CMV

Cytomegalovirus (CMV) testing is ordered to determine whether someone is currently, or has recently been, infected with CMV. It may also sometimes be ordered to determine whether someone has ever been exposed to CMV. Testing for CMV involves either a measurement of CMV antibodies, immune proteins created in response to CMV exposure, or by the detection of the virus itself. The virus is detected during an active infection by culturing CMV or by detecting the genetic material of the virus (its DNA).

In the United States, as many as 50% to 85% of adults have been infected with CMV. Most people are infected as children or young adults and do not experience any significant symptoms or health problems. CMV is found in many body fluids during an active infection, including saliva, urine, blood, breast milk, semen, cervical secretions, and cerebrospinal fluid. It is easily transmitted to others through close physical contact or by contact with infected objects, such as diapers or toys. After the initial “primary” infection has resolved, CMV becomes dormant or latent - like other members of the herpes family. Cytomegalovirus remains in a patient for the rest of their life without causing any symptoms, unless the virus reactivates when a patient’s immune system is compromised.

CMV can cause problems in three areas:

In young adults, primary CMV infection may cause a flu-like or mononucleosis-type illness. This condition, which causes symptoms such as extreme fatigue, fever, chills, body aches and/or headaches, usually resolves within a few weeks.

In infants, primary CMV infection may cause serious physical and developmental problems when women are first infected during pregnancy and then pass the infection to infants across the placental barrier. Most fetuses (about 90%) that are infected appear perfectly normal at birth but may develop hearing or vision problems, pneumonia, seizures, and/or delayed mental development a few months later. A few babies may be stillborn, while others may have symptoms at birth such as jaundice, anemia, an enlarged spleen or liver, and a small head. Some of these signs and symptoms will resolve with time, but others may persist.

In those with compromised immune systems, CMV may cause serious illness and death. This includes those with HIV/AIDS, those who have had organ or bone marrow transplants, and those undergoing chemotherapy treatment for cancer. Patients with compromised immune systems who become infected for the first time may experience more severe symptoms, and the CMV infection may remain active. Those who have been exposed to CMV previously may reactivate their infection. This may affect their eyes (causing inflammation of the retina, which can lead to blindness), gastrointestinal tract (causing bloody diarrhea and abdominal pain), lungs (causing pneumonia with a non-productive cough and shortness of breath), and brain (causing encephalitis). There can also be spleen and liver involvement, and those who have had organ or bone marrow transplants may experience some degree of rejection. Active CMV also further depresses the immune system, allowing other secondary infections, such as fungal infections, to occur.

 

The sample required depends on whether testing is being done to determine the presence of antibody or to detect the virus itself and on the health status of the patient. Antibody testing requires a blood sample, obtained by inserting a needle into a vein in the arm. Viral detection may be done on a variety of samples, including urine, blood, or sputum. Some samples may require a special procedure to collect amniotic fluid, duodenal fluid, cerebrospinal fluid, or body tissue (biopsy).

No test preparation is needed.