Cytomegalovirus (CMV) (cont.)

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How do physicians diagnose cytomegalovirus infection?

Most CMV infections go undiagnosed because the virus causes little to no symptoms. When a person is infected with CMV, antibodies (proteins) to the virus called IgM and/or IgG anti-CMV antibodies develop and stay in the body for the rest of the person's life. A blood test to detect the antibodies will be positive if the person has had a CMV infection. If the antibody test is negative, the person is considered to be CMV negative.

A diagnosis of an active CMV infection can be made if the virus is found in bodily fluids (such as blood, saliva, or urine) or body tissues by culturing (growing) the virus or detecting its DNA or specific protein called pp65 antigen by PCR tests. These tests are done if a person has a history of signs and symptoms consistent with an active CMV infection. The virus can become reactivated from its latent state (latent infection) when a person's immune system has weakened.

A physician may diagnose a congenital CMV infection if he or she detects the virus in a newborn's urine, saliva, blood, or other body tissues within two to three weeks after birth.

What is the treatment for cytomegalovirus infection?

There is no cure for CMV, and treatment for CMV infection is not necessary in healthy children and adults. People with a weakened immune system who have symptoms of CMV infection are placed on antiviral medication. Up to 75% of transplant recipients develop CMV infection. Those who have a very high risk of developing severe CMV infection may be placed on antiviral medication to prevent CMV disease. This pretreatment is called prophylaxis. This method has helped reduce the number of CMV infections in these patients. The antiviral medications against CMV include the following:

  • Ganciclovir (Cytovene) is the first antiviral medication approved for the treatment of CMV infection. Ganciclovir, given intravenously, is the drug of choice for the treatment of CMV infection. Side effects include fever, rash, diarrhea, anemia, and low white blood cell and platelet counts.
  • Valganciclovir (Valcyte) is an oral medication that is activated to ganciclovir in the body and widely used to prevent CMV infection (prophylaxis). It is used in selected patients for the treatment of CMV infection and is as effective as intravenous ganciclovir in non-severe cases.
  • Foscarnet (Foscavir) is active against CMV by a different mechanism than ganciclovir and used to treat infections with CMV that are resistant to ganciclovir. It is a second-line therapy for patients who do not tolerate ganciclovir treatment. Foscarnet is toxic to the kidneys and can cause seizures due to an imbalance of minerals and electrolytes.
  • Cidofovir (Vistide) is an alternative therapy for patients who have failed ganciclovir and foscarnet treatment. Its use is limited due to toxicity to the kidneys. It is used mainly for the treatment of CMV infection of the eye (retinitis) in patients with acquired immune deficiency syndrome (AIDS) caused by the human immunodeficiency virus (HIV).
  • CMV immune globulin contains antibodies (proteins) that are specific to CMV. It is FDA-approved to prevent CMV infection in high-risk lung transplant patients when given in addition to ganciclovir. It is also used with ganciclovir to treat CMV pneumonia.

No antiviral drug is FDA-approved for the treatment of congenital CMV infection. However, some infants who have infection involving the central nervous system (brain and spinal cord) may benefit from treatment. Some evidence shows that ganciclovir may prevent hearing loss and developmental problems in infants who have severe symptoms of congenital CMV infection. Because of the serious side effects of ganciclovir, a physician specialist should be consulted.

There are no home remedies proven to be effective in treating CMV infection.

Medically Reviewed by a Doctor on 5/7/2015

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