Among the long list of microbial diseases which are transmitted through the body fluids of an already infected person i.e. saliva, urine, blood, milk, or semen, infections associated with cytomegalovirus are common. According to the Centers for Disease Control and Prevention (CDC), approximately half of the adult US population has been infected with cytomegalovirus infection before the age of 40.
Although cytomegalovirus can infect anyone, the population groups most vulnerable to the virus include newborns as well as those with weak immune systems. Therefore, the importance of its timely detection followed by an immediate initiation of treatment cannot be denied. Hence, the present article summarizes the diagnostic tools for CMV including both invasive and non-invasive tests. Let’s take a look.
What is Cytomegalovirus?
Cytomegalovirus (CMV) refers to a genus of viruses that belong to the family Herpesviridae. This genus constitutes 11 species of viruses which are known to attack and cause diseases in humans as well as in other primates. Although many people are at risk of getting infected with CMV, most of them will experience a mild form of infection with few or no symptoms at all.
However, if a woman is exposed to cytomegalovirus during pregnancy, the infection will get transferred from the infected mother to the baby at the time of birth. As a result, problems like developmental issues or hearing loss are often reported in such cases.
Symptoms of Cytomegalovirus Infection
A wide range of symptoms have been associated with CMV infections which vary based on the patient’s immune system as well as the type of infection they have. Some of these symptoms include the following:
In people with immuno-competent i.e. healthy immune systems:
● Extreme fatigue
● Muscle pain
● Headaches
● Sore throat associated with pain
● Frequent sweating
● A rash over the skin
● Swollen lymph nodes
In people with immuno-compromised i.e. naturally weak immune systems:
● Tiredness
● Fever
● Enlarged liver
In the case of CMV pneumonitis:
● Cough
● Shortness of breath
● Muscle pain
● Weakness
In the case of CMV retinitis:
● Blurred vision
● Loss of vision
In the case of CMV gastritis/colitis:
● Nausea
● Vomiting
● Diarrhea
● Stomach ache
● Blood in the feces
In the case of CMV encephalitis:
● Headaches
● Confusion
● Seizures
Who Needs to be Tested for Cytomegalovirus Infection?
When it comes to cytomegalovirus testing, the following groups should be particularly focused due to being at higher risk:
● People who have flu-like symptoms that indicate cytomegalovirus infection
● Unusually long flu-like infections especially in pregnant women or immunocompromised people
● Children who are below the age of 5
● Infants experiencing seizures or other developmental problems
● Newborns with congenital abnormalities
● Newborns affected with anemia or jaundice
● Before conducting an organ transplant surgery
● People who are positive for HIV or AIDS
● People who live close to a CMV-infected patient
How to Get Tested for Cytomegalovirus Infection?
If a person has mild symptoms, the need to conduct a cytomegalovirus test is completely eliminated. However, in patients with symptoms prominent enough to pass for a CMV infection upon primary inspection, the following testing methods can be employed to confirm the initial findings:
1. Non-Invasive CMV Tests
● Saliva Test
A saliva or spit test is performed by taking a saliva sample from the patient. To do so, a sterile cotton or polyester swab can be used which is then sent to the lab for PCR analysis. Usually, this test is considered ideal for cytomegalovirus testing in newborn babies. The sample should be collected at least an hour after breastfeeding. In addition, the ideal time for a CMV infection test is within three weeks of birth.
● Urine Test
For cytomegalovirus diagnosis using a urine sample, your healthcare provider will ask you to give a urine sample which will be further analyzed for the presence of CMV virus.
2. Invasive CMV Tests
● Antibody Test (Serology)
For adult patients, an enzyme-linked immunosorbent assay (ELISA) is considered suitable. For this purpose, a blood sample is collected from a vein using a needle. The collected sample is then tested in a lab to detect the cytomegalovirus antibodies. Their nature and concentration is an indication of the presence or absence of a CMV infection. The results can be interpreted based on the following table:
| Status of antibodies in the sample | Possible interpretation | |
| CMV IgG | CMV IgM | |
| Negative | Negative | ● Absence of a cytomegalovirus infection presently ● Absence of any prior infection ● Infection is present but the patient cannot make enough antibodies due to being immunocompromised |
| Negative | Positive | ● An active infection is present ● Re-exposure to CMV has happened recently ● Reactivation of latent cytomegalovirus has happened |
| Positive (with a 4X rise in concentration between two samples collected at different times) | Positive | ● A primary infection is present ● A latent CMV infection has been reactivated |
| Positive | Negative | An infection has existed in the past A latent infection is present |
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Conclusion
Among many viral infections that affect the US population every year at a massive scale, those caused by cytomegaloviruses are often considered dangerous owing to their potential to result in several fatalities. Cytomegalovirus-associated infections are particularly risky when the patients are either newborns or immunocompromised.
Therefore, to save their lives, physicians often recommend one or more diagnostic tests to detect the presence of cytomegalovirus in the body. Although the accuracy of these tests varies from one another, all of these are considered essential while making a diagnosis for CMV infection. After all, an early and accurate detection followed by timely treatment can save many precious lives.
References
PhD Scholar (Pharmaceutics), MPhil (Pharmaceutics), Pharm D, B. Sc.
