Cytomegalovirus (CMV)
Cytomegalovirus (CMV)
Overall approximately 1% to 2%
of all newborns are CMV infected, about half due to primary infection during
pregnancy and the other half due to reactivation of a prior infection.Cx can
shed CMV virus !!! It is now known to virologists that intermittent CMV
shedding from the cervix and other body sites is quite possible if CMV remains
in host body as an dormant state and not cleared after primary infection
. In such situations as CMV being a herpes family virus
–Can Pap have some kind of reflection by exhibiting
some specific cytological changes due to CMV excretion via
endocervix?? ??
At the present
moment we don’t have any idea about abnormal cytology by HPV or else it is due
to other kind of Herpes family. Food for thought . Surprisingly, the great
majority of CMV infections are asymptomatic and we are aware of the fact that
presence of activation of dormant virus can be identified only by
prospective antibody testing.
After primary CMV
infection, virus replication may persist for many months and can be reactivated
months or years later, with intermittent CMV shedding from the saliva, tears,
urine, faeces, cervix and other sites. AS it is (CMV) is secreted via saliva /
tears therefore viral spread can occur by direct body contact amongst the
family members. The presence of IgM-specific CMV antibody correlates quite
well with infection. Immunoglobulin M antibody is detected with about 90% of
primary infections; however, it may also appear with recurrent infections. CMV
IgG avidity testing may be of value in assessing a patient's likelihood of
recent infection .
Matter of great
concern for obstetricians and Neonatologists too
. !!!
Surprise 1:- How
many of us believe that CMV (which is a virus of Herpes family like varicella,
E B Virus ) after causing an primary infection i the host , quite often remains
alive in the host in as an dormant state and can be an potential source of
reactivation and cause maternal illness and more importantly foetal harm ?
Surprise 2: Can
such state of reactivation occur in case of T Gondii also ?
Surprise 3 : What , according to will be best drug for
acute Cytomegalovirus infection if serologically confirmed after a brief
maternal illness in nonpregant state when CMV IgM is strongly
positive. .
Surprise 4 : Is
it true that maternal immunity against CMV does ensure guarantee against
prevention of vertical transmission of CMV in 70% only?
Surprise 5:
Avidity tests facility often unavailable in small towns.
Surprise 5 : Like
Covid we still dont have vaccination against CMV and also against Toxo
infections. .Members views and worry about these two organisms which attack
pregnant women often silently !!!
Overall approximately 1% to 2% of all newborns are CMV infected,
about half due to primary infection during pregnancy and the other half due to
reactivation of a prior infection.Cx can shed CMV virus !!! It is now known to
virologists that intermittent CMV shedding from the cervix and other body sites
is quite possible if CMV remains in host body as an dormant state and not
cleared after primary infection . In such situations as CMV being a herpes
family virus –Can Pap have some kind of reflection by exhibiting some specific
cytological changes due to CMV excretion via endocervix?? ??
At the present moment we don’t have any idea about abnormal
cytology by HPV or else it is due to other kind of Herpes family. Food for
thought . Surprisingly, the great majority of CMV infections are asymptomatic
and we are aware of the fact that presence of activation of dormant virus can
be identified only by prospective antibody testing.
After primary CMV infection, virus replication may persist for
many months and can be reactivated months or years later, with intermittent CMV
shedding from the saliva, tears, urine, faeces, cervix and other sites. AS it
is (CMV) is secreted via saliva / tears therefore viral spread can occur by
direct body contact amongst the family members. The presence of IgM-specific
CMV antibody correlates quite well with infection. Immunoglobulin M antibody is
detected with about 90% of primary infections; however, it may also appear with
recurrent infections. CMV IgG avidity testing may be of value in assessing a
patient's likelihood of recent infection.
DrSoubhagya
Subudhi
Respected members do guide me what tests should
I advise to a patient who had two first trimester miscarriage
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