Сlinical significance of determining cytomegalovirus markers in liver cirrhosis

A.V. Dedov¹, T.R. Kasyanova¹, O.L. Titova²

¹Astrakhan State Medical University, Astrakhan

²Alexander-Mariinsky Regional Clinical Hospital, Astrakhan

Background: cytomegalovirus (CMV) has polytropicity and is capable of affecting almost any human tissue and organs. Currently, the CMV behavior in mixed infections is of interest, for example, in the combination of CMV and Epstein-Barr virus, herpes, hepatitis and its contribution to the pathogenesis of various diseases. Given the high medical and social significance of liver cirrhosis (LC), its course duration and the central role of hepatotropic viruses in its progression, it seems relevant to study the CMV occurrence in this disease and the possible impact of this virus on the LC course.

Aim: to establish the diagnostic significance of the immunoglobulin M and G (IgM and IgG) determination to CMV and CMV DNA in patients with LC, taking into account the disease clinical manifestations.

Patients and Methods: IgG and IgM to CMV were detected by enzyme immunoassay, as well as CMV DNA by polymerase chain reaction (PCR) in 164 patients with LC. The control group consisted of 61 blood donors.

Results: in patients with LC and in persons from the control group, a high incidence of IgG to CMV was revealed. Patients with LC are significantly more likely to have IgM to CMV versus patients from the control group. There is a tendency to decrease the detection rate of IgM to CMV as the LC severity class increases according to the Child–Pugh Score. The presence of IgM to CMV was commonly associated with a greater severity of several clinical and biochemical activity signs, but not with the severity of portal hypertension in LC.

Conclusion: the results obtained may indicate the contribution of CMV to the particular LC course. Detection of IgM level to CMV in patients with LC and detection of mixed infection, detection of active CMV replication by PCR will expand therapeutic horizons for the administration of immunomodulatory and antiviral drugs, which will help stabilize the patient condition.

Keywords: cytomegalovirus, cytomegalovirus infection, liver cirrhosis, antiviral therapy, hepatotropic virus, mixed infection.

For citation: Dedov A.V., Kasyanova T.R., Titova O.L. Сlinical significance of determining cytomegalovirus markers in liver cirrhosis. RMJ. 2024;6:–34.