Human cytomegalovirus: Difference between revisions
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{{Infobox medical condition | |||
| name = Human cytomegalovirus | |||
| image = [[File:Cytomegalovirus_01.jpg|left|thumb|Cytomegalovirus]] | |||
| caption = Electron micrograph of a human cytomegalovirus virion | |||
| field = [[Virology]] | |||
| synonyms = HCMV, Human herpesvirus 5 (HHV-5) | |||
| symptoms = [[Fever]], [[sore throat]], [[fatigue]], [[swollen glands]] | |||
| complications = [[Congenital cytomegalovirus infection]], [[hearing loss]], [[vision loss]], [[neurological damage]] | |||
| onset = Varies; congenital or acquired | |||
| duration = Lifelong latent infection | |||
| causes = [[Cytomegalovirus]] infection | |||
| risks = [[Immunocompromised]] individuals, [[pregnancy]] | |||
| diagnosis = [[Serology]], [[PCR]], [[viral culture]] | |||
| differential = [[Mononucleosis]], [[toxoplasmosis]], [[rubella]] | |||
| prevention = [[Good hygiene]], [[safe sex]], [[screening blood products]] | |||
| treatment = [[Antiviral drugs]] such as [[ganciclovir]], [[valganciclovir]], [[foscarnet]], [[cidofovir]] | |||
| medication = [[Ganciclovir]], [[valganciclovir]] | |||
| frequency = Common; 50-80% of adults infected by age 40 | |||
| deaths = Rare in healthy individuals; higher in immunocompromised | |||
}} | |||
{{Short description|Virus of the family Herpesviridae}} | {{Short description|Virus of the family Herpesviridae}} | ||
'''Human cytomegalovirus''' ('''HCMV'''), also known as '''human herpesvirus 5''' ('''HHV-5'''), is a member of the [[Herpesviridae]] family of viruses. It is a common virus that infects people of all ages and is often asymptomatic in healthy individuals. However, it can cause significant disease in immunocompromised individuals and is a major cause of congenital infections. | '''Human cytomegalovirus''' ('''HCMV'''), also known as '''human herpesvirus 5''' ('''HHV-5'''), is a member of the [[Herpesviridae]] family of viruses. It is a common virus that infects people of all ages and is often asymptomatic in healthy individuals. However, it can cause significant disease in immunocompromised individuals and is a major cause of congenital infections. | ||
==Virology== | ==Virology== | ||
HCMV is a large, enveloped virus with a double-stranded DNA genome. It is classified as a [[betaherpesvirus]], which is characterized by a slow replication cycle and the ability to establish lifelong latency in the host. The virus can reactivate from latency, particularly in individuals with weakened immune systems. | HCMV is a large, enveloped virus with a double-stranded DNA genome. It is classified as a [[betaherpesvirus]], which is characterized by a slow replication cycle and the ability to establish lifelong latency in the host. The virus can reactivate from latency, particularly in individuals with weakened immune systems. | ||
The HCMV genome is approximately 230 kilobase pairs in length and encodes for a variety of proteins that help the virus evade the host immune response and establish infection. | The HCMV genome is approximately 230 kilobase pairs in length and encodes for a variety of proteins that help the virus evade the host immune response and establish infection. | ||
==Pathogenesis== | ==Pathogenesis== | ||
HCMV is transmitted through bodily fluids such as saliva, urine, blood, and breast milk. Once inside the host, the virus can infect a wide range of cell types, including epithelial cells, endothelial cells, fibroblasts, and leukocytes. | HCMV is transmitted through bodily fluids such as saliva, urine, blood, and breast milk. Once inside the host, the virus can infect a wide range of cell types, including epithelial cells, endothelial cells, fibroblasts, and leukocytes. | ||
In healthy individuals, HCMV infection is usually asymptomatic or may cause mild flu-like symptoms. However, in immunocompromised individuals, such as those with [[HIV/AIDS]], organ transplant recipients, or patients undergoing chemotherapy, HCMV can cause severe disease, including pneumonia, retinitis, and gastrointestinal disease. | In healthy individuals, HCMV infection is usually asymptomatic or may cause mild flu-like symptoms. However, in immunocompromised individuals, such as those with [[HIV/AIDS]], organ transplant recipients, or patients undergoing chemotherapy, HCMV can cause severe disease, including pneumonia, retinitis, and gastrointestinal disease. | ||
==Congenital Infection== | ==Congenital Infection== | ||
[[File:CMV_placentitis2_mini.jpg|CMV placentitis|thumb | [[File:CMV_placentitis2_mini.jpg|CMV placentitis|left|thumb]] | ||
HCMV is the most common cause of congenital viral infection, affecting approximately 0.5% to 2% of all live births. Congenital HCMV infection can lead to a range of outcomes, from asymptomatic infection to severe disease with long-term sequelae such as hearing loss, developmental delay, and microcephaly. | HCMV is the most common cause of congenital viral infection, affecting approximately 0.5% to 2% of all live births. Congenital HCMV infection can lead to a range of outcomes, from asymptomatic infection to severe disease with long-term sequelae such as hearing loss, developmental delay, and microcephaly. | ||
The risk of congenital infection is highest when a primary maternal infection occurs during pregnancy. The virus can cross the placenta and infect the fetus, leading to placental inflammation and fetal damage. | The risk of congenital infection is highest when a primary maternal infection occurs during pregnancy. The virus can cross the placenta and infect the fetus, leading to placental inflammation and fetal damage. | ||
==Diagnosis== | ==Diagnosis== | ||
Diagnosis of HCMV infection can be achieved through serological tests that detect antibodies against the virus, as well as molecular techniques such as PCR to detect viral DNA in blood or other body fluids. In congenital infections, diagnosis may involve testing the newborn's urine or saliva for the presence of the virus. | Diagnosis of HCMV infection can be achieved through serological tests that detect antibodies against the virus, as well as molecular techniques such as PCR to detect viral DNA in blood or other body fluids. In congenital infections, diagnosis may involve testing the newborn's urine or saliva for the presence of the virus. | ||
==Treatment== | ==Treatment== | ||
[[File:CMVschema.svg|CMV replication cycle|thumb | [[File:CMVschema.svg|CMV replication cycle|left|thumb]] | ||
Antiviral drugs such as [[ganciclovir]], [[valganciclovir]], [[foscarnet]], and [[cidofovir]] are used to treat HCMV infections, particularly in immunocompromised patients. These drugs inhibit viral DNA synthesis, thereby reducing viral replication. | Antiviral drugs such as [[ganciclovir]], [[valganciclovir]], [[foscarnet]], and [[cidofovir]] are used to treat HCMV infections, particularly in immunocompromised patients. These drugs inhibit viral DNA synthesis, thereby reducing viral replication. | ||
[[File:hcmvdrugs.pdf|Antiviral drugs for HCMV|left|thumb]] | |||
[[File:hcmvdrugs.pdf|Antiviral drugs for HCMV|thumb | |||
Treatment of congenital HCMV infection is more challenging, and the use of antiviral therapy in newborns is still under investigation. Early diagnosis and intervention are crucial to managing the disease and preventing long-term complications. | Treatment of congenital HCMV infection is more challenging, and the use of antiviral therapy in newborns is still under investigation. Early diagnosis and intervention are crucial to managing the disease and preventing long-term complications. | ||
==Prevention== | ==Prevention== | ||
Preventive measures for HCMV infection include practicing good hygiene, such as handwashing, and avoiding contact with bodily fluids from infected individuals. In healthcare settings, standard precautions should be followed to prevent nosocomial transmission. | Preventive measures for HCMV infection include practicing good hygiene, such as handwashing, and avoiding contact with bodily fluids from infected individuals. In healthcare settings, standard precautions should be followed to prevent nosocomial transmission. | ||
Research is ongoing to develop a vaccine against HCMV, which could significantly reduce the incidence of congenital infections and disease in immunocompromised individuals. | Research is ongoing to develop a vaccine against HCMV, which could significantly reduce the incidence of congenital infections and disease in immunocompromised individuals. | ||
==See also== | |||
== | |||
* [[Herpesviridae]] | * [[Herpesviridae]] | ||
* [[Congenital infection]] | * [[Congenital infection]] | ||
* [[Immunocompromised host]] | * [[Immunocompromised host]] | ||
[[Category:Herpesviridae]] | [[Category:Herpesviridae]] | ||
[[Category:Viral diseases]] | [[Category:Viral diseases]] | ||
[[Category:Congenital disorders]] | [[Category:Congenital disorders]] | ||
Latest revision as of 03:57, 7 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC
| Human cytomegalovirus | |
|---|---|
 | |
| Synonyms | HCMV, Human herpesvirus 5 (HHV-5) |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Fever, sore throat, fatigue, swollen glands |
| Complications | Congenital cytomegalovirus infection, hearing loss, vision loss, neurological damage |
| Onset | Varies; congenital or acquired |
| Duration | Lifelong latent infection |
| Types | N/A |
| Causes | Cytomegalovirus infection |
| Risks | Immunocompromised individuals, pregnancy |
| Diagnosis | Serology, PCR, viral culture |
| Differential diagnosis | Mononucleosis, toxoplasmosis, rubella |
| Prevention | Good hygiene, safe sex, screening blood products |
| Treatment | Antiviral drugs such as ganciclovir, valganciclovir, foscarnet, cidofovir |
| Medication | Ganciclovir, valganciclovir |
| Prognosis | N/A |
| Frequency | Common; 50-80% of adults infected by age 40 |
| Deaths | Rare in healthy individuals; higher in immunocompromised |
Virus of the family Herpesviridae
Human cytomegalovirus (HCMV), also known as human herpesvirus 5 (HHV-5), is a member of the Herpesviridae family of viruses. It is a common virus that infects people of all ages and is often asymptomatic in healthy individuals. However, it can cause significant disease in immunocompromised individuals and is a major cause of congenital infections.
Virology[edit]
HCMV is a large, enveloped virus with a double-stranded DNA genome. It is classified as a betaherpesvirus, which is characterized by a slow replication cycle and the ability to establish lifelong latency in the host. The virus can reactivate from latency, particularly in individuals with weakened immune systems. The HCMV genome is approximately 230 kilobase pairs in length and encodes for a variety of proteins that help the virus evade the host immune response and establish infection.
Pathogenesis[edit]
HCMV is transmitted through bodily fluids such as saliva, urine, blood, and breast milk. Once inside the host, the virus can infect a wide range of cell types, including epithelial cells, endothelial cells, fibroblasts, and leukocytes. In healthy individuals, HCMV infection is usually asymptomatic or may cause mild flu-like symptoms. However, in immunocompromised individuals, such as those with HIV/AIDS, organ transplant recipients, or patients undergoing chemotherapy, HCMV can cause severe disease, including pneumonia, retinitis, and gastrointestinal disease.
Congenital Infection[edit]
HCMV is the most common cause of congenital viral infection, affecting approximately 0.5% to 2% of all live births. Congenital HCMV infection can lead to a range of outcomes, from asymptomatic infection to severe disease with long-term sequelae such as hearing loss, developmental delay, and microcephaly. The risk of congenital infection is highest when a primary maternal infection occurs during pregnancy. The virus can cross the placenta and infect the fetus, leading to placental inflammation and fetal damage.
Diagnosis[edit]
Diagnosis of HCMV infection can be achieved through serological tests that detect antibodies against the virus, as well as molecular techniques such as PCR to detect viral DNA in blood or other body fluids. In congenital infections, diagnosis may involve testing the newborn's urine or saliva for the presence of the virus.
Treatment[edit]
Antiviral drugs such as ganciclovir, valganciclovir, foscarnet, and cidofovir are used to treat HCMV infections, particularly in immunocompromised patients. These drugs inhibit viral DNA synthesis, thereby reducing viral replication. File:Hcmvdrugs.pdf Treatment of congenital HCMV infection is more challenging, and the use of antiviral therapy in newborns is still under investigation. Early diagnosis and intervention are crucial to managing the disease and preventing long-term complications.
Prevention[edit]
Preventive measures for HCMV infection include practicing good hygiene, such as handwashing, and avoiding contact with bodily fluids from infected individuals. In healthcare settings, standard precautions should be followed to prevent nosocomial transmission. Research is ongoing to develop a vaccine against HCMV, which could significantly reduce the incidence of congenital infections and disease in immunocompromised individuals.
