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HIV, AIDS, and Cytomegalovirus

Cytomegalovirus (CMV) is a herpes virus. It is very common, infecting up to 80% of people in the U.S. by age 40. Normally, it hides out in the body. This is not a problem for most people because a healthy immune system can easily control it. However, it can cause severe disease in people with HIV (human immunodeficiency virus). It's able to take advantage of a weakened immune system, which is why it's called an opportunistic infection. The most common illness CMV causes is retinitis, an eye infection that can lead to blindness.

How You Can Get Cytomegalovirus?

Getting CMV from casual contact is not likely. But it is possible to become infected with cytomegalovirus by touching your eyes, nose, or mouth after contact with an infected person's:

  • Saliva
  • Semen
  • Vaginal secretions
  • Blood
  • Urine
  • Breast milk

You can also get cytomegalovirus through:

  • Sexual contact
  • Blood transfusions
  • Organ transplants

An infant can become infected before birth or through breastfeeding. This usually happens if the pregnant woman first becomes infected with CMV during the pregnancy.

Symptoms of Cytomegalovirus

Most healthy people who are infected with CMV don't know it. CMV usually causes no symptoms. However, you may have mild symptoms, such as fatigue, swollen glands, or fever. You can easily confuse these with other illnesses. If you're not treated, the CMV can move around your body. Then it can cause a variety of symptoms such as these:

  • Eyes: blind spots or moving black spots, called "floaters," blurred vision, and eventually blindness
  • Intestines: diarrhea or abdominal pain
  • Throat: painful or difficult swallowing
  • Spine: pain, weakness, or numbness at the base of your spine, causing trouble with walking
  • Brain (rare): personality changes, headaches, or trouble concentrating
  • Lungs (rare): shortness of breath or dry cough

If you are HIV-positive, your risk for becoming sick with CMV and developing symptoms is greatest if your CD4 count falls below 100. CD4 cells are a type of immune system cell.

Diagnosing Cytomegalovirus

Your doctor may diagnose cytomegalovirus by:

  • Doing a blood or urine test to check for the presence of the virus
  • Measuring antibodies against CMV (called serologic testing)
  • Doing an eye exam to look for inflammation in the retina (done by an eye doctor, called an ophthalmologist)
  • Removing tissue or fluid from the intestine, throat, or spine, for example, and examining it under a microscope (called a biopsy)
  • Conducting imaging tests such as CT scans to view a picture of the lungs

Treatment for Cytomegalovirus

For CMV retinitis, you may receive a drug implant in the eye. This is the current preferred therapy. An alternative is intensive IV treatment for two weeks. This is called induction therapy. You receive the treatment by intravenous infusion, meaning medication is given into a vein. You may need a permanent catheter in your chest for daily treatment.

WebMD Medical Reference

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