Cyto-Megalic Virus Information Needed

[MATTHEW FRANCIS WETTLAUFER]

Andrew Bailey (ja333710 at student.uq.edu.au) wrote: : I am after some
detailed information on cyto-megalic virus .... and the : immune response
when the virus is in both acute and chronic stages ... : -- 

I can give you
some information.  CMV is a commonly acquired disease during childhood in
developing countries; in developed countries the illness is sometimes not
acquired until later in life when it can cause damage.  Primary infection
with CMV during pregnancy is highly dangerous and can result in fetal
abnormalities.  Immunosuppression can allow CMV to become dangerous to the
host; in AIDS patintes it is a leading cause of blindness, and death. 

The virus is shed intermittently for life through urine and bodily fluids. 
Once infected the virus becomes "latent" rather than symptomatic. 
Symptomatic expressions of CMV, or "acute" phases can occur either at
primary infection or during reactivation due to some outside trigger such
as immunosuppression (following chemotherapy or HIV infection), or
pregnancy.  It seems that over 50% of women in affluent countries go into
pregnancy seronegative compared to 10% of women in the developing world. 
First exposure to the disease during pregnancy in the first 6 months
carries a 30-40% risk of prenatal infection and a 10-15% risk of fetal
abnormalities. 

The virus establishes latency in monocytes, endothelial cells, 
smooth muscle cells, and some CD8+.  It is not yet known which cells act 
as principle reservoir for the viral genome, nor is it known whether 
latency is a true latency or a low level chronic production of virus 
restricted by immune mediation (hence reactivation due to immunesuppression).

NK cells are important during early infection.  The virus can spread from 
cell to cell (like HIV) hence evading the immune system and 
neutralization by antibody.   

Blood transfusions, iatrogenic transmission, exchange of bodily fluids 
during unprotected sex--all are means of transmission, as in HIV.  
Expression of symptoms for CMV mononucleosis are similar to EBV but less 
severe, with symptoms demonstrating liver malfunction and hepatitis.  In 
immunocompromised individuals symptoms are much more severe, ranging from 
pnuemonia, hepatitis, retinitis, and arthritis, to encephalitis and 
Guillain-Barre syndrome.  There is also a prenatal infection called 
Cytomegalic Inclusion Disease, with encephalitis, jaundice, petechial 
hemorrhages, hepatosplenomegaly and other conditions.  Many of such 
infants require lifetime specialized care.

If you need more information on assays, etc. please email me.  All my 
information comes from David White and Frank Fenner's text 
Medical Virology, Academic Press, New York, NY, 1994, pp. 334-341.

Hope this helps!

Matt Wettlaufer
SFSU/Virology, Microbiology