Cytomegalovirus (CMV) testing is requested to determine whether someone is currently, or has recently been, infected with CMV. It may also sometimes be used 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 detecting the genetic material of the virus (its DNA).In the United Kingdom, 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, but the most common symptoms are fever, tiredness and jaundice. 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 sexual contact and sharing saliva or by contact with infected objects, such as nappies 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, the initial primary CMV infection may cause an illness characterised by fever, tiredness or jaundice; it usually resolves within a few weeks but can cause prolonged illness with fever and sweating.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 foetuses (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, anaemia, 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 diarrhoea 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.
