CMVrelated

CMV-related refers to conditions caused by cytomegalovirus infection, a ubiquitous herpesvirus. Most infections are asymptomatic; latent infection persists for life. CMV is a leading cause of congenital infection and an opportunistic pathogen in immunocompromised individuals.

Transmission occurs via contact with body fluids; congenital CMV arises from in utero infection. During immunosuppression, reactivation or primary infection can cause disease. Populations at risk include newborns with congenital CMV, transplant recipients, people living with HIV/AIDS before modern antiretroviral therapy, and patients receiving immunosuppressive therapy.

Congenital CMV is the most common congenital infection and the leading non-genetic cause of sensorineural hearing loss; other signs include microcephaly, intrauterine growth restriction, intracranial calcifications, and chorioretinitis. In immunocompromised hosts, CMV can cause retinitis, pneumonitis, colitis, esophagitis, hepatitis, and encephalitis.

Diagnosis is through detection of CMV DNA by PCR in blood or other fluids; antigenemia assays and serology help in certain settings. In neonates, CMV testing of urine or saliva within the first three weeks of life confirms congenital infection.

Treatment involves antiviral agents such as valganciclovir or ganciclovir for congenital CMV with symptomatic central nervous system involvement and for CMV disease in immunocompromised patients; alternatives include foscarnet and cidofovir in resistant cases. Prevention includes prophylaxis or preemptive therapy in high-risk groups; vaccination development is an area of ongoing research.