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CMV Infection: Causes, Symptoms and Treatment

CMV infection is a common viral infection caused by the cytomegalovirus. It is usually harmless in healthy individuals but can be dangerous for immunocompromised patients and unborn children.

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Things worth knowing about "CMV Infection"

CMV infection is a common viral infection caused by the cytomegalovirus. It is usually harmless in healthy individuals but can be dangerous for immunocompromised patients and unborn children.

What is a CMV Infection?

A CMV infection (cytomegalovirus infection) is a widespread viral infection caused by the cytomegalovirus (CMV), a member of the herpesvirus family. CMV is found globally, and an estimated 50 to 80 percent of adults in developed countries have been infected at some point, often without knowing it. After the initial infection, the virus remains dormant (latent) in the body for life and can reactivate if the immune system becomes weakened.

Causes and Transmission

CMV is transmitted through close contact with infected body fluids. The virus can be found in:

Saliva (e.g., through kissing or sharing utensils)
Urine (especially from young children)
Blood and blood products
Breast milk
Semen and vaginal secretions
Transplanted organs or stem cells
Transmission from mother to unborn child (congenital CMV infection)

Risk Groups

While the infection is typically mild in healthy individuals, it can be life-threatening for certain groups:

Immunocompromised individuals (e.g., HIV patients, transplant recipients, patients undergoing chemotherapy)
Pregnant women and their unborn children (congenital CMV)
Premature and newborn infants

Symptoms

In healthy adults, CMV infection is often asymptomatic (without symptoms). Occasionally, symptoms similar to mononucleosis may appear:

Fever and general feeling of illness
Fatigue and tiredness
Sore throat and swollen lymph nodes
Muscle aches

In immunocompromised patients, CMV can cause severe organ damage, including:

CMV retinitis (inflammation of the retina, risk of blindness)
CMV pneumonia (lung inflammation)
CMV colitis (inflammation of the large intestine)
CMV encephalitis (brain inflammation)

In cases of congenital CMV infection (infection of the unborn child), serious consequences can occur, including hearing loss, intellectual disability, and neurological developmental disorders.

Diagnosis

CMV infection is diagnosed using several methods:

Blood test (serology): Detection of CMV antibodies (IgM and IgG) in the blood
PCR (polymerase chain reaction): Direct detection of viral DNA in blood, urine, or other body fluids
Viral culture: Growing the virus in a laboratory setting (rarely used)
Histology: Tissue examination when organ involvement is suspected

In pregnancy, if a primary CMV infection is suspected, an amniocentesis (analysis of amniotic fluid) may be performed to detect fetal infection.

Treatment

In healthy, immunocompetent individuals, no specific treatment is usually necessary, as the infection resolves on its own. In immunocompromised patients and severe cases, antiviral medications are used:

Ganciclovir and Valganciclovir (oral or intravenous) – first-line treatments
Foscarnet – used in cases of resistance to ganciclovir
Cidofovir – reserved as a second-line option

In transplant patients, prophylactic or pre-emptive antiviral therapy is commonly used to prevent or treat CMV disease at an early stage.

Prevention

No approved CMV vaccine is currently available. Preventive measures include:

Regular handwashing, especially after contact with urine or saliva from young children
Avoiding close contact with infected individuals during pregnancy
Use of CMV-negative or irradiated blood products for high-risk patients

References

Robert Koch-Institut (RKI): Cytomegalovirus Infection. RKI Advisory, 2023. Available at: https://www.rki.de
Lazzarotto T, et al. - Congenital cytomegalovirus infection: recent advances in the diagnosis, treatment and management. Journal of Clinical Virology, 2020.
Kotton CN, et al. - The Third International Consensus Guidelines on the Management of Cytomegalovirus in Solid-organ Transplantation. Transplantation, 2018.

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