Citomegalovirus: come si contrae? Come si cura?
Table of Contents
Che cos’è il citomegalovirus?
Ilcitomegalovirusè un virus appartenente alla famiglia degliherpesvirus. L’infezione asintomatica è diffusa nel mondo intero, gli anticorpi specifici possono essere rinvenuti nel 40% della popolazione ed il virus è presente nella saliva, nell’urina, nello sperma, nelle secrezioni vaginali della donna soprattutto durante la gravidanza e nel latte materno. Il citomegalovirus si trasmette per contagio sessuale, in particolare negli omosessuali. L’infezione può essere contratta da trasfusioni di sangue massicce e manifestarsi dopo un periodo di incubazione di 4-8 settimane. Il virus può essere riattivato in caso di immunodepressione.
Quali sono i sintomi del citomegalovirus?
- Forma prenatale: la maggior parte delle infezioni transplacentari sono probabilmente asintomatiche. In un piccolo numero di casi, l’infezione si manifesta con sintomi generali già dalla nascita:epatosplenomegalia con ittero, porpora, petecchie e sintomi neurologici(letargia, convulsioni).
- Forma postnatale: il bambino èinfettato alla nascita dalle secrezioni vaginali della madree l’infezione si manifesta dopo un periodo da 3 a 12 settimane.
- Forma acuta acquisita: l’infezione dell’adulto, è più spesso asintomatica ma può provocare febbre e a volte il quadro dellamononucleosi infettiva.
- Forme polmonari: nei pazienti trattati con immunosoppressori, si possono osservare polmonite opportuniste gravi.
Diagnosi
Il sospetto clinico va corroborato dalla dimostrazione del virus o di suoi componenti piuttosto che degli anticorpi specifici di classe IgG e IgM, di solito con tecnica immunoenzimatica. Il sospetto di infezione primaria può essere confermato dalla presenza di IgM specifiche e in qualche caso dall”aumento da 2 a 4 volte del titolo IgG specifiche in prelievi successivi. Nelle altre forme cliniche da citomegalovirus la sierologia non è di regola utile.
Come si cura il citomegalovirus ?
I farmaci attivi contro il citomegalovirus sono:ganciclovir, valganciclovir, foscarnet e cidofovir.Sono terapie da eseguire sempre sotto controllo specialistico per i frequenti effetti collaterali anche gravi. Nei pazienti immunocompromessi occorre spesso far eseguire ai trattamenti di induzione lunghi periodi di terapia soppressiva a dosaggio ridotto finché persiste lo stato di immunodeficienza.
Leggi anche:
Varicella: sintomi, diagnosi e complicanze
Mononucleosi infettiva: sintomi , diagnosi e complicanze
Fuoco di Sant’ Antonio- Herpes Zoster
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