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Cytomegaloveirusýkingar heilbrigðra

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Authors
Elínborg Bárðardóttir
Ásbjörn Sigfússon
Helga Kristjánsdóttir
Þorgerður Árnadóttir
Sigurður B. Þorsteinsson
Issue Date
1995-02-01

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Other Titles
Cytomegalovirus infections in healthy adults
Citation
Læknablaðið 1995, 81(2):135-43
Abstract
Background: Primary cytomegalovirus (CMV) infections in healthy adults are considered extremely rare. To study the extent of this problem in Iceland we undertook a two year (1989-1990) retrospective study of all new CMV infections in adults. Methods: All positive tests for CMV antibodies in clinical samples (194) were identified in the sole virology laboratory in Iceland. Patients younger than 16 years and all patients with underlying diseases that could cause immunosuppression were excluded (154). The 40 remaining patients were contacted, their case histories reviewed and their serology for CMV, Epstein-Barr and HIV antibodies remeasured. Primary CMV infection was not confirmed in 14 patients leaving 26 immune competent patients who fullfilled our criteria for primary sym-tomatic CMV infection by the presence of IgM anti-CMV antibodies. Results: Duration of illness in the 26 study patients varied from 1 to 25 weeks, usually 7-10 weeks. Fifteen patients were hospitalized. Diagnostic delay was considerable. Immunological tests (DTH skin test, serum immunoglobulines and lymphocyte differential counts) done 172-2 years after the illness did nor reveal any persistent immune abnormalities except for an absolute increase in the number of CD8+ T lymphocytes Conclusions: We conclude that primary CMV infections in adults are not uncommon and probably underdiagnosed. When adult patients present with non-specific symptoms such as low grade fever, malaise and unexplained fatigue, CMV should be considered or excluded with appropriate serological tests.
Megintilgangur þessarar rannsóknar var að athuga veikindi vegna cytomegaloveirusýkinga hjá heilbrigðum, fullorðnum einstaklingum. Farið var yfir öll veirurannsóknarsvör tveggja ára og leitað að einstaklingum með teikn um nýlega cytomegaloveirusýkingu. Upplýsingum um einkenni, skoðim og rannsóknarniðurstöður var safnaö úr sjúkraskrám og auk þess voru allir sjúklingarnir rannsakaðir á göngudeild hálfu til tveimur árum eftir veikindi. Á þeim tveimur árum sem athuguð voru fundust 26 annars hraustir, fullorðnir einstaklingar sem veikst höfðu af völdum cytomegaloveiru. Oftast höfðu sjúklingar verið veikir í meira en tvær vikur áður en leitað var að mótefnum gegn cytomegaloveiru og lengst dróst greining í 12 vikur. Flestir höfðu væg almenn sýkingareinkenni en nokkrir urðu alvarlega veikir. Fimmtán sjúklingar lögðust inn á sjúkrahús og tveir voru lengi á spítala, annar í 19 daga og hinn í tvo mánuði. Athyglisvert er að flestir voru lengi að ná sér að fullu eftir veikindin, flestir voru frá vinnu í meira en mánuð og einn einstaklingur var óvinnufær í hálft ár. Rannsóknir hálfu til tveimur árum eftir veikindi bentu ekki til neinnar ónæmisbiiunar eöa annarra veikinda sem gætu hafa átt þátt í cytomegaloveirusýkingu. Niðurstöður okkar benda til þess að veikindi af völdum cytomegaloveiru hjá annars heilbrigðum, fullorðnum einstaklingum séu mun algengari en almennt hefur verið talið og aö greining sjúkdómsins dragist oft lengi. Full ástæða er til að hafa þessa veiru í huga þegar almenn og oft óljós sýkingareinkenni dragast á langinn.
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