Synonyms
Cytomegalovirus (CMV), Human Cytomegalovirus (HCMV), Human Herpes Virus 5 (HHV 5), Cytomegaly, CytomegalyThe cytomegalovirus is a virus of the herpes virus family, more precisely the ? herpes viruses. It contains a double-stranded DNA surrounded by an icosahedral (with 20 surfaces) protein capsule (capsid).
Around this capsid, there is another virus envelope, which is made up of fats and glycoproteins and is very sensitive. The cytomegalovirus, typical for the genus of the ? herpesviruses, reproduces rather slowly and has a narrow host spectrum, thus mainly affecting humans.
Cells infected by the virus show up histologically as giant cells with inclusion bodies, also better known as owl eye cells. The virus can be transmitted both by parental route (blood, organ transplantation) and by smear and droplet infection (urine, saliva, sperm, vaginal and cervical secretions, breast milk). Transmission to the fetus during pregnancy via the placenta is also possible.
Frequency Cytomegalovirus
The cytomegalovirus is found worldwide. In industrialized countries it is estimated that up to 70% of the population is infected, while in other geographical regions up to 100% of the population is infected with the virus.
Causes of the cytomegalovirus
The cytomegalovirus mainly attacks the superficial cells (epithelial cells) of the salivary glands. Apparently, the virus remains detectable in the body for life after infection (in salivary glands, kidneys.). In general, the initial infection with the cytomegalovirus is asymptomatic or only with very weak symptoms.
Only 1-2% of those infected show signs of disease. Thus, the majority of those affected do not notice an infection at all. For this very reason, it has not yet been possible to specify an exact incubation period for the disease.
One assumes about 2-10 weeks. Prerequisite for the clinically not appearing infection is a competent immune system. If symptoms do occur, they are similar to mononucleosis with fever and swelling of the lymph nodes.
Headaches and aching limbs as well as, rarely, hepatitis (inflammation of the liver) and polyneuritis (inflammation of the nerves) can also occur. In immunocompromised patients such as AIDS patients, transplanted patients, leukaemia patients or tumor patients treated with cytostatic drugs, the disease can become severe. Possible complications include severe pneumonia, transplant rejection, retinal involvement in AIDS that can lead to blindness, and colitis (inflammation of the colon) with diarrhea.
Additional bacterial infections and ulcers of the gastrointestinal tract are not uncommon and are often very severe. A fatal outcome is possible. Infection of the child with the cytomegalovirus during pregnancy is also serious and can be life-threatening for the unborn child.
Cytomegalovirus infection is the most common infection during pregnancy. It is estimated that about 0.3-4% of all pregnant women become infected and that this infection is transmitted to the child in about 40%. However, symptoms occur in only 10% of infected children.
If infection occurs during the first or second trimester of pregnancy, malformations of the child may result. The skeleton, muscles, gastrointestinal tract and cardiovascular system are particularly affected. Also coagulation disorders, microcephaly (skull too small), hepatosplenomegaly (enlarged liver and spleen), jaundice as well as hearing disorders and mental retardation are not uncommon.
Many of these symptoms only appear some time after birth. For up to 30% of the affected children, the infection is fatal. To detect an infection during pregnancy, a test for antibodies against the cytomegalovirus is used nowadays.
This is usually carried out during early pregnancy and repeated at around the 20th to 24th week of pregnancy. Diseases that occur during pregnancy must be reported in any case. The diagnosis of cytomegalovirus can be made by antibody detection, virus cultivation and polymerase chain reaction. Viral antigens (virus components that can cause immune reactions) can also be detected by immunofluorescence, such as the virus’ own phosphorus protein pp65.
