bubble_chart Overview

Cytomegalovirus infection is a systemic infectious syndrome caused by human cytomegalovirus. Due to the enlargement of infected cells and the presence of inclusion bodies in the nucleus and cytoplasm, the disease is also known as cytomegalic inclusion disease. Cytomegalovirus infection can be classified into two types: one is salivary gland virus disease, which is an asymptomatic localized infection more common in infants and young children; the other is systemic infection, primarily affecting infants, which is relatively rare.

bubble_chart Etiology

After initial infection, CMV will persist indefinitely in host cells in a latent state. It may involve multiple tissues and organs, and autopsies suggest that the lungs, liver, pancreas, salivary glands, central nervous system, and intestines may also serve as sites for viral latency. The severity of congenital infection is related to the inability to produce precipitating antibodies and the T-cell response to CMV. Following CMV infection in children and adults, activated T lymphocytes with a suppressive cytotoxic phenotype appear in the peripheral blood. If the host's T-cell function is impaired, the latent virus may reactivate and cause various syndromes. Chronic stimulation after tissue transplantation provides conditions for CMV reactivation and disease induction. Certain potent immunosuppressants targeting T cells, such as anti-thymocyte globulin, are associated with a high incidence of clinical CMV syndromes. Additionally, CMV can functionally act as a cofactor, reactivating latent HIV infection.

bubble_chart Diagnosis

Symptoms

The natural history of CMV infection is complex. After primary infection, viral shedding often persists for weeks, months, or even years before the infection becomes latent. Recurrent infections with renewed viral shedding are common. Even many years after the initial infection, reactivation of latent virus or reinfection with different antigenically distinct strains of sexually transmitted disease may occur. The clinical manifestations of CMV infection are related to the individual's immune function and age. As shown in Table 2, the symptoms and signs arising from vertical transmission, horizontal transmission, or iatrogenic infection are highly diverse.

Regarding acquired CMV infection, it is clinically common to observe post-transfusion mononucleosis, as well as vasculitis, retinitis, pneumonia, and gastrointestinal infections due to immune dysfunction. Additionally, most patients are complicated with Guillain-Barré syndrome.

Examinations

1. Virus isolation.

2. Serum antibody detection: The most commonly used methods include complement fixation test (CF), indirect immunofluorescence assay (IIF), enzyme immunoassay (EIA), indirect hemagglutination test (IHA), and radioimmunoassay (RIA) for detecting CMV-IgG and IgM antibodies.

bubble_chart Treatment Measures

The treatment of

cytomegalovirus infection can involve various antiviral agents such as GCV, anti-cytomegalovirus immunoglobulin preparations, interferon, and transfer factor. However, these drugs do not address the root cause of the problem, and the virus often rebounds latently after discontinuation of medication. Given that this virus may serve as one of the disease causes of Acquired Immune Deficiency Syndrome, scholars worldwide are dedicated to researching methods to control its infection.