Cytomegalovirus (CMV) is a virus from the herpes family, but it causes different symptoms such as fever, malaise, and abdominal swelling.
Like herpes, cytomegalovirus is present in most people but usually only causes symptoms when the immune system is weakened, such as in pregnant women, people with HIV, or patients receiving cancer treatment.
During pregnancy, CMV can be detected through prenatal testing. In most cases, it is harmless and does not affect the baby, especially when the mother was infected before becoming pregnant. However, if the infection occurs during pregnancy, it can lead to problems such as microcephaly and hearing loss in the baby.
Main symptoms
In most cases, cytomegalovirus does not cause symptoms, and people often only discover the infection during a specific blood test. However, when the immune system is weakened, symptoms may include:
-
Fever above 100.4 °F (38 °C)
-
Severe fatigue
-
Abdominal swelling
-
Abdominal pain
-
General malaise
-
Liver inflammation
-
Miscarriage
In people with HIV/AIDS, CMV may cause retinal infection, blindness, encephalitis, pneumonia, and ulcers in the intestine or esophagus.
Because cytomegalovirus can increase the risk of birth defects, all pregnant women should be tested, even if they have no symptoms. This allows treatment to begin if needed to help prevent complications for the baby.
Confirming a diagnosis
Cytomegalovirus infection is diagnosed through a blood test that detects antibodies against the virus.
A “CMV IgM reactive” result indicates that the infection is recent or in its early stages. A “CMV IgG reactive” result shows that the infection occurred in the past, as the virus remains in the body for life, similar to herpes.
During pregnancy, if the result is “CMV IgM reactive,” the doctor may recommend treatment with antivirals or immunoglobulins to reduce the risk of transmission to the baby.
What IgG reactive means
A “CMV IgG reactive” result means the person has antibodies against the virus due to a recent or past infection. Additional tests are usually required to confirm the infection before starting treatment.
What causes cytomegalovirus?
Cytomegalovirus infection is caused by a virus in the herpes family. It spreads through contact with body fluids, such as saliva or respiratory secretions, through intimate contact with an infected person, or by sharing contaminated items like cups, cutlery, or towels.
The virus can also be transmitted through blood transfusions, organ or bone marrow transplants, or from mother to baby during pregnancy, particularly if the infection occurs while pregnant.
How to prevent
Prevention of cytomegalovirus infection includes washing hands thoroughly, especially before and after using the bathroom or changing a baby’s diaper, and washing food well before cooking.
It is also important to use condoms during sexual activity and to avoid sharing personal items with others.
Treatment options
Treatment for cytomegalovirus may involve antiviral medications such as ganciclovir and foscarnet. However, these drugs can be highly toxic to blood cells and the kidneys, so they are generally only prescribed in special situations, such as during pregnancy or in severe infections.
For people who develop CMV infection after a transplant and do not respond to standard antivirals, doctors may prescribe maribavir (Livtencity). This FDA-approved medication prevents the virus from replicating and can be used in adults and children over 12 years old.
In most cases, treatment focuses on relieving symptoms with medications such as acetaminophen to reduce fever and headaches. This type of supportive care usually lasts about 14 days and can be managed at home with rest, hydration, and the medications recommended by a doctor.
Possible complications
Complications from cytomegalovirus infection occur mainly in babies infected during pregnancy and may include:
-
Microcephaly
-
Developmental delays
-
Chorioretinitis and blindness
-
Cerebral palsy
-
Abnormal tooth development
-
Paralysis in certain parts of the body, especially the legs
-
Sensorineural hearing loss
In adults, complications are more likely in people with weakened immune systems when the infection progresses, often leading to blindness or paralysis of the legs.