CMV - immunocompromised host Health Article

Definition

Cytomegalovirus (CMV) is a member of a group of herpes-type viruses that can cause disease in different parts of the body in people with weakened immune systems.

Alternative Names

Cytomegalovirus - immunocompromised host

Causes, incidence, and risk factors

Most humans are exposed to CMV in their lifetime, but typically only individuals with weakened immune systems become ill from CMV infection. Usually, CMV produces no symptoms. However, serious CMV infections can occur in people with weakened immune systems due to AIDS, organ transplants, bone marrow transplant, chemotherapy, or medicines that suppress the immune system.

A CMV infection may affect different parts of the body. Infections include:

• CMV esophagitis
• CMV gastroenteritis
• CMV retinitis
• CMV pneumonia
• Mononucleosis -like illness

Once a person becomes infected, the virus remains alive, but usually dormant, within that person's body for life. Rarely does it cause recurrent disease, unless the person's immune system is suppressed due to medication or disease. Therefore, for most people, CMV infection is not a serious problem.

Primary CMV infection in pregnant women can cause harm to the developing fetus. See: Congenital cytomegalovirus

Symptoms

The symptoms of CMV infection are similar to those of mononucleosis. In fact, in a small percentage of people with mononucleosis, CMV is the cause. The symptoms of primary CMV infection are:

• Fatigue
• General discomfort, uneasiness, or ill feeling (malaise)
• Joint stiffness
• Loss of appetite
• Muscle aches or joint pain
• Night sweats
• Prolonged fever
• Weakness
• Weight loss

In immunocompromised people, CMV can attack specific organs. The major symptoms of these organ-specific infections are:

Eye:

• Blindness
• Visual impairment

Lung:

• Pneumonia with impaired oxygen uptake (hypoxia)

Gastrointestinal:

• Diarrhea
• Ulcerations with bleeding

Brain:

• Coma
• Encephalitis with behavioral changes
• Seizures

Signs and tests

Blood and urine tests can detect and measure substances specific to CMV. A tissue biopsy may also be done.

Treatment

Several antiviral medications are available to treat CMV. These medicines require close monitoring for adverse reactions. Antiviral drugs can help stop the virus from copying itself within the body. However, the drugs do not eliminate the virus from the body.