metal” is present in their name, which means “big”. If the laboratory does not have a special microscope (it is quite expensive), they carry out PCR - diagnostics and detect antibodies to pathogens in the blood.

Treatment of cytomegalovirus

Pregnant women at any time in the presence of a virus and the absence of antibodies in the blood are sent to an infectious diseases hospital. Cytomegalovirus is treated with specific immunoglobulins, which help to quickly develop antibodies.

In the acute phase of the disease, interferons are treated in 2 courses of 10 days. Mandatory immunocorrection drugs (licopid, polyoxidonium, valvir, amixin). Pregnant women with anemia (with cytomegalovirus, hemoglobin in the blood often decreases) are prescribed an iron-based drug ferrovir (5 injections per course).

Preparations plant origin do not apply - they are ineffective. Arbidol will not work either.

After treatment, stress should be avoided. Within six months, any physical activity and sports are contraindicated. You need to walk more in the fresh air, consume vitamins, fruits, vegetables, follow a diet (table number 5). Chocolate and alcohol are not allowed.

What measures to take to avoid getting sick? Pregnant women must strictly observe hygiene, do not kiss other people's children, and be regularly checked for viruses.

It is necessary to carefully check the donors from whom blood is transfused to newborn children.

Avoid contact with carriers.

Sexual life can begin only after recovery from cytomegalovirus.

If you get sick, you must definitely examine your partner.

Immunity does not sleep

When we are talking about antibodies to cytomegalovirus, you need to understand what the laboratory norm is. This is the absence of antibodies, that is, zero.

The absence of antibodies is not at all the norm when it comes to the human body. It would be better if they were, and here's why: cytomegalovirus infection belongs to the group of endogenous herpesvirus infections, by the age of 30 almost all people on the planet have been ill with this virus. When a person has an infection and recovers, G antibodies are produced. If there are many of them, this indicates the normal functioning of the immune system.

This virus cannot be removed from the body. It diverges through the blood stream and through the lymphatic system through organs and tissues and settles inside the cells of which they are composed. As long as the immune system is working well, the virus is inactive, does not cause any symptoms, and does not require treatment.

And only if for some reason the body's defenses weaken, the virus can become active, that is, leave the cell into the blood. This is accompanied by certain symptoms: pneumonia, hepatitis, acute nephritis, or a prolonged flu-like syndrome. Urgent medical intervention is needed.

If the infection is activated in a pregnant woman, then the virus can pass through the placenta to the baby through the mother's bloodstream, but this is very rare.

If the virus is inactive, then it will not be transmitted to the child, but the mother's class G antibodies will be transmitted and remain in the child's blood for 12-14 months. Then they disappear, and the baby will get infections, get sick with them and build up his antibodies.

Reactivation (repeated exacerbation of the disease) of cytomegalovirus infection (CMV), acute phase of this disease or primary (first occurred in a pregnant woman) herpetic infection can cause a "frozen" pregnancy.

But these are not the main and not the most common reasons that the fetus stops growing. The detection of antibodies (IgM and IgG) in any amount is not a basis for the diagnosis of "active CMV infection" and the appointment of treatment. Neither valaciclovir nor immunoglobulin this case are not effective.

There are methods for preventing exacerbations of herpes and CMV infection during pregnancy, but only an infectious disease specialist can determine the tactics of treatment in each case.

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Since cytomegalovirus infection, treatment is prescribed to suppress the activity of pathogens in the blood and to increase immunity. In people with good immunity, the disease does not require any specific treatment. The presence of antibodies to cytomegalovirus in the blood, positive PCR results, culture for the virus in the absence of any symptoms of infection is not an indication for antiviral therapy.

Treatment of cytomegalovirus is carried out only with the development of hepatitis, encephalitis, hearing and vision disorders, as well as in those who have symptoms of congenital cytomegalovirus infection (jaundice, prematurity, subcutaneous hemorrhages, etc.). For the treatment of cytomegalovirus, antiviral drugs are used that suppress the reproduction of the virus: Ganciclovir, Foscarnet, Viferon, etc. The dose of drugs and the duration of their administration are determined by the attending physician, they depend on body weight, age of the patient and other factors.

Drugs for the treatment of cytomegalovirus

"Ganciclovir" is used intravenously in the form of infusions. One dose of the drug is administered at the rate of 5 mg per 1 kg of the patient's weight every 12 hours, a dropper is made within an hour. One course should be 3-4 weeks. Cytotect, a drug from the group of immunoglobulins, helps to fight cytomegalovirus. The composition of the drug includes specific antibodies, the action of which is directed against the causative agent of the disease. Cytotect is prescribed for the treatment of cytomegalovirus infection in patients with weak immunity. A single dose of the drug should be 50 IU per 1 kg of body weight. "Cytotect" is administered in a minimum single dose of 100 IU per 1 kg of body weight with an interval of two days. The solution must be at body temperature. The rate of administration of the drug should not be more than 20 drops per minute. The drug is contraindicated in case of individual intolerance to human immunoglobulin.

For the treatment of cytomegalovirus infection, Viferon may be prescribed. The composition of the drug includes human interferon, alpha-tocopherol acetate. The agent exhibits an immunostimulating effect. "Viferon" is also prescribed from 7 years old, 1 suppository containing 500 thousand, 1 million or 3 million IU of interferon once a day. Children under 7 years of age are prescribed one suppository of the drug containing 150 thousand IU of interferon. "Viferon" is contraindicated in case of hypersensitivity to the components of the drug, the agent can cause urticaria, itching.

Cytomegalovirus belongs to the herpetic group. This infection is transmitted by almost all possible ways and settles in the body child forever and ever. For children with a strong immune system, such a virus is not dangerous, since it manifests itself only when the level of immune defense decreases. In this case, the development of diseases of various organs and systems is observed. child's body. Unfortunately, it is impossible to completely get rid of the virus.

You will need

• - St. John's wort;
• - Melissa;
• - rose hip;
• - viburnum.

Instruction

Children who have been diagnosed with cytomegalovirus should be treated healthy lifestyle life. Take him for walks, do exercises with him, make sure he is right. All these things significantly improve health and increase the level, and, therefore, significantly reduce the risk of developing an infection.

ethnoscience also recommends tempering the body child. Conduct douches cold water, drive child in baths and saunas, if, of course, his age allows. Remember that all procedures for stabbing the body must be carried out gradually.

Sometimes the doctor also prescribes the intake of vitamins, since it is vitamin deficiency, as a rule, that causes the transition of the virus to an active state. You must also ensure that child was complete and contained all the necessary vitamins and minerals. Let your child eat as much as possible fresh vegetables and fruits.

Cytomegalovirus infection is a fairly common disease that can occur in both children and adults. Are there effective methods to get rid of this disease?

Can cytomegalovirus (CMV) be cured?

Many people who have received this infection are concerned about the question, can cytomegalovirus be cured? Unfortunately, modern medicine has not yet invented drugs that would completely remove this virus from the body. It can usually exist for a long time in a latent state and proceed asymptomatically, and become more active only in case of a decrease in immunity. Currently, there are medications that can alleviate the patient's condition. Their main goal is to suppress the activity of CMV and bring it into a state of long-term inactivity.

How to cure CMV?

With a latent course of the disease, the use of any special drugs is not required. In this case, you can apply traditional treatment, for example, as with a simple cold. The main rule is to drink as much liquid as possible during this period.

For patients with immunodeficiency, as well as people who have an exacerbation of the disease, doctors usually prescribe medications such as:

• Acyclovir;
• Genferon;
• Viferon;
• Megalotect.

If we talk about how to cure cytomegalovirus in newborns, then one of the most effective drugs can be attributed to the cytotext, which has an increased content of antibodies against CMV.

How to defeat cytomegalovirus?

People with a similar infection, who have good immunity, usually do not complain about the manifestation of any unpleasant symptoms and do not require treatment. How to defeat cytomegalovirus in patients with a weakened body? As a rule, doctors prescribe them immunological drugs and antiviral agents, which must be taken for a long time in order to completely cure CMV.

It is possible to cure the disease and strengthen the body not only with the help of drug therapy, but also using various medicinal fees and plants, such as echinacea, leuzea, ginseng or lemongrass, for example. It will also help to defeat cytomegalovirus proper nutrition, which includes products containing required amount minerals and trace elements. An important role in ridding the patient of the disease is played by daily physical exercise and outdoor walks.

18 Sep 2014, 11:08

18 Sep 2014, 11:20

Reviews and comments

It is impossible to cure. Even a bone marrow transplant, preceded by total body irradiation, does not kill the virus. You can only suppress the virus with antiviral drugs and try to increase immunity.

Modern statistics show that every fifth child becomes infected with cytomegalovirus infection at the age of 1 year. Among the ways of infection, the most dangerous is intrauterine infection. In this way, 5 to 7 percent of children become infected. About 30 percent of cases of transmission of the virus to the child occur during breastfeeding. The rest of the children become infected with the infection in children's groups. AT adolescence the virus occurs in 15 percent of children. At the age of 35, more than 40 percent of the population is affected by the disease, and by the age of 50, 99 percent of people become infected with the virus.

In the United States of America, a congenital infection is diagnosed in 3 percent of all newborns, of which 80 percent have clinical manifestations in the form of various pathologies. The mortality rate for congenital cytomegalovirus with complications at birth is 20 percent, which is between 8,000 and 10,000 children annually. In the absence of complications at birth, 15 percent of children infected during fetal development subsequently develop diseases of varying severity. Between 3 and 5 percent of children worldwide become infected in the first 7 days of life.

Among pregnant women, about 2 percent of women are exposed to primary infection. The probability of transmission of the virus at the time of bearing a child with primary infection is from 30 to 50 percent. These children are born with following deviations- neurosensory disorders - from 5 to 13 percent; mental retardation - up to 13 percent; bilateral hearing loss - up to 8 percent.

Interesting facts about cytomegalovirus infection

The conclusions of the colleges of America and Great Britain boil down to the fact that a systematic examination for the determination of cytomegalovirus in pregnant women is not recommended due to the large number of unexplored factors of this disease. A mandatory recommendation is to provide all pregnant women with information that will allow them to observe precautionary and hygiene measures in the prevention of this disease.

What is cytomegalovirus?

The structure of the cytomegalovirus

The components of the cytomegalovirus virion are:

• virus genome;
• nucleocapsid;
• protein ( protein) matrix;
• supercapsid.

Nucleocapsid
"Nucleocapsid" is translated from ancient Greek as "shell of the nucleus." It is a protein layer that surrounds the virus genome. The nucleocapsid is formed from 162 capsomeres ( shell protein fragments). Capsomeres form a geometric figure with pentagonal and hexagonal faces arranged according to the type of cubic symmetry.

Protein Matrix
The protein matrix occupies the entire space between the nucleocapsid and outer sheath virion. Proteins that make up the protein matrix are activated when the virus enters the host cell and participate in the reproduction of new viral units.

Supercapsid
The outer shell of the virion is called the supercapsid. It consists of a large number glycoproteins ( complex protein structures containing carbohydrate components). Glycoproteins are located differently in the supercapsid. Some of them protrude above the surface of the main layer of glycoproteins, forming small "spikes". With the help of these glycoproteins, the virion "feels" and analyzes the external environment. When the virus comes into contact with any cell of the human body, with the help of "spikes" it attaches itself and penetrates into it.

Properties of cytomegalovirus

The main properties of cytomegalovirus are:

• low virulence ( degree of pathogenicity);
• latency;
• slow reproduction;
• pronounced cytopathic ( cell-destroying) Effect;
• reactivation in host immunosuppression;
• instability in the external environment;
• low contagiousness ( ability to infect).

Latency
Once in the human body, cytomegalovirus remains in it for life. Thanks to the body's immune defenses, the virus can long time exist in a latent, dormant state, without causing any clinical manifestations of the disease.

With the help of glycoprotein "thorns" the virion recognizes and attaches itself to the membrane of the cell it needs. Gradually, the outer membrane of the virus merges with the cell membrane and the nucleocapsid penetrates inside. Inside the host cell, the nucleocapsid inserts its DNA into the nucleus, leaving a protein matrix on the nuclear membrane. Using the enzymes of the cell nucleus, viral DNA multiplies. The protein matrix of the virus, which remained outside the nucleus, synthesizes new capsid proteins. This process is the longest - it takes an average of 15 hours. The synthesized proteins pass into the nucleus and combine with new viral DNA, forming the nucleocapsid. Gradually, proteins of a new matrix are synthesized, which attaches to the nucleocapsid. The nucleocapsid emerges from the cell nucleus and attaches to inner surface cell membrane and is enveloped by it, creating a supercapsid for itself. Copies of the virion that have left the cell are ready to penetrate into another healthy cell for further reproduction.

Reactivation in host immunosuppression
For a long time, cytomegalovirus can be in a latent state in the human body. However, under conditions of immunosuppression, when the human immune system is weakened or destroyed, the virus is activated and begins to enter the host cells for reproduction. As soon as the immune system returns to normal, the virus is suppressed and falls into "hibernation".

Main adverse factors environment for cytomegalovirus are:

• high temperatures ( more than 40 - 50 degrees Celsius);
• freezing;
• fat dissolvers ( alcohol, ether, detergents).

Methods of infection with cytomegalovirus

Favorable factors for infection with cytomegalovirus are:

• constant, long and close contact with the source of infection;
• violation of the biological protective barrier - the presence of tissue damage ( cuts, wounds, microtrauma, erosion) at the site of contact with the infection;
• disturbances in the functioning of the body's immune system during hypothermia, stress, infection, and various internal diseases.

Methods of infection with cytomegalovirus

Contact household way

airborne way

Contact-sexual way

oral route

Transplacental route

iatrogenic pathway

Cytomegalovirus can also enter the body when reusable unsterilized medical equipment.

Transplant route

The spread of cytomegalovirus infection in the body proceeds in several stages.

The stages of the spread of cytomegalovirus infection are:

• local cell damage;
• distribution in regional lymph nodes;
• primary immune response;
• circulation in the circulatory and lymphatic system;
• dissemination ( Spread) in organs and tissues;
• secondary immune response.

At this time, the immune system is activated in the human body, which suppresses the spread of foreign particles through the blood and lymph. However, the immune system is not able to completely destroy the infection. Cytomegalovirus can remain latent in the lymph nodes for a long time.

In the case of immunosuppression, the body is not able to stop the reproduction of the virus. Cytomegalovirus penetrates into blood cells and spreads to all organs and tissues, affecting them.
During the secondary immune response, a large number of antibodies to the virus are produced, which suppress its further replication ( reproduction). The patient recovers, but becomes a carrier ( virus persists in lymphoid cells).

Symptoms of cytomegalovirus infection in women

After the penetration of cytomegalovirus into the human body, an incubation period begins. During this period, the virus actively multiplies in the body, but without showing any symptoms. With cytomegalovirus infection, this period lasts from 20 to 60 days. Then comes the acute phase of the disease. Women with strong immune systems may experience this phase with mild flu-like symptoms. A slight temperature may be observed ( 36.9 - 37.1 degrees Celsius), mild malaise, weakness. As a rule, this period passes imperceptibly. However, in favor of the presence of cytomegalovirus in the body of a woman, an increase in the titer of antibodies in her blood testifies. If she makes a serological diagnosis during this period, then acute-phase antibodies to this virus will be detected ( anti-CMV IgM).

The acute phase of cytomegalovirus lasts 4 to 6 weeks. After that, the infection subsides and is activated only with a decrease in immunity. In this form, the infection can persist for life. Only with random or planned diagnostics can it be detected. In this case, in the blood of a woman or in a smear, if a PCR smear is performed, chronic phase antibodies to cytomegalovirus are detected ( anti-CMV IgG).

It is believed that 99 percent of the population is a carrier of latent cytomegalovirus infection, and these people are detected anti-CMV IgG. If the infection does not manifest itself, and the woman's immunity is strong enough for the virus to remain in an inactive form, then she becomes a virus carrier. As a rule, the virus carrier is not dangerous. But, at the same time, in women, a latent cytomegalovirus infection can cause miscarriages, the birth of dead children.

In immunocompromised women, the infection is active. In this case, two forms of the disease are observed - acute mononucleosis-like and generalized form.

Acute cytomegalovirus infection

First, the cervical lymph nodes increase. They can be very large and exceed 5 centimeters. Further, the submandibular, axillary and inguinal nodes. The internal lymph nodes are also enlarged. Lymphadenopathy appears first of the symptoms and the last to disappear.

Other symptoms of the acute phase are:

• malaise;
• liver enlargement ( hepatomegaly);
• increase in leukocytes in the blood;
• the appearance in the blood of atypical mononuclear cells.

Differences between cytomegalovirus and infectious mononucleosis
Unlike infectious mononucleosis, angina is not observed with cytomegalovirus. It is also extremely rare to observe an increase in the occipital lymph nodes and spleen ( splenomegaly). In laboratory diagnostics, the Paul-Bunnel reaction, which is inherent in infectious mononucleosis, is negative.

Generalized form of cytomegalovirus infection

The most common manifestations of a generalized infection are:

• liver damage with the development of cytomegalovirus hepatitis;
• lung damage with the development of pneumonia;
• damage to the retina with the development of retinitis;
• damage to the salivary glands with the development of sialadenitis;
• kidney damage with the development of nephritis;
• damage to the organs of the reproductive system.

The course of hepatitis can be acute, subacute and chronic. In the first case, the so-called fulminant hepatitis develops, often with a fatal outcome.

Diagnosis of cytomegalovirus infection is reduced to needle biopsy. In this case, with the help of a puncture, a piece of liver tissue is taken for further histological examination. When examining the tissue, huge cytomegalic cells are found.

Cytomegalovirus pneumonia
With cytomegalovirus, as a rule, interstitial pneumonia initially develops. With this type of pneumonia, not the alveoli are affected, but their walls, capillaries and tissue around the lymphatic vessels. This pneumonia is difficult to treat, resulting in a long course.

Very often, such prolonged pneumonia is complicated by the addition of a bacterial infection. As a rule, staphylococcal flora joins with the development of purulent pneumonia. Body temperature rises to 39 degrees Celsius, fever and chills develop. The cough quickly becomes wet with a large amount of purulent sputum. Shortness of breath develops, chest pain appears.

In addition to pneumonia, cytomegalovirus infection can develop bronchitis, bronchiolitis. The lymph nodes of the lungs are also affected.

Cytomegalovirus retinitis
Retinitis affects the retina of the eye. Retinitis is usually bilateral and may be complicated by blindness.

The symptoms of retinitis are:

• photophobia;
• blurred vision;
• "flies" before the eyes;
• the appearance of lightning and flashes before the eyes.

Cytomegalovirus sialadenitis
Sialoadenitis is characterized by damage to the salivary glands. The parotid glands are often affected. In the acute course of sialadenitis, the temperature rises, shooting pains appear in the gland area, salivation decreases and dryness is felt in the mouth ( xerostomia).

Very often, cytomegalovirus sialoadenitis is characterized by a chronic course. In this case, there are periodic pain, slight swelling in the parotid gland. The main symptom continues to be reduced salivation.

Kidney damage
The kidneys are very common in people with an active form of cytomegalovirus infection. In this case, inflammatory infiltration is found in the tubules of the kidney, in its capsule and in the glomeruli. In addition to the kidneys, the ureters may be affected, bladder. The disease progresses from rapid development kidney failure. A sediment appears in the urine, which consists of epithelium and cytomegalovirus cells. Sometimes there is hematuria ( blood in urine).

Damage to the organs of the reproductive system
In women, very often the infection occurs in the form of cervicitis, endometritis and salpingitis. As a rule, they proceed chronically with periodic exacerbations. A woman may complain of recurrent, mild pain in the lower abdomen, pain when urinating, or pain during intercourse. Sometimes there may be urination disorders.

Cytomegalovirus infection in women with AIDS

AIDS patients develop bilateral diffuse pneumonia lung tissue. Pneumonia is most often prolonged, with a painful cough and shortness of breath. Pneumonia is one of the most common causes of death in HIV infection.

Also, AIDS patients develop cytomegalovirus encephalitis. Encephalitis with encephalopathy rapidly develops dementia ( dementia), which is manifested by a decrease in memory, attention, intelligence. One form of cytomegalovirus encephalitis is ventriculoencephalitis, which affects the ventricles of the brain and cranial nerves. Patients complain of drowsiness, severe weakness, impaired visual acuity.
The defeat of the nervous system in cytomegalovirus infection is sometimes accompanied by polyradiculopathy. In this case, the roots of the nerves are repeatedly affected, which is accompanied by weakness and pain in the legs. Cytomegalovirus retinitis in women with HIV infection often causes complete loss of vision.

Cytomegalovirus infection in AIDS is characterized by multiple lesions of internal organs. In the last stages of the disease, multiple organ failure is detected with damage to the heart, blood vessels, liver, and eyes.

Pathologies that cause cytomegalovirus in women with immunodeficiency are:

• kidney damage- acute and chronic nephritis ( kidney inflammation), foci of necrosis on the adrenal glands;
• liver disease hepatitis, sclerosing cholangitis ( inflammation and narrowing of the intrahepatic and extrahepatic bile ducts), jaundice ( a disease in which the skin and mucous membranes become stained yellow ), liver failure;
• diseases of the pancreas- pancreatitis ( inflammation of the pancreas);
• diseases of the gastrointestinal tract- gastroenterocolitis ( joint inflammation of the small intestine, large intestine and stomach), esophagitis ( damage to the esophageal mucosa), enterocolitis ( inflammatory processes in the small and large intestine), colitis ( inflammation of the colon);
• lung disease- pneumonia ( pneumonia);
• eye diseases- retinitis ( retinal disease), retinopathy ( non-inflammatory ocular lesion). Eye problems occur in 70 percent of patients with HIV infection. About one fifth of patients lose their sight;
• spinal cord and brain damage- meningoencephalitis ( inflammation of the membranes and substances of the brain), encephalitis ( brain damage), myelitis ( inflammation of the spinal cord), polyradiculopathy ( damage to the nerve roots of the spinal cord), polyneuropathy lower extremities (disorders in the peripheral nervous system), infarction of the cerebral cortex;
• disease genitourinary system - cervical cancer, lesions of the ovaries, fallopian tubes, endometrium.

Symptoms of cytomegalovirus infection in children

Congenital cytomegalovirus infection in children

Cytomegalovirus belongs to the group of TORCH infections that lead to severe malformations. When a virus enters the blood of a child, a congenital infection does not always develop. According to various sources, from 5 to 10 percent of children whose blood has entered the virus develop an active form of the infection. As a rule, these are the children of those mothers who suffered a primary cytomegalovirus infection during pregnancy.
With the reactivation of a chronic infection during pregnancy, the degree of intrauterine infection does not exceed 1-2 percent. In the future, 20 percent of these children have serious pathologies.

Clinical manifestations of congenital cytomegalovirus infection are:

• malformations of the nervous system - microcephaly, hydrocephalus, meningitis; meningoencephalitis;
• Dandy-Walker syndrome;
• heart defects - carditis, myocarditis, cardiomegaly, valve malformations;
• defeat hearing aid- congenital deafness;
• defeat visual apparatus- cataract, retinitis, chorioretinitis, keratoconjunctivitis;
• anomalies in the development of teeth.

In the blood of such children, there is an increase in liver enzymes, bilirubin, the number of platelets drops sharply ( thrombocytopenia). Mortality in this period is very high. Surviving children subsequently experience mental retardation, speech disorders. Most children with congenital cytomegalovirus infection suffer from deafness, and blindness is less common.

Due to damage to the nervous system, paralysis, epilepsy, and intracranial hypertension syndrome develop. Subsequently, such children lag behind not only in mental, but also in physical development.

A separate variant of congenital cytomegalovirus infection is Dandy-Walker syndrome. With this syndrome, various anomalies of the cerebellum and expansion of the ventricles are observed. Mortality in this case is from 30 to 50 percent.

The frequency of symptoms in intrauterine CMV infection in children is as follows:

• skin rash - from 60 to 80 percent;
• hemorrhages in the skin and mucous membranes - 76 percent;
• jaundice, 67 percent;
• enlargement of the liver and spleen - 60 percent;
• reduction in the size of the skull and brain - 53 percent;
• disorders of the digestive system - 50 percent;
• prematurity - 34 percent;
• hepatitis, 20 percent;
• inflammation of the brain - 15 percent;
• inflammation of blood vessels and retina - 12 percent.

Acquired cytomegalovirus infection in children

The nature of the consequences of an acquired cytomegalovirus infection depends on the age of the child and the state of his immune system. The most common consequence of the virus is acute respiratory diseases (ORZ), which are accompanied by inflammation of the bronchi, pharynx and larynx. Often there is a lesion of the salivary glands, most often in the parotid zones. A characteristic complication acquired infection are inflammatory processes in connective tissues in the region of the pulmonary alveoli. Another manifestation of cytomegalovirus infection is hepatitis, which occurs in a subacute or chronic form. Rare complication virus is such a lesion of the central nervous system as encephalitis ( inflammation of the brain).

Symptoms of acquired cytomegalovirus infection are:

• children under 1 year old- lag in physical development with impairments motor activity and frequent seizures. There may be lesions of the gastrointestinal tract, vision problems, hemorrhages;
• children from 1 to 2 years old- most often the disease is manifested by mononucleosis ( viral disease ), the consequences of which are an increase in lymph nodes, swelling of the mucous throat, liver damage, changes in blood composition;
• children from 2 to 5 years old- the immune system at this age is not able to adequately respond to the virus. The disease causes complications such as shortness of breath, cyanosis ( bluish discoloration of the skin), pneumonia.

Acquired cytomegalovirus infection in children can also result from blood transfusions or organ transplants. In this case, the penetration of the virus into the body occurs with donated blood or organs. Similar infection usually proceeds according to the type of mononucleosis syndrome. At the same time, the temperature rises, nasal discharge and sore throat appear. At the same time, the lymph nodes are enlarged in children. The main manifestation of post-transfusion cytomegalovirus infection is hepatitis.

In 20 percent of cases after organ transplantation, cytomegalovirus pneumonia develops. After a kidney or heart transplant, the virus causes hepatitis, retinitis, and colitis.

In children with immunodeficiency ( for example, those who suffer malignant diseases ) cytomegalovirus infection is very difficult. As in adults, it leads to prolonged pneumonia, fulminant hepatitis, visual impairment. Reactivation of the virus begins with a rise in temperature and chills. Often, children develop a hemorrhagic rash that affects the entire body. AT pathological process such internal organs as the liver, lungs, central nervous system are involved.

Symptoms of cytomegalovirus infection in women during pregnancy

During the initial infection with the virus or its reactivation, pregnant women may experience a number of symptoms that can manifest themselves or in combination. Some women are diagnosed with increased uterine tone, which does not respond to therapy.

Manifestations of CMV infection in pregnant women are:

• polyhydramnios;
• premature aging or placental abruption;
• improper attachment of the placenta;
• large blood loss during childbirth;
• spontaneous miscarriages.

Inflammatory processes in the genitourinary system in pregnant women with CMV are:

• endometritis (inflammatory processes in the uterus) - pain in the abdomen ( lower part). In some cases, pain may radiate to the lower back or sacrum. Patients also complain about poor general well-being, lack of appetite, headaches;
• cervicitis (damage to the cervix) - discomfort during intimacy, itching in the genitals, aching pain in the perineum and lower abdomen;
• vaginitis (inflammation of the vagina) - irritation of the genital organs, an increase in body temperature, discomfort during intercourse, aching pain in the lower abdomen, redness and swelling of the external genitalia, frequent urination;
• oophoritis (inflammation of the ovaries) - a feeling of pain in the pelvis and lower sections abdomen, bloody discharge that occurs after intercourse, a feeling of discomfort in the lower abdomen, pain during intimacy with a man;
• cervical erosion- the appearance of blood in the discharge after intimacy, abundant vaginal discharge, sometimes there may be pain that is not very pronounced during intercourse.

The effect of CMV on the body of a pregnant woman

The consequences of the virus are:

• inflammation of the salivary glands, tonsils;
• pneumonia, pleurisy;
• myocarditis.

With severely weakened immunity, the virus can take a generalized form, affecting the entire body of the patient.

Complications of a generalized infection in women during pregnancy are:

• inflammatory processes in the kidneys, liver, pancreas, adrenal glands;
• dysfunction of the digestive system;
• vision problems;
• lung dysfunction.

Diagnosis of cytomegalovirus infection

Diagnostic methods for cytomegalovirus infection are:

• isolation of the virus by culturing it in cell culture;
• polymerase chain reaction (PCR);
• linked immunosorbent assay ( ELISA);
• cytological method.

Virus isolation

Virus isolation occurs in cell culture. Single-layer cultures of human fibroblasts are most commonly used. researched biological material initially centrifuged to isolate the virus itself. Next, the virus is applied to cell cultures and placed in a thermostat. There is, as it were, infection of cells with this virus. Cultures are incubated for 12 to 24 hours. As a rule, several cell cultures are infected and simultaneously incubated. Further, the obtained cultures are identified using various methods. Most often, cultures are stained with fluorescent antibodies and examined under a microscope.

The disadvantages of this method is the significant time spent on the cultivation of the virus. The duration of this method is from 2 to 3 weeks. At the same time, fresh material is needed to isolate the virus.

PCR

biological material
For PCR, any biological fluids are taken ( blood, saliva, urine, cerebrospinal fluid), swabs from the urethra and vagina, feces, swabs from mucous membranes.

Conducting PCR
The essence of the analysis is to isolate the DNA of the virus. Initially, a fragment of a DNA strand is found in the test material. Further, this fragment is cloned many times with the help of special enzymes to obtain a large number of DNA copies. The resulting copies are identified, that is, they are determined to which virus they belong. All these reactions take place in a special apparatus called an amplifier. The accuracy of this method is 95 - 99 percent. The method is carried out quickly enough, which allows it to be widely used. Most often it is used in the diagnosis of hidden urinary infections, cytomegalovirus encephalitis and for screening for TORCH infections.

ELISA

biological material
The patient's blood is used to detect antibodies.

ELISA
The essence of the method is to detect antibodies to cytomegalovirus both in the acute phase and in the chronic. In the first case, anti-CMV IgM are detected, in the second, anti-CMV IgG. The analysis is based on the antigen-antibody reaction. The essence of this reaction is that antibodies ( produced by the body in response to a virus) bind specifically to antigens ( proteins on the surface of the virus).

The analysis is carried out in special tablets with wells. Biological material and antigen are placed in each well. Next, the tablet is placed in a thermostat for certain time during which the formation of antigen-antibody complexes occurs. After that, washing is carried out with a special substance, after which the formed complexes remain at the bottom of the wells, and the non-bound antibodies are washed off. After that, more antibodies treated with a fluorescent substance are added to the wells. Thus, a "sandwich" is formed of two antibodies and an antigen in the middle, which are processed with a special mixture. When this mixture is added, the color of the solution in the wells changes. The color intensity is directly proportional to the amount of antibodies in the test material. In turn, the intensity is determined using an apparatus such as a photometer.

Cytological diagnostics

Treatment of cytomegalovirus infection

Mechanism of therapeutic action

Activation of cellular defense genes
Interferons activate a number of genes that are involved in cellular defense against the virus. Cells become less vulnerable to the penetration of viral particles.

p53 protein activation
The p53 protein is a special protein that starts the processes of cell repair when they are damaged. If cell damage is irreversible, then the p53 protein triggers the process of apoptosis ( programmed death) cells. In healthy cells, this protein is in an inactive form. Interferons have the ability to activate the p53 protein in cytomegalovirus-infected cells. It evaluates the state of the infected cell and starts the process of apoptosis. As a result, the cell dies, and the virus does not have time to multiply.

Stimulation of the synthesis of special molecules of the immune system
Interferons stimulate the synthesis of special molecules that help the immune system recognize viral particles more easily and quickly. These molecules bind to receptors on the surface of the cytomegalovirus. Killer cells ( T-lymphocytes and natural killers) of the immune system find these molecules and attack the virions to which they are attached.

Stimulation of cells of the immune system
Interferons have the effect of direct stimulation of certain cells of the immune system. These cells include macrophages and natural killers. Under the influence of interferons, they migrate to the affected cells and attack them, destroying them together with the intracellular virus.

In the treatment of cytomegalovirus infection, various drugs based on natural interferons are used.

Natural interferons used in the treatment of cytomegalovirus infection are:

• human leukocyte interferon;
• leukinferon;
• wellferon;
• feron.

Release form and methods of using some natural interferons in cytomegalovirus infection

The biggest disadvantage natural preparations is their high cost, so they are used less often.

Currently, there are a large number of recombinant drugs of the interferon group, which are used in the complex therapy of cytomegalovirus infection.

The main representatives of recombinant interferons are the following drugs:

• viferon;
• kipferon;
• realdiron;
• reaferon;
• laferon.

Release form and methods of application of some recombinant interferons in cytomegalovirus infection

Evaluation of the treatment method

Is treatment necessary for asymptomatic cytomegalovirus infection?

For this, it is recommended to prevent chronic infections ( especially urinary), which are the main cause of reduced immunity. It is also recommended to take immunostimulants, such as Echinacea Hexal, Derinat, Milife. They should only be taken as directed by a doctor.

What are the consequences of cytomegalovirus infection?

The consequences of cytomegalovirus for people with normal immunity

Depending on the moment of infection, the consequences of a cytomegalovirus infection for a developing fetus are:

• blastopathy(malformations that occur when infected during the period from 1 to 15 days of pregnancy) - death of the embryo, non-developing pregnancy, spontaneous abortion, various systemic pathologies in the fetus;
• embryopathies(when infected on the 15th - 75th day of pregnancy) – pathology of the vital systems of the body ( cardiovascular, digestive, respiratory, nervous). Some of these malformations are incompatible with fetal life;
• fetopathy(with late infection) - the infection can provoke the development of jaundice, damage to the liver, spleen, lungs.

The consequences of cytomegalovirus infection for children who have had an acute form of the disease

The consequences of infection with cytomegalovirus in children are:

• jaundice from the first days of life occurs in 50 - 80 percent of sick children;
• hemorrhagic syndrome is registered in 65 - 80 percent of patients and is manifested by hemorrhages in the skin, mucous membranes, adrenal glands. Bleeding from the nose or umbilical wound is also possible;
• hepatosplenomegaly ( enlargement of the liver and spleen) diagnosed in 60-75 percent of children. Together with jaundice and hemorrhagic syndrome, this disease is the most common complication of CMV that develops in infected children from the first days of life;
• interstitial pneumonia manifests itself with symptoms respiratory disorders;
• nephritis is a complication that develops in a third of sick children;
• gastroenterocolitis occurs in 30 percent of cases;
• myocarditis ( inflammation of the heart muscle) diagnosed in 10% of patients.

Other complications of cytomegalovirus are:

• lag in psychomotor development;
• lesions of the gastrointestinal tract;
• pathology of the organ of vision ( chorioretinitis, uveitis);
• blood disorders ( anemia, thrombocytopenia).