Cytomegalovirus

Cytomegalovirus

Cytomegalovirus or CMV is a group of herpes viruses that can infect and survive in the human body for a long time . This virus can be transmitted through bodily fluids, such as saliva, blood , urine , semen and breast milk .

In healthy people, CMV infection is generally harmless and does not cause health problems or only cause mild symptoms that heal on their own. This is because the immune system can still control the viral infection.

However, if CMV affects people with weakened immune systems, such as those with type 2 diabetes mellitus or HIV , infection with this virus can cause a variety of symptoms and increase the risk of serious complications, such as neurological disorders and pneumonia.

Causes of Cytomegalovirus

CMV virus transmission can occur through direct contact with body fluids, sex, organ transplants, or blood donations. CMV virus can also be transmitted from mother to baby during delivery or breastfeeding.

Cytomegalovirus is a virus that can survive in the human body for a long time, in an inactive state, and does not cause any symptoms. However, the virus can reactivate at any time, usually when the immune system is weakened.

Cytomegalovirus risk factors

Cytomegalovirus infection can happen to anyone. However, the following factors can increase a person's risk of being infected with cytomegalovirus:

  • Work or live with a person with cytomegalovirus infection
  • Receiving an organ transplant or blood transfusion
  • Having a weak immune system, for example as a result of suffering from HIV/AIDS or having a smoking habit
  • Taking drugs that suppress the immune system, such as immunosuppressant drugs
  • Frequently changing partners in sexual activity

Symptoms of Cytomegalovirus

Cytomegalovirus infection in healthy adults generally causes no symptoms at all. However, some patients may experience symptoms such as:

  • Fever
  • Muscle ache
  • Fatigue
  • skin rash
  • Sore throat
  • Swollen lymph nodes
  • Decreased appetite
  • Headache

CMV infection will have more impact on infants or people with weakened immune systems. In the fetus or infant, symptoms of CMV infection can be detected after birth or several years later. Some of the symptoms of CMV infection that can be experienced by newborns are:

  • Premature birth with low birth weight
  • Small baby head size ( microcephaly )
  • Yellow skin and eyes (jaundice)
  • Liver enlargement and decreased liver function
  • Spleen enlargement
  • Purple bruised patches on the skin
  • Pneumonia

Meanwhile, symptoms that are usually found months or years later are hearing loss or growth retardation. Sometimes there can also be visual disturbances.

In people with a weakened immune system, CMV infection can affect almost any organ in the body and cause serious conditions, such as:

  • Inflammation of the retina (retinitis), which is characterized by impaired vision
  • Severe pneumonia , which is characterized by shortness of breath, cough, and chest pain
  • Digestive system disorders, including liver, which is characterized by difficulty swallowing, abdominal pain, yellow skin, bloody diarrhea
  • Encephalitis , which is characterized by headaches or even weakness in certain parts of the body

When to see a doctor

Generally, flu-like symptoms caused by cytomegalovirus will go away on their own within 3 weeks. However, if the symptoms do not improve, you should immediately consult a doctor, so that the virus can be detected and treated before it causes complications.

If you experience the above symptoms, you are also advised to see a doctor immediately if you are pregnant, undergoing treatment that suppresses the immune system, or suffers from a disease that weakens the immune system.

Cytomegalovirus diagnosis

To diagnose cytomegalovirus infection, initially the doctor will ask about symptoms, conditions and medical history, as well as medications or supplements that the patient is currently taking. Next, the doctor will do a physical.

Investigations will be carried out if the doctor suspects a CMV infection. Investigations that can be carried out include:

  • Antibody examination, usually with a rapid antibody test , to check whether the body has the special antibodies that are produced if there is CMV infection
  • Examination of blood samples , to detect the presence of the virus in the body and the amount of the virus
  • Biopsy , to find out whether the CMV virus is active in the body
  • Eye examination , to detect disorders of the retina, especially in patients whose immune systems are weak
  • Radiological examination, to detect whether there are changes or abnormalities in the lungs or brain

Especially for pregnant women suspected of being infected with CMV, the doctor will perform additional examinations in the form of:

  • Pregnancy ultrasound , to detect abnormalities in the fetus
  • Amniocentesis (examination of amniotic fluid), to detect the presence of the CMV virus if abnormalities are found in the fetus

In the fetus suspected of being infected with CMV, the doctor will conduct an examination 3 weeks after delivery. CMV in newborns can be diagnosed by urine examination.

Please note, tests to confirm the diagnosis of cytomegalovirus infection are often not performed, especially in adults and children with good immune systems. This is because CMV infection in people with strong immunity can heal on its own without treatment.

Cytomegalovirus Treatment

As previously explained, people with cytomegalovirus infection with a healthy immune system and only experiencing mild symptoms do not need treatment.

Treatment is needed for people with CMV infection with a weakened immune system, experiencing severe symptoms, and infants. The doctor will determine the treatment according to the severity and symptoms experienced by the patient.

The drugs that are generally given are antiviral drugs, for example valganciclovir and ganciclovir . This drug cannot completely kill the CMV virus. However, this drug can slow the development of the virus in the body, thereby relieving symptoms and reducing the risk of complications.

Complications of Cytomegalovirus

Cytomegalovirus complications vary and can be experienced by anyone, depending on the general condition of the patient.

In people with CMV with a weakened immune system, complications that can arise are:

  • Blindness, due to inflammation of the retina
  • Respiratory failure, due to pneumonia
  • Malnutrition, due to disorders of the digestive system
  • Swelling of the brain and loss of consciousness, due to encephalitis

Complications are also possible in infants with congenital CMV infection. These complications can be:

  • Hearing loss
  • Impaired vision
  • Seizure
  • Lack of body coordination
  • Disorders of the muscles
  • Decreased intellectual function

In rare cases, cytomegalovirus can also cause complications in otherwise healthy adults. These complications include:

  • Mononucleosis
  • Digestive system disorders, such as esophagitis and colitis
  • Nervous system disorders, such as encephalitis
  • Disorders of the heart, such as myocarditis
  • Guillain-Barré syndrome

Cytomegalovirus prevention

Prevention of cytomegalovirus is very important, especially in pregnant women and people with weakened immune systems. CMV infection can be prevented in the following ways:

  • Wash hands with soap and water for 15–20 seconds, especially before and after contact with young children.
  • Avoid direct contact with other people's bodily fluids, such as kissing on the lips, especially for pregnant women.
  • Avoid sharing food or drinks from the same glass or plate with other people.
  • Clean tables, chairs or toys regularly, especially objects that children often touch.
  • Dispose of waste carefully, especially waste that has been contaminated with bodily fluids, such as diapers and tissues.
  • Do a TORCH examination when you are planning a pregnancy or when you find out you are pregnant.
  • Avoid having risky sexual relationships, such as having multiple sexual partners and not wearing condoms or having sex with people whose sex life history is unknown.
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