Cytomegalovirus (CMV): positive, IgG/IgM, interpretation

Cytomegalovirus CMV positive IgGIgM interpretation

Cytomegalovirus (or CMV) belongs to the Herpes virus family. It is a normally harmless viral infection, but can be serious for immunocompromised people and pregnant women.

THE cytomegalovirus (abbreviated CMV) is a Herpes family virus and may be responsible foran infection, often going unnoticed. At the pregnant woman or the person immunocompromisedit is particularly dangerous. How do you catch the CMV virus? What are the symptoms CMV infection? How to heals a CMV infection? How about protect ?

Definition: what is a cytomegalovirus or CMV?

CMV is a viral disease normally harmless, but which can be serious for immunocompromised people. It’s a virus generally responsible for few symptoms in individuals with an efficient immune system, responsible for fatigue or other mild and uncharacteristic symptoms such as pain or feverbut it can be serious in immunocompromised people or in pregnant women.

Serology is the study of sera to detect changes induced by disease. Cytomegalovirus is detectable through blood serology (blood test) where the the presence of antibodies specific for this virus is demonstrated. After an incubation period of 28 to 60 days (40 days on average), CMV infection induces the IgM production followed by IgG antibody production. Serology measures anti-CMV IgG and IgM levels. The presence of IgG alone, regardless of the disease, always reflects an old infection. “However when there is only IgM it is a recent infection or in progress”, reports Dr. Philippe Mironneau. In this case, you have to make A “Anti-CMV IgG Avidity Test” which will make it possible to date the beginning of the infection. This serological test can identify a primary infection less than 3 months old if the avidity is low, or more than 3 months old if the avidity is high.

Very often in individuals with no other pathology, the infection caused by this virus goes unnoticed or simply manifests as fatigue.

What are the symptoms of CMV?

Very often in the individual without another pathology, the infection caused by this virus goes unnoticed or simply manifests as fatigue and fever. Sometimes headaches, muscle aches or slight weight loss. This is the case in 90% of adults. Sometimes the affected individual may present with feverof the diffuse pain. In the immunocompromised patient or HIV carrier, for example, it is on the other hand a potentially serious infection often manifested by:

  • retinal damage
  • digestive inflammation
  • neurological inflammation.
Diagram of a cytomegalovirus (CMV) © mikrostoker – 123RF / Women’s Journal

How do you catch cytomegalovirus?

“Contamination is essentially the result of saliva and urine“, explains Dr. Philippe Mironneau, gynecologist and obstetrician in Dijon. It can also be done by intimate secretions and tears. CMV infection is common in people with HIV at advanced stages of the disease.

What is the incubation time for CMV?

Iincubation of CMV is 20 to 40 days on average but it remains very variable.

What are the risks of cytomegalovirus during pregnancy?

Cytomegalovirus infection is a viral disease that can have serious consequences if it occurs during pregnancy. Indeed, if the disease affects the fetus, many sequels are possible ranging from a psychomotor delay, hearing damage (risk of deafness), growth retardation (microcephaly in particular). In some cases, death in utero may occur. According to High Council of Public Health “Most infected newborns who are asymptomatic at birth will not develop a disability, only 10% may develop deafness until the age of 5”. The rate of transmission increases with the term but the sequelae are more serious if transmitted during the first trimester. This is why it is important to confirm the infection in the mother and to estimate its age. For this, several biological examinations are possible. When fetal CMV infection has been diagnosed, a ultrasound monitoring should be instituted, including an assessment of fetal anatomy and growth.

Currently, no treatment is available either prenatally or for asymptomatic newborns. The standard treatment uses antivirals can cause fetal malformations. It is phosphonoformic acid (Foscarnet) and DHPG. For pregnant women, prevention is therefore essential: washing your hands frequently, not tasting your baby’s spoon… There is no no vaccine against CMV infection.

  • do not kiss the child on the mouth
  • do not taste on your plate, finish your dish
  • do not suck the baby’s pacifier
  • don’t kiss a crying baby on the cheeks
  • do not suck the nose of a baby with a cold without taking precautions (you must use tissues in particular and wash your hands)
  • do not take a bath with a baby who is likely to urinate in it
  • wash hands after touching toys, clothes wet with urine

Thanks to Dr Philippe Mironneau, gynecologist and obstetrician in Dijon.

Source : Diagnosis by serology and/or by research of the viral genome of congenital cytomegalovirus infection, HASNovember 2015

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