Cytomegalovirus infection igg. What does the detection of antibodies to cytomegalovirus IgG and IgM mean? What do IgM and IgG antibodies to cytomegalovirus show?

About 80% of the inhabitants of the planet are carriers, although they are not aware of it. Often, the disease is detected by chance, during a laboratory examination to detect antibodies in the blood. The main danger is the latent stay of the virus in the body. Only timely detection, the adoption of therapeutic measures will prevent the recurring nature of the viral manifestation.

More about abbreviations

Ig is the abbreviation for immunoglobulin. The last letter G is the class of immunoglobulins Ig.

Igg are immunoglobulins or protective protein antibodies produced by the immune system in response to an infection. These are markers with which laboratory technicians and doctors, during the course of serological analysis, can identify infection to establish an accurate diagnosis. In particular, to recognize what percentage of the infection in the blood, the degree of deviation of indicators from the norm. These are the reference igg values ​​that protect the body from the invasion of viruses and bacteria.

The production of class G antibodies is slow, but quite stable. Igg levels in the bloodstream can be low for many years, and the infection will manifest itself after 20-25 days. Usually, doctors prescribe a second analysis to clarify the diagnosis, to get a complete picture of the ratio of antibodies (igg, igm) in the body.

Important information

The igg test is performed by drawing blood as a sample directly from a fasting vein to detect specific antibodies to cytomegalovirus igg. It is prescribed for suspected infection with viruses, because in case of infection, the body begins to increase the production of antibodies.

A distinctive feature of the igg class immunoglobulin is the ability to persist in the body throughout life. Getting rid of the virus in its entirety is almost impossible. Gradually, the immune system develops a stable barrier that can prevent viral attacks, their transition to the active stage.

Such testing to date or allows you to identify.

Cytomegalovirus is alive. Even if the initial test result is negative, this does not mean the absence of infection in the body.

The amount of igg in the blood plays a big role. With the activation and growth of the population of microorganisms, the virus will eventually begin to be detected constantly, and the person will become a carrier. The igg analysis allows doctors to determine when the infection occurred, whether it is primary or secondary. Maybe the disease is progressing, receding or has an uncertain character.

Often. Mom can become a virus carrier. Infection can be intrauterine due to the high ability of viruses to penetrate the placental barrier or acquired in case of infection at the time the child passes through the birth canal.

The main routes of transmission of the virus from person to person:

• contact household;
• sexual;
• airborne.

The source of infection is a sick person, as well as contaminated household items, sexual contacts, any biological fluid (urine, saliva, breast milk, semen, vaginal secretions).

The risk group includes HIV-infected patients, pregnant women, the elderly, or those who have undergone transplantation of one or another organ.

Indications for passing the analysis

An analysis is prescribed for patients with a weakened immune system or if a pathology is suspected. Indications for carrying out:

• pregnancy;
• performed transplantation;
• hiv infection;
• oncology;
• frequent miscarriages, spontaneous abortion in women, regardless of the gestational age;
• frequent colds (ARVI, flu);
• neoplastic disease;
• pneumonia with a non-standard course;
• feverish state, heat unresponsive to medication.

If cytomegalovirus is detected in a woman during pregnancy, then the analysis is carried out in babies immediately after birth. In particular, children are completely unstable before the onslaught of infection from the outside and may well get an acquired form of the disease at the time of visiting crowded places (kindergartens, schools).

What does a positive test result indicate?

Positive igg cytomegalovirus indicates primary or secondary infection. Immunoglobulins in the blood serve as a marker to identify the severity of the course inflammatory process in the body. The test is necessary to determine the exact concentration of class G immunoglobulin, prescribing timely treatment if necessary.

Titer G immunoglobulin will be considered positive when its concentration reaches more than 1 mm honey / ml. This means that the human body was first infected with viruses no more than 3 weeks ago, but resistant antibodies to them are produced, entering into an active struggle. If the virus is activated, then the excess igg in the blood will be more than 4 times. If antibodies of the igm class are additionally present and their indicators are also overestimated, then during the laboratory research the concentration of both immunoglobulins is taken into account, then the doctors compare and interpret the results.

If a cytomegalovirus igg is not detected or the percentage in the blood does not exceed 0.9 mm honey / ml, which means that there is no infection, the susceptibility to the initial infection is increased in the body.

Often, doctors perform an ELISA test to compare the possible ratios between igg and igm immunoglobulins:

• G - negative and M - positive - infection has occurred recently, the virus is at the stage of maximum activity;
• M - negative, G - positive - the virus is not active, but a disease is observed in the body;
• G - negative, M - negative - in the body there is no stable immunity against viruses due to their absence;
• G - positive, M - positive - the immune system is greatly weakened, the disease is activated and can take a chronic course.

Symptoms of a positive result

Main symptoms: fever (over 6-7 weeks), high temperature. It's like a cold. Additionally observed:

• muscle, headache;
• aches in the joints;
• sore throat;
• diarrhea;
• rash, itching on the body;
• (cervical, parotid, submandibular);

Signs of cytomegalovirus in children:

• mononucleosis;
• classical;
• type ;
• hepatitis B, yellowness of the skin;
• retinitis;
• encephalitis;
• indigestion;
• pneumonia;
• weakness;
• stool disorder.

The infection proceeds quite interestingly and can remain in a latent latent state for a long time, but under certain circumstances it can lead to (heart, liver, lungs), in particular systems (genitourinary, nervous, reproductive).

Women begin to complain about gynecological problems when diseases are detected: cervical erosion, vulvovaginitis, colpitis. In men, damage to the testicles, urethra is possible.

Of course, the immune system will start attacking with viruses, producing antibodies in an enhanced mode and driving pathogens into the kidneys, salivary glands. Further, the symptoms may subside and stop altogether. Viruses can take a dormant state, waiting for the right moment to wake up again.

What to do if antibodies are found in the body?

It is almost impossible to remove viruses completely from the body, but the immune system can bring them into an inactive state. This applies to more people with healthy immunity, and even if positive igg no special treatment is required. It is enough to monitor your health, strengthen your immune system, prevent stress and overstrain, and normalize your diet.

More attention needs to be paid to:

1. Children with frequent colds.
2. Pregnant women during the period of unstable hormonal levels, unstable immunity.

Primary infection with cytomegalovirus during pregnancy is especially dangerous and can negatively affect the formation and development of the fetus. The threat of miscarriage, intrauterine infection, premature birth or the birth of a baby with mental, physical disabilities.

The insidiousness of the virus is in a latent course. It happens that it manifests itself by type, but not all women attach special importance to this. If the microorganisms come to life and begin to progress, creating entire colonies, then at the time of pregnancy this can simply lead to the rejection of the fetus, taken by the body as a foreign object.

Follow-up treatment

If a positive igg test is detected in the first 12-14 weeks of pregnancy, women may be given emergency therapy. Before developing a treatment program, the doctor must monitor the medical history of patients, and the fact of possible infection is revealed.

At the initial stage, the treatment is medication. The goal is to increase the body's defenses, suppress the viability of active viruses, bacteria in the body. Anti-inflammatory drugs are prescribed: Valgantsiklov, Ganciclovir. In severe cases, a blood transfusion procedure may be performed.

It is impossible to get rid of cytomegalovirus completely. Medicines can muffle its development, “lull” for many years. Unfortunately, the body is doomed to function in conjunction with insidious neighbors. Doctors strongly recommend treating colds, acute respiratory viral infections, acute respiratory infections in time, undergoing a routine examination at least every 1 year, undergoing an ELISA test when prescribed in order to protect yourself from the development of complications, exacerbations and relapses of cytomegalovirus infection.

Antibodies to cytomegalovirus lgG, CMV IgG quantitative- allows you to determine the presence of IgG antibodies to cytomegalovirus (CMV or CMV), which indicates a current or recent infection.

Duration incubation period ranges from 15 days to 3 months. With this infection, non-sterile immunity occurs (that is, complete elimination of the virus is not observed). Immunity in cytomegalovirus infection (CMVI) is unstable, slow. Reinfection with an exogenous virus or reactivation of a latent infection is possible. Due to prolonged persistence in the body, the virus acts on all parts of the patient's immune system. When a person comes into contact with CMV, their immune system reacts defensively by producing IgM and IgG antibodies against CMV.

Antibodies of the IgG class to cytomegalovirus are specific immunoglobulins that are produced in the human body during the period of pronounced clinical manifestations of cytomegalovirus infection and indicate current or recent infection.

Cytomegalovirus infection- this is a widespread viral lesion of the body, which refers to the so-called opportunistic infections, which usually occur latently. Clinical manifestations are observed against the background of physiological immunodeficiency states (children of the first 3-5 years of life, pregnant women - more often in the 2nd and 3rd trimesters), as well as in people with congenital or acquired immunodeficiencies (HIV infection, the use of immunosuppressants, oncohematological diseases, radiation exposure, diabetes, etc. .P.).

Cytomegalovirus belongs to the herpes virus family. Like other representatives of this group, it can persist in a person all his life. The risk group is children aged 5–6 years, adults 16–30 years old, as well as people who practice anal sex. Children are susceptible to airborne transmission from parents and other children with latent infections. For adults, sexual transmission is more common. The virus is found in semen and other body fluids. Vertical transmission of infection (from mother to fetus) occurs transplacentally and during childbirth.

At healthy people with normal immunity, the primary infection is uncomplicated (and often asymptomatic). In rare cases, the picture develops infectious mononucleosis(about 10% of all cases of infectious mononucleosis), clinically indistinguishable from mononucleosis caused by the Epstein-Barr virus. Virus replication occurs in the tissues of the reticuloendothelial system, epithelium of the urogenital tract, liver, and mucous membranes. respiratory tract and digestive tract. With a decrease in immunity after organ transplantation, immunosuppressive therapy, HIV infection, as well as in newborns, CMV poses a serious threat, since the disease can affect any organ. Perhaps the development of hepatitis, pneumonia, esophagitis, gastritis, colitis, retinitis, diffuse encephalopathy, fever, leukopenia. The disease can be fatal.

Cytomegalovirus in immunodeficiency states
Cytomegalovirus is dangerous in immunodeficiency and during pregnancy is potentially dangerous for the development of the fetus. Therefore, 5-6 months before the planned pregnancy, it is necessary to undergo a test for TORCH in order to assess the state of immunity in relation to these viruses, if necessary, to carry out treatment, or to ensure prevention and control.

With primary infection of a pregnant woman with cytomegalovirus (in 35–50% of cases) or reactivation of the infection during pregnancy (in 8–10% of cases), intrauterine infection develops. Confirmation or exclusion of the fact of recent infection is especially important when examining pregnant women, since it is with primary infection during pregnancy that the risk is high. vertical transmission infection and fetal pathology.

With the development of intrauterine infection for up to 10 weeks, there is a risk of malformations, spontaneous abortion is possible. When infected at 11–28 weeks, intrauterine growth retardation, hypo- or dysplasia occur internal organs. If infection occurs at a later date, the lesion may be generalized, involve a specific organ (for example, fetal hepatitis) or manifest itself after birth (hypertensive-hydrocephalic syndrome, hearing impairment, interstitial pneumonia, etc.). Manifestations of infection also depend on the immunity of the mother, virulence and localization of the virus.

To date, no vaccine has been developed against cytomegalovirus. Medical therapy allows you to increase the period of remission and influence the recurrence of infection, but does not allow you to eliminate the virus from the body.

It is impossible to completely cure this disease: it is impossible to remove cytomegalovirus from the body. But if in a timely manner, at the slightest suspicion of infection with this virus, you consult a doctor, perform the necessary tests, then you can keep the infection in a “sleeping” state for many years. This will ensure normal pregnancy and birth. healthy child.

Special meaning laboratory diagnostics cytomegalovirus infection has in the following categories of subjects:

Women preparing for pregnancy

1. Latent course of the disease
2. Difficulty differential diagnosis primary infection and recurrence of infection during examination during pregnancy
3. Severe consequences of intrauterine infection in newborns

Pregnant women

1. Severe consequences of intrauterine infection in newborns
2. Immunodeficiency states (generalized forms)

Sequential repeated determination of the level of IgG antibodies in newborns makes it possible to distinguish congenital infection (constant level) from neonatal infection (increase in titers). If the titer of IgG antibodies does not increase during a second (two weeks later) analysis, then there is no reason for alarm, if the titer of IgG grows, an abortion should be considered.

CMV and TORCH
CMV infection is included in the group of TORCH infections (the name is formed by the initial letters in the Latin names - Toxoplasma, Rubella, Cytomegalovirus, Herpes), which are considered potentially dangerous for the development of the child. Ideally, a woman needs to consult a doctor and undergo a laboratory examination for TORCH infection 2-3 months before the planned pregnancy, since in this case it will be possible to take appropriate medical or preventive measures and, if necessary, in the future to compare the results of studies before pregnancy with the results of examinations during pregnancy.

Indications:

• preparation for pregnancy;
• signs of intrauterine infection, feto-placental insufficiency;
• the state of immunosuppression in HIV infection, neoplastic diseases, taking cytostatic drugs, etc.;
• clinical picture infectious mononucleosis in the absence of Epstein-Barr virus infection;
• hepato-splenomegaly of unclear nature;
• fever of unknown etiology;
• increased levels of hepatic transaminases, gamma-HT, alkaline phosphatase in the absence of markers of viral hepatitis;
• atypical course of pneumonia in children;
• miscarriage (missed pregnancy, habitual miscarriages).

Interpretation of results
Units of measure: UE*

A positive result will be accompanied by an additional comment indicating the sample positivity ratio (PC*):

• KP >= 11.0 - positive;
• KP<= 9,0 - отрицательно;
• KP 9.0–11.0 - doubtful.

• CMV infection;
• intrauterine infection is possible, the likelihood of its occurrence is unknown.

• CMV infection was not detected;
• infection has occurred within the previous 3–4 weeks;
• intrauterine infection is not possible (except in the presence of IgM).

*Positivity ratio (PC) is the ratio of the optical density of the patient sample to the threshold value. KP - the coefficient of positivity, is a universal indicator used in enzyme immunoassays. The CP characterizes the degree of positivity of the test sample and may be useful to the doctor for the correct interpretation of the result. Since the positivity coefficient does not correlate linearly with the concentration of antibodies in the sample, it is not recommended to use the CP for dynamic monitoring of patients, including monitoring the effectiveness of treatment.

Cytomegalovirus is a microorganism of the herpetic type, which is opportunistic and latently inhabits the organisms of 90% of people. When the immune system is weakened, it begins to actively multiply and leads to the development of infection. To diagnose the disease, enzyme-linked immunosorbent assay for cytomegalovirus IgM is mainly used - determining the presence of antibodies to the infectious agent in the blood.

Indications for the study

As a rule, cytomegalovirus does not pose a danger to a person with normal immunity and is asymptomatic; sometimes there are mild symptoms of general intoxication of the body, which do not lead to the development of complications. However, for pregnant women and immunocompromised people, acute infection can be dangerous.

An enzyme immunoassay for antibodies to CMV is performed if the following symptoms are observed:

• increase in body temperature;
• rhinitis;
• sore throat;
• enlarged lymph nodes;
• inflammation and swelling of the salivary glands in which the virus is concentrated;
• inflammation of the genitals.

Most often, cytomegalovirus is difficult to distinguish from the usual acute respiratory disease. It is worth noting that the vivid manifestation of symptoms indicates a weakening of the immune system, so in this case, you should additionally check for immunodeficiency.

The easiest way to distinguish cytomegalovirus from a cold is by the timing of the development of the disease. Symptoms of acute respiratory infections disappear within a week, a herpes infection can remain in an acute form for 1–1.5 months.

Thus, the indications for the appointment of the analysis are as follows:

1. Pregnancy.
2. Immunodeficiency (caused by HIV infection, taking immunosuppressants, or congenital).
3. The presence of the above symptoms in a person with normal immunity (the disease should first be differentiated from the Epstein-Barr virus).
4. Suspicion of CMV in a newborn child.

Given the possible asymptomatic course of the disease, during pregnancy, the analysis should be performed not only in the presence of symptoms, but also for screening.

The immune system first of all reacts to the ingress of any foreign microorganisms into the blood by producing antibodies. Antibodies are immunoglobulins, large protein molecules with a complex structure that are able to bind to the proteins that make up the shell of viruses and bacteria (they are called antigens). All immunoglobulins are divided into several classes (IgA, IgM, IgG, etc.), each of which performs its function in the body's natural defense system.

Immunoglobulins of the IgM class are antibodies that are the first protective barrier against any infection. They are produced urgently when the CMV virus enters the body, do not have a specification and have a short lifespan - up to 4–5 months (although residual proteins with a low antigen binding coefficient may remain 1–2 years after infection).

Thus, the analysis for IgM immunoglobulins allows you to determine:

• primary infection with cytomegalovirus (in this case, the concentration of antibodies in the blood is maximum);
• exacerbation of the disease - the concentration of IgM rises in response to a sharp increase in the number of viral microorganisms;
• reinfection - infection with a new strain of the virus.

Based on the remnants of IgM molecules, IgG immunoglobulins are formed over time, which have a specification - they “remember” the structure of a particular virus, persist throughout life and prevent infection from developing if the overall strength of immunity is not reduced. Unlike IgM, IgG antibodies against different viruses have clear differences, so the analysis for them gives a more accurate result - they can be used to determine which virus has infected the body, while the analysis for IgM only confirms the presence of infection in a general sense.

Antibodies of the IgG class are very important in the fight against cytomegalovirus, since it is impossible to completely destroy it with the help of medicines. After the end of the exacerbation of the infection, a small number of microorganisms remain in the salivary glands, on the mucous membranes, and internal organs, which is why they can be detected in samples of biological fluids using polymerase chain reaction (PCR). The virus population is controlled precisely by IgG immunoglobulins, which do not allow cytomegaly to go into an acute form.

Deciphering the results

Thus, enzyme immunoassay allows you to accurately determine not only the presence of cytomegalovirus, but also the time elapsed since infection. It is important to assess the presence of both major types of immunoglobulins, so IgM and IgG antibodies are considered together.

The results of the study are interpreted as follows:

Particular attention should be paid to a positive result for IgM antibodies in pregnant women. If IgG immunoglobulins are present, there is nothing to worry about; acute infection is dangerous for the development of the fetus. Complications in this case appear in 75% of cases.

In addition to the actual presence of antibodies, enzyme immunoassay evaluates the avidity coefficient of proteins - their ability to bind to antigens, which decreases as they are destroyed.

The results of the avidity study are deciphered as follows:

• >60% - immunity to cytomegalovirus is developed, infectious agents are present in the body, that is, the disease proceeds in a chronic form;
• 30-60% - relapse of the disease, the immune response to the activation of the virus, which was previously in a latent form;
• <30% - первичное инфицирование, острая форма заболевания;
• 0% - no immunity, no CMV infection, no pathogens in the body.

It should be borne in mind that a person with strong immunity does not need to worry about positive test results - cytomegalovirus does not require drug treatment, the body is quite able to cope with the infection on its own. However, if the results indicate an acute phase of the development of the disease, contact with healthy people, especially pregnant women, should be limited, since the likelihood of spreading the virus is high.

Positive IgM result in pregnancy

For women who are planning a pregnancy or who are already carrying a child, it is very important to know about infection with cytomegalovirus in the past, as this can affect the development of the fetus. An enzyme immunoassay for antibodies comes to the rescue.

The results of tests during pregnancy are regarded differently. The safest option is positive IgG and negative IgM - nothing to worry about, as the woman has immunity against the virus, which will be passed on to the child, and there will be no complications. The risk is also low if a positive IgM is detected - this indicates a secondary infection with which the body is able to fight, and there will be no serious complications for the fetus.

If antibodies of none of the classes are detected, a pregnant woman should be very careful. It is important to observe measures to prevent infection with cytomegalovirus:

• avoid sexual intercourse without the use of contraceptives;
• avoid exchanging saliva with other people - do not kiss, do not use the same dishes, toothbrushes, etc.;
• observe hygiene, especially when playing with children, who, if they are infected with cytomegalovirus, are almost always carriers of the virus, since their immunity is not yet fully developed;
• be observed by a doctor and take tests for IgM in case of any manifestations of cytomegalovirus.

It is important to remember that it is much easier to become infected with the virus during pregnancy due to the fact that a woman's immunity is naturally weakened when carrying a fetus. This is a defense mechanism against rejection of the embryo by the body. Like other latent viruses, the old cytomegalovirus can be activated during pregnancy; this, however, only in 2% of cases leads to infection of the fetus.

If the result is positive for IgM antibodies and negative for IgG, the situation is most dangerous during pregnancy. The virus can enter the body of the fetus and infect it, after which the development of the infection may be different depending on the individual characteristics of the child. Sometimes the disease is asymptomatic, and permanent immunity against CMV develops after birth; in 10% of cases, various pathologies of the development of the nervous or excretory system are a complication.

Especially dangerous is infection with cytomegalovirus during pregnancy for less than 12 weeks - an underdeveloped fetus cannot resist the disease, which leads to miscarriage in 15% of cases.

The analysis for IgM antibodies only helps to determine the presence of the disease; the risk to the child is assessed through additional tests. Based on a number of factors, an appropriate pregnancy management strategy is being developed that helps to minimize the likelihood of complications and congenital malformations in a child.

A positive result in a child

An embryo can become infected with cytomegalovirus in several ways:

• through sperm during the fertilization of the egg;
• through the placenta;
• through the amniotic membrane;
• during childbirth.

If the mother has IgG antibodies, then the child will also have them until about 1 year old - initially they are, because during pregnancy the fetus has a common circulatory system with the mother, then they come with breast milk. As breastfeeding stops, immunity weakens, and the child becomes susceptible to infection from adults.

A positive IgM in a newborn indicates that the child was infected after birth, and the mother does not have antibodies to the infection. If CVM is suspected, not only enzyme-linked immunosorbent assay, but also PCR is carried out.

If the child’s own body defense is not enough to fight the infection, complications may develop:

• slowdown in physical development;
• jaundice;
• hypertrophy of internal organs;
• various inflammations (pneumonia, hepatitis);
• CNS lesions - intellectual retardation, hydrocephalus, encephalitis, problems with hearing and vision.

Thus, the child should be treated if IgM antibodies are detected in the absence of IgG immunoglobulins inherited from the mother. Otherwise, the body of a newborn with normal immunity will cope with the infection itself. Exceptions are children with serious oncological or immunological diseases, the course of which can affect the functioning of the immune system.

What to do with a positive result?

The human body with healthy immunity is able to cope with the infection on its own, therefore, if an immune response to cytomegalovirus infection is detected, nothing can be done. Treatment of a virus that does not manifest itself in any way will only lead to a weakening of the immune system. Medications are prescribed only if the causative agent of the infection began to actively develop due to an insufficient reaction of the body.

Treatment is also not needed during pregnancy if there are IgG antibodies. If only the IgM test is positive, medication is necessary, but it is intended to contain an acute infection and make the cytomegalovirus latent. It should be remembered that CMV drugs are also unsafe for the body, so they can only be used if they are prescribed by a doctor - self-medication will lead to various adverse consequences.

Thus, a positive IgM indicates an active stage of CMV infection. It should be considered in conjunction with other test results. Particular attention to the indications of the study should be paid to pregnant women and people with weakened immune systems.

Any viral infection during pregnancy can harm the unborn baby. However, there is a special group of TORCH diseases. These viral infections can cause very severe damage to the fetus, which will significantly affect the future life of the child.

One of the viruses in the TORCH group is cytomegalovirus. For adults, in most cases it is relatively safe / But with intrauterine infection, it poses a deadly threat to the fetus.

Determination of infection is carried out by ELISA. What to do if antibodies to cytomegalovirus IgG are positive?

• Who is the virus dangerous for?

Who is the virus dangerous for?

Cytomegalovirus is a very common pathogen. The vast majority of people in the world come into contact with it at least once in their lives. For an ordinary person, cytomegalovirus does not pose a serious danger, since the immune system copes with it perfectly. However, there are situations when the virus can threaten human life and health.

These should include:

• immunodeficiency states of any nature, especially HIV
• age up to 5 years
• neonatal period
• weakening of the immune system due to prolonged sluggish infections
• pregnancy period

But during the gestation of the fetus, the woman's immunity is very persistent, therefore, the pathogenic microorganism is weakly affected. But the embryo is extremely vulnerable, since the virus has a tropism for dividing cells.

Affecting the body of the fetus, it causes severe malformations that have an extremely negative impact on the entire future life of the child.
Therefore, the detection of cytomegalovirus during pregnancy is a complex problem that requires a balanced and competent approach to its solution.

Diagnosis of cytomegalovirus infection

After infection, which most often occurs during sexual contact or by household means, a protective reaction of the immune system develops in the human body.

Specific antibodies begin to circulate in the blood, which are easily detected during a diagnostic study. This is how class G (G) and M immunoglobulins are formed and determined. However, the rate of appearance of immunoglobulins in serum varies greatly.

IgG is a long circulating structure that indicates the long-term presence of the virus in the body. IgM usually appears in the very debut of the disease, which indicates an acute illness. Therefore, the presence of class M immunoglobulins is more often accompanied by a clinical picture /

Especially in immunocompromised patients. The result is evaluated by the number of circulating immune complexes. If immunoglobulins of any class are detected by enzyme immunoassay, a positive conclusion is issued about the presence of infection.

Identified class G immunoglobulins to cytomegalovirus in a child: what does this mean

Among the decreed contingents of people who can be seriously harmed by the virus, a large group is made up of children of the younger age group.
Already by the age of 5, such a strong immune defense is formed that infection with cytomegalovirus in most cases will not be harmful. But children under 5 years old can suffer from infection due to the weakness and imperfection of the immune response.

If the child has a positive analysis for G-class immunoglobulins, then an additional assessment of clinical symptoms should be carried out. The presence of immunoglobulins G to cytomegalovirus in children under 5 years of age suggests that they have already met with the causative agent of the disease.

How seriously the body is affected is estimated from a combination of the following factors:

• mental development
• liver pathology
• hearing condition
• features of intelligence
• baby's appearance
• physical development

In the absence of clinical manifestations of the disease, a positive result should be treated very carefully. This means that the child had a favorable encounter with cytomegalovirus, and the disease did not develop. The second, rarer option is the presence of a sluggish infection that requires dynamic monitoring.

The clinic or symptoms of mononucleosis (damage to the upper respiratory tract, spleen and lymph nodes) can be combined with a positive Anti CMV IgG. Perhaps this indicates the presence of an infectious disease with cytomegalovirus.

In this situation, the degree of damage is assessed, since antiviral treatment is prescribed only in the most severe cases. Gross congenital defects, combined with a positive CMV IgG, indicate a previous intrauterine infection or congenital disease. In this case, complex corrective therapy is required, aimed not only at eliminating the virus, but also at mitigating the consequences of its negative impact on the body.

Positive test during pregnancy

Diagnosis of any latent infections is best done in advance - before the planned conception of a child. This will help protect the unborn baby from severe intrauterine anomalies. However, the detection of IgG to cytomegalovirus during pregnancy does not yet indicate the presence of the disease.

The clinical picture is usually not taken into account, since if a woman does not have an immunodeficiency, the virus is practically not dangerous for her. However, the detected CMV IgG cannot be ignored. Since there may be an infection in the body that can adversely affect the condition of the fetus. Therefore, during pregnancy, it is desirable to determine the avidity of the detected immunoglobulins. This term shows how "fresh" the reaction of the woman's body to infection.

If the antibodies are highly avid, then the probability of infection in the first trimester of pregnancy is extremely small. This means that the patient is not a source of potential danger to the child.

Low-grade antibodies indicate infection within the last 4 months, which can play a crucial role in assessing the degree of risk of infection for the unborn child. In this case, dynamic three-dimensional control over the intrauterine development of the fetus is necessary.

And if anomalies are detected, even for a period of up to 20 weeks, it is necessary to resolve the issue at the medical commission on the advisability of further carrying the embryo. The presence of low-avid immunoglobulins in the early stages of pregnancy - before the formation of the placenta, is a direct indication for interruption for medical reasons.

Why is cytomegalovirus dangerous for an unborn child

The virus easily crosses the blood-placental barrier and infects the embryo. Actively dividing cells are a target for the pathogenic effects of a microorganism. The virus brings especially severe disorders in the first trimester of pregnancy, as the main life-supporting systems of the child are laid.

Intrauterine infection can lead to the following consequences:

• brain damage and subsequent severe mental retardation
• development of congenital immunodeficiency
• destruction of liver cells
• hearing loss
• violation of the formation of the bone skeleton
• multiple organ damage (liver, nervous system, lungs)

But even before the baby is born, the negative impact of the virus is possible. Often it affects the placenta, which leads to miscarriage. Therefore, miscarriage is a direct indication for the determination of immunoglobulins to cytomegalovirus before the next pregnancy.

Even a mild degree of damage to the fetus can seriously affect his future life. The child develops cerebral calcification, which leads to a decrease in intellectual abilities.

Such children are often unable to perform skilled work in the future, and sometimes become disabled. Due to such severe consequences for the fetus, which may not be visible even with a three-dimensional ultrasound, it is necessary to decide on the termination of pregnancy if low-avid antibodies to CMV are detected.

Positive IgM to cytomegalovirus: what to do

Immunoglobulin class M indicates the presence of an acute infection. If a positive IgM to cytomegalovirus is detected during pregnancy, then the likelihood of intrauterine infection is extremely high.

What does this mean for a woman?

Only the fact that the infection occurred no more than 4 weeks ago, since class G antibodies have not yet formed. A "fresh" infection is dangerous for the fetus, since the virus can cause severe disturbances in the dividing cells of the embryo.

For the woman herself, such a result is usually not too dangerous. Since her body will cope with the disease without any treatment. But in the presence of immunodeficiency of any etiology, especially HIV, immediate antiviral therapy is required.

If class G immunoglobulin to cytomegalovirus is found in a child under 5 years of age, therapeutic measures are also necessary.
The virus can infect many organs of the baby, which often leads to death.

Detection of IgM in adolescence or in schoolchildren requires only dynamic observation and search for the source of infection.

Therapeutic measures for positive IgM to CMV

CMV is a virus related to herpes infection. Therefore, the principles of treatment usually do not differ too much from the treatment of herpes.

Indications for the appointment of specific therapy are as follows:

• the presence of low-avid antibodies during pregnancy in case of refusal to terminate
• positive result in children under 5 years of age
• all cases of IgM detection in people with immunodeficiency
• the presence of IgG in HIV infection (only in the case of a combination of antiherpetic therapy with antiretroviral measures)
• preparation for a planned pregnancy with a history of miscarriage
• the presence of clinical manifestations of the disease
• patient's desire for treatment

In most cases, therapeutic measures are not required. Since in adults and children over 5 years old, the immune system copes well with the infection. However, if the patient wishes to undergo a course of treatment, doctors often meet the wishes of the person.

Anti-herpetic drugs are used for treatment. Both 1st generation drugs (acyclovir) and modern drugs (ganciclovir, valaciclovir) act on cytomegalovirus.

The choice of the drug is carried out by the doctor based on the individual characteristics of the human body and the clinical manifestations of the disease. Experienced professionals who have practical experience in treating such diseases are best aware of how to treat CMV infection.

It is important to remember that it is impossible to completely eliminate the virus from the human body.

However, therapeutic measures reduce the risk of intrauterine infection of the fetus, and also reduce the severity of the clinical manifestations of the disease in children.

In immunodeficiency states, treatment of cytomegalovirus can prolong the patient's life. Since the virus can affect many organs and systems of a weakened person. Thus, if CMV IgG is positive, then an urgent consultation is needed to assess the degree of risk for decreed populations.

Detection of cytomegalovirus should be carried out by all women planning to conceive a child. If this has not been done in advance, then during pregnancy it is important to contact the Dermatovenerologic Dispensary in the early stages.

Only with highly efficient reagents, which are used by PTC specialists, it is possible to quickly obtain an accurate result. Appeal to the dermatovenerological dispensary is very convenient. Since with a positive result, you can immediately get advice on further tactics of treatment or childbirth.

Cytomegalovirus infection often becomes an unpleasant surprise in the lives of many people. Therefore, a timely appeal to the KVD for the purpose of diagnosis and treatment will positively affect the future fate of each person.

Description

Method of determination Enzyme immunoassay (ELISA).

Material under study Serum

Home visit available

Antibodies of the IgM class to cytomegalovirus (CMV, CMV).

In response to the introduction of cytomegalovirus (CMV) into the body, an immune restructuring of the body develops. The incubation period ranges from 15 days to 3 months. With this infection, non-sterile immunity occurs (that is, complete elimination of the virus is not observed). Immunity in cytomegalovirus infection (CMV) is unstable, slow. Reinfection with an exogenous virus or reactivation of a latent infection is possible. Due to prolonged persistence in the body, the virus acts on all parts of the patient's immune system. The protective reaction of the body is manifested primarily in the form of the formation of specific antibodies of the IgM and IgG classes to CMV. Specific antibodies are responsible for the lysis of an intracellular virus, and also inhibit its intracellular replication or spread from cell to cell. The sera of patients after primary infection contain antibodies that react with internal CMV proteins (p28, p65, p150). The serum of recovered people contains mainly antibodies that react with envelope glycoproteins. The greatest diagnostic value is the definition of IgM, as an indicator of the activity of the process, which may indicate an acute current disease, reinfection, superinfection or reactivation. The appearance of anti-CMV IgM antibodies in a previously seronegative patient is indicative of a primary infection. With endogenous reactivation of infection, IgM antibodies are formed irregularly (usually in fairly low concentrations) or may be absent altogether. Detection of class G immunoglobulins also makes it possible to identify primary cytomegalovirus infection (CMVI), monitor the dynamics of persons with clinical manifestations of infection, and help with retrospective diagnosis. In severe CMV infections, as well as in pregnant women and young children, the production of antibodies to CMV is slowed down. This is manifested by the detection of specific antibodies in low concentrations or the absence of positive antibody dynamics. features of the infection. Cytomegalovirus (CMV) infection is a widespread viral lesion of the body, which refers to the so-called opportunistic infections, usually occurring latently. Clinical manifestations are observed against the background of physiological immunodeficiency states (children of the first 3-5 years of life, pregnant women - more often in the 2nd and 3rd trimesters), as well as in persons with congenital or acquired immunodeficiencies (HIV infection, the use of immunosuppressants, oncohematological diseases, radiation, diabetes etc.). Cytomegalovirus is a virus of the herpes family of viruses. Like other members of the family, after infection, it remains in the body for almost a lifetime. Resistant in a humid environment. The risk group consists of children 5-6 years old, adults 16-30 years old, as well as people who practice anal sex. Children are susceptible to airborne transmission from parents and other children with latent infections. For adults, sexual transmission is more common. The virus is found in semen and other body fluids. Vertical transmission of infection (from mother to fetus) occurs transplacentally and during childbirth. CMV infection is characterized by a variety of clinical manifestations, but with full immunity it is clinically asymptomatic. In rare cases, a picture of infectious mononucleosis develops (about 10% of all cases of infectious mononucleosis), clinically indistinguishable from mononucleosis caused by the Epstein-Barr virus. The replication of the virus occurs in the tissues of the reticuloendothelial system, the epithelium of the urogenital tract, the liver, the mucous membrane of the respiratory tract and the digestive tract. With a decrease in immunity after organ transplantation, immunosuppressive therapy, HIV infection, as well as in newborns, CMV poses a serious threat, since the disease can affect any organ. possible development of hepatitis, pneumonia, esophagitis, gastritis, colitis, retinitis, diffuse encephalopathy, fever, leukopenia. The disease can be fatal.

Cytomegalovirus infection in pregnant women, examination during pregnancy. With primary infection of a pregnant woman with cytomegalovirus (in 35–50% of cases) or reactivation of the infection during pregnancy (in 8–10% of cases), intrauterine infection develops. With the development of intrauterine infection for up to 10 weeks, there is a risk of malformations, spontaneous abortion is possible. When infected at 11-28 weeks, intrauterine growth retardation, hypo- or dysplasia of internal organs occur. If infection occurs at a later date, the lesion may be generalized, involve a specific organ (eg, fetal hepatitis) or appear after birth (hypertensive-hydrocephalic syndrome, hearing loss, interstitial pneumonitis, etc.). Manifestations of infection also depend on the immunity of the mother, virulence and localization of the virus.

To date, no vaccine has been developed against cytomegalovirus. Drug therapy allows you to increase the period of remission and influence the recurrence of infection, but does not allow you to eliminate the virus from the body. It is impossible to completely cure this disease: it is impossible to remove cytomegalovirus from the body. But if in a timely manner, at the slightest suspicion of infection with this virus, you consult a doctor, perform the necessary tests, then you can keep the infection in a “sleeping” state for many years. This will ensure normal pregnancy and delivery of a healthy baby. Of particular importance is the laboratory diagnosis of cytomegalovirus infection in the following categories of subjects:

Sequential repeated determination of the level of IgG antibodies in newborns makes it possible to distinguish congenital infection (constant level) from neonatal infection (increase in titers). If the titer of IgG antibodies does not increase during a second (two weeks later) analysis, then there is no reason for alarm; if the titer of IgG increases, an abortion should be considered. IMPORTANT! CMV infection is included in the group of TORCH infections (the name is formed by the initial letters in the Latin names - Toxoplasma, Rubella, Cytomegalovirus, Herpes), which are considered potentially dangerous for the development of the child. Ideally, a woman needs to consult a doctor and undergo a laboratory examination for TORCH infection 2-3 months before the planned pregnancy, since in this case it will be possible to take appropriate therapeutic or preventive measures, and also, if necessary, to compare the results of studies before pregnancy in the future with the results of examinations during pregnancy.

Indications for appointment

• Preparation for pregnancy.
• Signs of intrauterine infection, feto-placental insufficiency.
• The state of immunosuppression in HIV infection, neoplastic diseases, taking cytotoxic drugs, etc.
• The clinical picture of infectious mononucleosis in the absence of Epstein-Barr virus infection.
• Hepato-splenomegaly of unclear nature.
• Fever of unknown etiology.
• An increase in the level of hepatic transaminases, gamma-HT, alkaline phosphatase in the absence of markers of viral hepatitis.
• Atypical course of pneumonia in children.
• Miscarriage (missed pregnancy, habitual miscarriages).

Interpretation of results

The interpretation of test results contains information for the attending physician and is not a diagnosis. The information in this section should not be used for self-diagnosis or self-treatment. An accurate diagnosis is made by the doctor, using both the results of this examination and the necessary information from other sources: history, results of other examinations, etc.

Reference values: in the INVITRO laboratory, when anti-CMV IgM antibodies are detected, the result is "positive", in case of their absence - "negative". At very low values ​​("grey zone"), the answer is "doubtful, it is recommended to repeat in 10 - 14 days". Attention! To increase the information content of studies, as an additional test to clarify the likelihood of a recent primary infection, a study of the avidity of IgG antibodies is performed. It is carried out free of charge for the patient in cases where the result of the anti-CMV-IgM antibody test is positive or doubtful. If the test No. 2AVCMV Avidity of IgG antibodies to cytomegalovirus is ordered by the client immediately upon application, it is performed in any case and is paid.

Negative:

1. CMV infection occurred more than 3 - 4 weeks ago;
2. infection during the period of 3-4 weeks before the examination is excluded;
3. intrauterine infection is unlikely.

Positively:

1. primary infection or reactivation of infection;
2. intrauterine infection is possible.

“Doubtful” is a boundary value that does not allow one to reliably (with a probability of more than 95%) attribute the result to “Positive” or “Negative”. It should be borne in mind that such a result is possible with a very low level of antibodies, which can occur, in particular, in the initial period of the disease. Depending on the clinical situation, it may be useful to re-test the level of antibodies after 10-14 days to assess the trend.