Cytomegalovirus (CMV) is a common virus that belongs to the herpes family. It can infect people of any age and usually does not cause symptoms in healthy individuals. However, it can lead to serious illness in people with weakened immune systems such as those who have received organ transplants or have HIV/AIDS and in babies infected before birth, a condition known as congenital CMV.
Once a person is infected, CMV stays in the body for life in an inactive state, known as latency. The virus can become active again if the immune system becomes weak. It spreads through close contact with body fluids like saliva, urine, blood, semen, vaginal fluids, and breast milk.
In most healthy people, CMV causes no symptoms or only mild, flu-like signs such as fever, tiredness, and sore throat. In people with weak immune systems, it can cause serious problems affecting major organs like the lungs, liver, brain, eyes, or digestive system. In newborns infected during pregnancy, CMV can lead to hearing loss, vision problems, small head size (microcephaly), and delays in growth and development.
Preventing infection mainly involves good hygiene, such as frequent handwashing after contact with bodily fluids especially for pregnant women. Although there is no cure for CMV, antiviral drugs like ganciclovir and valganciclovir can help control the virus and reduce its impact in people who are severely affected.
Those most at risk include individuals with weakened immune systems and newborn babies infected before or shortly after birth.
Types of CMV Infection
Cytomegalovirus (CMV) infection is generally classified into three main forms: primary, latent, and reactivated infection. Each represents a different stage in the virus’s relationship with its host and varies in its clinical impact.
Primary infection occurs when a person is exposed to CMV for the first time and becomes infected. In most healthy individuals, this initial infection causes no symptoms or only mild, flu-like illness. However, in people with weakened immune systems, such as those undergoing organ or bone marrow transplantation, CMV can cause severe disease affecting multiple organs. In pregnant women, primary infection carries the greatest risk for the developing fetus, as the virus can cross the placenta and result in congenital CMV infection, which may cause long-term disabilities such as hearing loss, vision problems, and developmental delays.
After the primary infection, CMV transitions into a latent phase. During latency, the virus remains dormant within specific cells of the body—particularly in myeloid lineage cells such as monocytes and macrophages. In this state, CMV does not cause symptoms or active disease, and only a few viral genes are expressed. This allows the virus to persist undetected by the immune system for years or even for the lifetime of the host. Latency is a defining feature of herpesviruses, and it represents a biological balance between the virus’s survival strategy and the host’s immune control.
Reactivation occurs when the latent virus becomes active again and begins to replicate. This can happen during periods of immune suppression, such as after organ transplantation, chemotherapy, HIV infection, or severe stress. Reactivation may lead to new symptoms or serious disease, particularly in immunocompromised individuals. For example, reactivated CMV can cause CMV pneumonitis, retinitis, hepatitis, or gastrointestinal ulceration in vulnerable patients. In transplant recipients, CMV reactivation can trigger graft rejection and secondary infections, making it a major cause of post-transplant complications.
CMV Life Cycle
The life cycle of CMV involves several distinct stages that allow the virus to infect host cells, replicate, and persist within the body. Understanding this cycle helps explain how CMV maintains lifelong infection and occasionally reactivates to cause disease.
The process begins when the virus attaches to and enters a host cell through a mechanism known as membrane fusion. CMV typically targets epithelial cells, endothelial cells, fibroblasts, and certain immune cells. Once inside the cell, the viral envelope merges with the host membrane, releasing the viral capsid and genetic material—double-stranded DNA—into the cell’s nucleus.
Inside the nucleus, the CMV genome initiates a series of gene expression events in three regulated phases:
- Immediate-early phase – The virus expresses regulatory proteins that prepare the host cell for viral replication. These proteins also help suppress the host’s antiviral defenses.
- Early phase – Viral proteins involved in DNA replication are produced. The viral DNA is then copied multiple times within the host nucleus.
- Late phase – Structural proteins are synthesized, forming the components of new virus particles (virions).
After replication, newly formed viral DNA is packaged into capsids within the nucleus. These partially assembled virions are transported to the cytoplasm, where they acquire additional layers, including the viral envelope. The mature virions are then released from the cell through a process called exocytosis, allowing them to infect nearby cells or spread to other tissues in the body.
During latency, CMV minimizes its activity by expressing only a limited set of genes, which prevents the immune system from recognizing and destroying infected cells. This “silent” phase is maintained through complex interactions between viral and host factors that suppress viral replication.
When the immune system is weakened or exposed to stress signals, the virus may reactivate. This involves reinitiating viral gene expression, resuming DNA replication, and producing new infectious particles. The reactivation process can lead to symptomatic infection, particularly in immunocompromised hosts, where the virus can cause significant tissue damage and systemic illness.
Causes and Transmission of CMV
Cytomegalovirus infection results from exposure to body fluids containing the virus.
Modes of Transmission
CMV is primarily transmitted through direct contact with infected bodily fluids, which include saliva, urine, blood, semen, vaginal secretions, tears, and breast milk. The virus can enter the body through mucous membranes—such as those in the mouth, eyes, or genital tract—or through breaks in the skin. In most cases, infection occurs after prolonged or repeated exposure rather than casual contact.
1. Person-to-person transmission:
CMV is frequently spread among family members, sexual partners, and caregivers. Young children, particularly those in daycare settings, are major sources of infection because they often shed the virus in their saliva and urine for months after initial infection. Parents, caregivers, and healthcare workers who come into contact with contaminated materials such as diapers or utensils can easily contract the virus if hygiene practices are inadequate.
2. Perinatal and postnatal transmission:
Transmission from mother to child can occur in several ways:
- Congenital transmission (vertical transmission): This occurs when a pregnant woman with a primary or reactivated CMV infection passes the virus to her fetus through the placenta. Congenital CMV is one of the most common viral causes of birth defects worldwide.
- Perinatal transmission: Newborns may acquire CMV during childbirth through exposure to infected genital secretions.
- Postnatal transmission: Infants can also be infected through breast milk, especially if the mother has a reactivated infection during lactation. While postnatal infection is usually mild in full-term infants, it can be serious in premature or low-birth-weight babies.
3. Transmission through medical procedures:
CMV can also spread through blood transfusions, organ transplants, and bone marrow transplants. Donor blood or organs that contain CMV can transmit the virus to recipients especially those with compromised immune systems, causing severe, sometimes life-threatening disease. To reduce this risk, healthcare systems in many countries use CMV-negative or leukocyte-depleted blood products for high-risk patients, such as newborns and transplant recipients.
4. Sexual transmission:
Because CMV is present in semen and vaginal secretions, it can be transmitted through unprotected sexual contact. The virus may spread during vaginal, anal, or oral sex. Although CMV infection is common among sexually active adults, it often goes unnoticed because symptoms are mild or absent. Safe sexual practices, including the use of condoms, can reduce the likelihood of transmission.
5. Environmental and surface contamination:
While CMV is relatively fragile compared to some viruses, it can remain infectious on surfaces such as plastic, metal, or glass for several hours under favorable conditions. Indirect transmission through contaminated objects (known as fomites) such as toys, utensils, or doorknobs is possible but rare. Effective hygiene, including regular handwashing with soap and water, remains one of the most reliable methods of preventing spread.
Risk Factors
Certain groups of people are more likely to acquire or suffer complications from CMV infection.
1. Young children and childcare workers:
Children under the age of five, particularly those in daycare centers, are frequently exposed to CMV through contact with other children’s saliva and urine. Because they shed large amounts of virus for extended periods, they represent a major source of community transmission. Parents and childcare staff who have close, repeated contact with these children are also at elevated risk of infection.
2. Pregnant women:
Pregnant women who contract CMV for the first time during pregnancy face a risk of passing the virus to the fetus. Primary maternal infection carries the highest risk of congenital CMV transmission. Although many infected infants are born without symptoms, some develop long-term complications such as hearing loss, visual impairment, or neurodevelopmental delays. For this reason, health authorities recommend that pregnant individuals avoid contact with potentially infected body fluids—particularly from young children—and follow strict hygiene practices.
3. Immunocompromised individuals:
People with weakened immune systems are at greatest risk for severe CMV disease. This includes organ and bone marrow transplant recipients, HIV/AIDS patients, and cancer patients receiving chemotherapy. In these groups, CMV reactivation or reinfection can cause life-threatening conditions such as pneumonia, retinitis (inflammation of the retina that can lead to blindness), hepatitis, or gastrointestinal ulceration. Preventive antiviral therapy (prophylaxis) and regular CMV screening are essential parts of post-transplant care.
4. Sexually active adults:
Since CMV is a sexually transmissible virus, individuals with multiple sexual partners or inconsistent condom use are more likely to contract the infection. However, CMV infection is not restricted to any specific sexual orientation or behavior; rather, risk increases with the number and frequency of sexual contacts.
5. Healthcare and caregiving occupations:
Healthcare workers, nurses, and caregivers who handle patient specimens or body fluids may be at higher risk of exposure if infection control measures are not rigorously followed. Routine hygiene practices, including the use of gloves and proper handwashing, are effective in preventing occupational transmission.
CMV Reservoirs and Epidemiology
Humans serve as the only natural reservoir for CMV. Once infected, the virus establishes lifelong latency, primarily in white blood cells and glandular tissues.
Seroprevalence varies by age, region, and socioeconomic status. In developed countries, 50-80% of adults have antibodies against CMV, while rates can exceed 90% in developing regions.
Reactivation can occur without symptoms, leading to intermittent viral shedding. This contributes to ongoing transmission within communities and healthcare settings.
Symptoms of CMV Infection
Cytomegalovirus infection manifests differently depending on the individual’s age and immune status. Symptoms can range from mild and flu-like to severe and life-threatening.
Common Symptoms in Adults
In healthy adults, CMV infection often causes no symptoms or mild illness. When symptoms do occur, they resemble mononucleosis. These include:
- Fever
- Fatigue
- Sore throat
- Swollen lymph nodes
- Muscle aches
These symptoms usually last for a few weeks. Severe complications in healthy adults are rare.
Congenital CMV Symptoms
Congenital CMV infection occurs when the virus passes from mother to fetus. Many infants show no immediate signs at birth. However, symptomatic newborns may present:
- Low birth weight
- Jaundice
- Enlarged liver and spleen
- Microcephaly
- Seizures
- Hearing loss or vision impairment
Long-term developmental delays and neurological problems are common in severely affected infants.
Symptoms in Immunocompromised Individuals
In people with weakened immune systems, CMV can cause severe illness. Symptoms depend on the affected organs but often include:
- Persistent fever
- Pneumonia with cough and shortness of breath
- Gastrointestinal symptoms like diarrhea and abdominal pain
- Retinitis leading to vision loss
- Encephalitis causing confusion and neurological deficits
Without treatment, CMV infection in this group can be life-threatening.
Diagnosis of CMV Infection
Diagnosing CMV infection requires specific tests to identify the virus or the body’s immune response. Methods include detecting viral proteins, antibodies, or viral DNA, each with specific roles in acute and chronic cases.
Laboratory Tests for CMV
Laboratory diagnosis often starts with detecting CMV antigens or culturing the virus from body fluids. The pp65 antigenemia test identifies CMV proteins in white blood cells and is useful during active infection. Viral culture, though slower, remains a standard for confirming live virus presence.
Samples commonly used include blood, urine, saliva, and tissue biopsies. The choice depends on the patient’s clinical presentation. Testing in immunocompromised patients prioritizes early detection to prevent disease progression.
Serological Testing
Serological tests measure antibodies against CMV to determine past or recent infection. IgM antibodies indicate recent or active infection, but false positives can occur. IgG antibodies demonstrate previous exposure and immunity.
Avidity testing of IgG antibodies helps distinguish primary infection from reactivation. High IgG avidity usually excludes recent primary infection. Serology is less useful in immunocompromised patients due to impaired antibody responses.
Molecular and PCR Methods
Polymerase chain reaction (PCR) assays detect CMV DNA in blood or other fluids with high sensitivity and specificity. Real-time quantitative PCR provides viral load data essential for monitoring therapy response.
PCR is the preferred method for diagnosing CMV disease in transplant recipients and neonates. It rapidly confirms viral presence before symptoms develop, allowing timely treatment.
Complications Associated With CMV
CMV infection can lead to significant adverse outcomes in specific populations. Its effects vary depending on the individual’s health status and immune system functionality.
CMV in Pregnancy
When CMV infection occurs during pregnancy, the virus can cross the placenta—the organ that connects mother and fetus—and infect the unborn baby. This is known as congenital CMV infection, which is one of the most common causes of congenital viral illness globally. Approximately 1 in 150 babies are born with congenital CMV, and it is a leading cause of sensorineural hearing loss, vision impairment, and neurodevelopmental disabilities in children.
Infected fetuses may develop a variety of symptoms depending on the timing and severity of infection. Early infection in pregnancy (during the first or early second trimester) tends to cause more severe outcomes because the baby’s organs and nervous system are still forming. Symptoms in newborns can include jaundice (yellowing of the skin and eyes due to liver involvement), petechiae (small red or purple spots on the skin caused by bleeding under the skin), microcephaly (abnormally small head size, indicating brain underdevelopment), seizures, low birth weight, enlarged liver or spleen, and feeding difficulties.
However, it is important to note that most congenitally infected infants, around 85–90%—show no symptoms at birth. Despite appearing healthy, some may later develop long-term complications, most notably hearing loss that may worsen progressively during early childhood, or developmental delays that become evident over time.
Diagnosis during pregnancy can be made through amniocentesis, a procedure in which a small amount of amniotic fluid is sampled to test for the presence of CMV DNA. Ultrasound may also reveal abnormalities suggestive of fetal infection, such as brain calcifications, growth restriction, or fluid buildup (hydrops fetalis).
Currently, there is no universally approved antiviral treatment for CMV during pregnancy. Some studies have explored the use of antiviral drugs such as valganciclovir or CMV-specific hyperimmune globulin to reduce transmission or disease severity, but their effectiveness remains under investigation.
Long-Term Health Effects
In immunocompromised individuals, CMV can cause widespread and potentially fatal disease. These patients include organ and bone marrow transplant recipients, HIV-positive individuals, and cancer patients receiving chemotherapy. In such populations, CMV can damage vital organs and systems, leading to severe complications such as:
- CMV pneumonitis: A life-threatening lung infection causing shortness of breath, coughing, and fever.
- CMV retinitis: A progressive inflammation of the retina that can lead to blindness, especially in people with advanced HIV/AIDS.
- CMV hepatitis: Liver inflammation that can result in jaundice and liver dysfunction.
- CMV gastrointestinal disease: Ulceration and bleeding in the stomach, intestines, or colon, leading to abdominal pain and diarrhea.
- CMV encephalitis: Inflammation of the brain that can cause confusion, seizures, or coma in severe cases.
In contrast, immunocompetent individuals (those with normal immune function) typically experience either no symptoms or mild, flu-like illness, including fever, sore throat, fatigue, and swollen lymph nodes. However, in some cases, CMV can cause prolonged fatigue and malaise, similar to chronic fatigue syndrome, which can last for weeks or months.
Emerging research suggests that CMV may also play a role in accelerated immune aging, a process known as immunosenescence. This phenomenon occurs when the immune system gradually loses its effectiveness with age. Persistent CMV infection appears to alter the balance of immune cells, reducing the body’s ability to respond efficiently to new infections or vaccines. Over time, this may contribute to increased vulnerability to other infectious diseases, cardiovascular conditions, and inflammatory disorders, particularly in elderly populations.
CMV and Other Infections
CMV infection frequently interacts with other pathogens, complicating the course and severity of disease. Its reactivation in individuals with weakened immune systems can make them more susceptible to secondary infections and worsen existing conditions.
In transplant recipients, CMV reactivation is one of the most serious post-transplant complications. The virus can trigger graft rejection, impair healing, and increase the risk of bacterial and fungal infections. It also significantly contributes to morbidity and mortality in this patient group. For this reason, transplant programs often include routine CMV screening, antiviral prophylaxis, and preemptive therapy to prevent and control viral reactivation.
In people living with HIV/AIDS, CMV often reactivates when immune function declines, particularly when CD4+ T-cell counts fall below 50 cells/µL. CMV infection in this context may cause retinitis, leading to irreversible blindness if untreated, or disseminated infection affecting multiple organs. The presence of CMV also accelerates HIV disease progression by further weakening immune defenses and increasing systemic inflammation.
Furthermore, CMV co-infection can worsen outcomes in patients with sepsis, COVID-19, and other severe infections by amplifying inflammatory responses and disrupting immune regulation. Managing these complex interactions requires careful clinical monitoring and the use of combination antiviral therapies such as ganciclovir, valganciclovir, foscarnet, or cidofovir in high-risk patients.
Treatment and Management
Effective management of cytomegalovirus (CMV) infection involves targeted antiviral drugs, careful supportive care, and consistent monitoring to prevent complications. The approach varies based on patient risk factors and severity of infection.
Antiviral Therapies
Antiviral drugs remain the cornerstone of CMV management, primarily targeting viral DNA replication. The most widely used medications include ganciclovir, valganciclovir, foscarnet, and cidofovir.
Ganciclovir, a guanine analog, is often the first-line drug for severe or systemic CMV infections. It is administered intravenously, especially in hospitalized or high-risk patients such as bone marrow and solid-organ transplant recipients. Valganciclovir, an oral prodrug of ganciclovir, provides improved bioavailability and is preferred for long-term maintenance or outpatient therapy.
Foscarnet and cidofovir are typically used when the virus develops resistance to ganciclovir or when patients experience ganciclovir-induced bone marrow suppression. However, both alternatives carry risks of nephrotoxicity and electrolyte imbalance, necessitating close renal monitoring during therapy.
The duration of antiviral therapy is guided by viral load measurements and clinical improvement, often ranging from 3 to 6 weeks. In cases of persistent or recurrent infection, prolonged or maintenance therapy may be indicated to prevent relapse.
Emerging antiviral agents, such as letermovir, are being explored for CMV prophylaxis in transplant patients. Letermovir acts by inhibiting the viral terminase complex, offering an alternative mechanism of action and reduced toxicity compared to older antivirals.
Supportive Care
Supportive care addresses symptoms and complications rather than the virus itself.
- Fever, malaise, and pain are treated with antipyretics and analgesics. Adequate hydration and nutritional support are essential for maintaining recovery, particularly in cases involving gastrointestinal symptoms.
- In CMV retinitis—a major cause of blindness in patients with advanced AIDS—intravitreal injections of ganciclovir or foscarnet can deliver high local concentrations of the drug directly to the retina. These are often combined with systemic antivirals to prevent contralateral eye involvement or systemic relapse.
- CMV hepatitis, pneumonitis, colitis, or encephalitis require multidisciplinary management involving hepatologists, pulmonologists, gastroenterologists, and neurologists. For instance, CMV pneumonitis may require supplemental oxygen, while colitis may necessitate nutritional therapy and bowel rest.
In transplant patients, supportive care also includes modifying immunosuppressive regimens to enhance viral clearance while preventing graft rejection—a delicate balance requiring specialist oversight.
Monitoring and Follow-Up
Regular monitoring of viral load guides treatment adjustment and effectiveness. Blood PCR tests are standard for assessing CMV DNA levels.
The quantitative polymerase chain reaction (qPCR) test is the standard tool for tracking CMV viral load in blood and tissues. Regular testing helps clinicians assess antiviral efficacy and detect early signs of relapse or drug resistance. Viral load monitoring is particularly vital during and after antiviral therapy to confirm viral suppression and determine the appropriate duration of treatment.
In transplant recipients, routine screening (often weekly or biweekly) is conducted for the first several months post-transplant, as this is when reactivation risk is highest. Monitoring is also essential during periods of heightened immunosuppression, such as after rejection episodes.
Prevention Strategies for CMV
Preventing CMV infection involves specific actions focused on hygiene, awareness, and advancements in vaccine development. Effective measures reduce transmission risk, especially in high-risk groups such as pregnant women and immunocompromised individuals.
Personal Hygiene Measures
Good hygiene remains the most practical and effective way to reduce CMV transmission in daily life. CMV spreads primarily through direct contact with infectious bodily fluids such as saliva, urine, semen, vaginal secretions, and breast milk. Therefore, meticulous hygiene practices are essential to limit exposure and protect susceptible individuals.
1. Hand Hygiene:
Frequent handwashing with soap and water for at least 20 seconds is the single most effective preventive measure. This is especially important after changing diapers, wiping a child’s nose or mouth, handling children’s toys, or coming into contact with any potentially contaminated surface. Alcohol-based hand sanitizers can be used when soap and water are unavailable, though washing remains superior for removing organic material.
2. Avoiding Shared Items:
CMV can persist on objects contaminated with bodily fluids. Avoiding sharing utensils, drinking glasses, food, straws, or toothbrushes significantly reduces the likelihood of transmission. Parents and caregivers should refrain from kissing young children on the mouth or cheek near saliva and instead opt for the top of the head or forehead.
3. Safe Caregiving Practices:
Healthcare workers, daycare staff, and caregivers should wear disposable gloves when handling diapers, tissues, or bodily fluids. Proper disposal of contaminated materials and regular disinfection of commonly touched surfaces such as countertops, toys, and bathroom fixtures are crucial in communal settings.
4. Environmental Disinfection:
In childcare environments, where CMV transmission is most common, routine cleaning of toys, pacifiers, and high-touch surfaces using approved disinfectants can markedly reduce infection rates. Because CMV can remain infectious on surfaces for several hours, consistent cleaning practices are vital in both domestic and institutional settings.
5. Special Considerations for Pregnant Women:
Pregnant women, particularly those working with children under five years of age, are at higher risk for CMV exposure. Educating expectant mothers about transmission routes and emphasizing hygiene precautions is essential for preventing congenital CMV infection, which can have lifelong effects on the fetus. Simple behavioral adjustments like avoiding contact with children’s saliva or urine can dramatically lower the risk of maternal infection during pregnancy.
Investigational Vaccines
Developing a CMV vaccine remains one of the most promising long-term strategies for preventing infection and congenital transmission. Despite decades of research, no vaccine has yet achieved regulatory approval, but several promising candidates are in advanced stages of clinical trials.
1. Subunit Vaccines:
These vaccines typically use glycoprotein B (gB)—a key surface protein involved in viral entry—as the primary antigen. The gB/MF59 vaccine has shown efficacy in eliciting strong antibody responses and partial protection against CMV infection in seronegative women.
2. Viral Vector Vaccines:
Viral vector-based vaccines employ harmless carrier viruses (like adenoviruses or modified vaccinia Ankara) engineered to express CMV proteins. These stimulate both humoral and cellular immune responses, which are critical for controlling CMV infection.
3. mRNA Vaccines:
Following the success of mRNA technology in COVID-19 vaccines, mRNA-based CMV vaccines are now in advanced development. These vaccines encode multiple CMV antigens—such as gB and the pentameric complex (gH/gL/UL128-131)—to trigger broad immunity. Early trials of mRNA-1647 (developed by Moderna) have shown robust neutralizing antibody responses and are currently undergoing phase 3 evaluation for preventing primary CMV infection in women of childbearing age.
4. DNA and Live-Attenuated Vaccines:
Other experimental approaches include DNA vaccines and live-attenuated vaccines derived from weakened CMV strains. While these have demonstrated immunogenicity, challenges related to durability of protection and safety in immunocompromised individuals remain under investigation.
CMV Infection in Special Populations
Certain groups face higher risks from CMV due to weakened immune systems or developmental vulnerability. The infection can lead to severe complications, requiring tailored diagnostics, monitoring, and treatment strategies.
Immunocompromised Patients
In immunocompromised individuals—such as those with HIV/AIDS or undergoing chemotherapy—CMV infection can cause life-threatening conditions like pneumonitis, retinitis, and gastrointestinal disease. The virus may reactivate from latency due to impaired immune control.
Early detection through PCR testing of blood or bodily fluids is critical. Antiviral therapy, primarily ganciclovir or valganciclovir, is the treatment cornerstone. Immune reconstitution improves prognosis but managing drug toxicity is essential.
Regular monitoring of viral load guides treatment duration and adjustment. Prophylactic or preemptive antiviral use reduces disease incidence in high-risk patients.
Transplant Recipients
CMV poses a significant threat to solid organ and hematopoietic stem cell transplant recipients. Infection can lead to graft rejection, delayed engraftment, or systemic illness.
Risk factors include donor and recipient CMV serostatus mismatch and the intensity of immunosuppression. Prophylaxis with antivirals often begins post-transplant for 3–6 months, depending on risk.
Preemptive monitoring using quantitative PCR detects early viral replication. Prompt initiation of antivirals upon detection reduces morbidity. CMV disease manifestations vary but commonly impact the lungs, liver, and gastrointestinal tract.
Neonates and Infants
CMV is the leading cause of congenital viral infection, transmitted transplacentally or perinatally. Congenital infection may result in sensorineural hearing loss, neurodevelopmental delay, or intracranial abnormalities.
Diagnosis involves PCR testing of urine or saliva within the first three weeks of life. Symptomatic neonates require antiviral treatment with intravenous ganciclovir or oral valganciclovir to minimize long-term sequelae.
Screening programs for at-risk pregnancies and newborns can aid early identification. Postnatal infection is usually mild but can be severe in premature or immunocompromised infants.
Prognosis and Long-Term Outcomes
The prognosis of Cytomegalovirus (CMV) infection varies significantly depending on the patient’s immune status. In healthy individuals, CMV infection is often asymptomatic or results in mild illness, with full recovery expected.
For immunocompromised patients, such as transplant recipients or those with HIV/AIDS, CMV can cause severe disease with higher risks of complications. Persistent infection may result in organ dysfunction and increased mortality.
Congenital CMV infection presents a different challenge. Infants symptomatic at birth are at risk for long-term disabilities, including sensorineural hearing loss, vision impairment, and neurodevelopmental delays.
| Patient Group | Prognosis | Common Long-Term Outcomes |
| Immunocompetent Adults | Good recovery | Usually no lasting effects |
| Immunocompromised | Variable, often guarded | Organ damage, increased infection risk |
| Congenital CMV | Variable, depends on symptoms at birth | Hearing loss, developmental disabilities |
Late sequelae may develop months or years after initial infection, especially in congenital and immunosuppressed cases. Regular monitoring is recommended for early detection of complications.
Antiviral treatment can improve outcomes but may not fully prevent long-term effects in severe cases.