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Cytomegalovirus (HHV-5)

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Human Herpesvirus 5: Cytomegalovirus

Infection is very common, and is present in over half of the adult population.

Causes persistent and latent infections, which are usually subclinical.

The virus is shed in urine and other bodily secretions.

Transmitted upon close contact (including sexual contact) and organ transplant; the virus can also be transmitted from mother to neonates

Replicates in epithelial cells, macrophages, fibroblasts, and other cells

Owl-eye basophilic inclusion bodies in kidney epithelial cells:

https://phil.cdc.gov/Details.aspx?pid=1155

The virus establishes latency in myeloid stem cells, monocytes, lymphocytes, bone marrow, and other cells.

Reactivation of the virus can occur in times of immunosuppression.

Infections:

Healthy individuals: Asymptomatic, Mononucleosis

Often asymptomatic infection.

Mononucleosis: In contrast to Epstein-Barr Virus mononucleosis, pharyngitis and swollen lymph glands are less pronounced, and, because cytomegalovirus is not a B cell infection, heterophile antibodies are not produced

More serious outcomes are possible, but rare

Immunocompromised individuals: Transplant recipients and HIV patients Infection can produce multi-organ effects: Hepatitis, pneumonia, retinitis, colitis, and esophagitis

Neonates Infection can lead to still birth or premature birth with congenital defects.

Complications are most likely when the mother experiences primary CMV infection during pregnancy. CMV is associated with small size, microcephaly, petechial rash, jaundice, and mental retardation

Infection is also associated with specific neurological complications, including sensorineural hearing loss (SNHL), chorioretinitis, and periventricular calcifications.

Cytomegalovirus is one of the TORCHeS infections.

Cytomegalovirus (HHV-5)

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