Cytomegaloviruses – latent danger

Cytomegaloviruses - latent danger

Cytomegalovirus (CMV) is distributed worldwide. Many people become infected unnoticed in the course of their lives. However, once acquired, the pathogen remains in the body and can pose a risk in the case of an immune deficiency for the affected person or pregnancy for the unborn child. The CMV belongs to the large group of herpes viruses that can cause not only the well-known cold sores but also chickenpoxshingles and glandular fever.

Viruses stay in the body for life.

What they all have in common is that they remain in the body for life, usually without making themselves felt. Only when the immune system is weakened do they come back to life? This can be caused by stress and fever ( e.g. cold sores ), but also severe infections, cancer or organ transplants. Then, the viruses are hazardous because they can cause serious diseases.

 

Spread of cytomegaloviruses

It is estimated that 50 to 80 per cent of adults are infected with the virus. This means that the risk of becoming infected can hardly be averted. This is all the more true as most people do not know they carry CMV since the initial infection usually goes unnoticed or manifests in mild flu-like symptoms.

The pathogens are found in body fluids such as saliva, blood, urine, semen or the cervix’s mucus – they are transmitted through the skin and mucous membranes due to smear or droplet infection. The unborn child can become infected through the placenta and the infant through breast milk when breastfeeding. The latter is problematic in premature babies since the virus can still cause brain damage in them.

Symptoms of cytomegaly

The initial infection is often unproblematic, with little or no symptoms. However, if people with a weakened immune system become infected or if the already lurking virus is reactivated, life-threatening clinical pictures can occur. Therefore, if there is a suspicion, a blood test must be carried out, during which the virus can be detected early, and treatment can be initiated.

If this is not done, there will be exhaustion, fever, and muscle and joint pain like the flu after a few days. In the future, various organ systems can be affected by the virus. Typical symptoms include lung inflammation, heart muscle, kidneys, liver, brain, and retina (retinitis). The bone marrow can also be affected, leading to disturbances in blood cell production, further weakening the immune system, and increasing the risk of infection, such as fungi.

In about a third of the cases in which women are first infected with CMV during pregnancy, the virus is transmitted to the unborn child. Symptoms vary from enlarged liver and spleen to life-threatening diseases. Complications include loss of hearing, vision and mental development. If the pregnant woman was previously infected, the rate of infection transmission to the child is only one per cent, with no symptoms or disorders to be feared as a rule.

 

Diagnosis of cytomegaly

CMV infection is detected using various blood tests. On the one hand, the virus can be quantitatively detected directly. It is determined how high the “viral load” is, i.e. how many viruses are in the body. This procedure is essential to check if a drug is working. On the other hand, the infection can be indirectly detected by specific antibodies. The latter also indicates whether the disease is acute or a long time ago.

Prevention and therapy of cytomegaly

Patients with a weakened immune system must be protected against CMV infection or reactivation. Those affected include:

  • HIV infected
  • Cancer patients, especially those undergoing chemotherapy
  • Transplant recipient. CMV infection is one of the most common complications of transplantation, and retinitis, in particular, is a common complication in HIV patients.

For efficient prevention, it is first estimated how high the individual risk is, and the treatment or controls are adjusted accordingly. If it is high, those affected receive an antiviral agent (antiviral) before the virus can even multiply in the blood. If it is lower, they are regularly monitored with a blood test and – if the virus multiplies – therapeutic measures are initiated if necessary before symptoms appear. Depending on the case, the drugs are in the form of infusions such as tablets or capsules.

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