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Introduction ⬇

Cytomegalovirus (CMV) is a ubiquitous human viral pathogen that belongs to the herpesvirus family. Infection with CMV usually has no symptoms (up to 60 days) and can persist in the host as a chronic or latent infection. CMV has been linked with STIs. Blood banks routinely screen for CMV antibodies and report these as CMV negative or CMV positive.

This test determines the presence of CMV antibodies and is routinely done in congenitally infected newborns, immunocompromised patients, and sexually active persons who present with mononucleosis-like symptoms. Antibody results must be evaluated in the context of the patient’s current clinical symptoms and viral culture results. Tests to detect CMV antigen are available and aid in early detection. Viral culture confirms CMV infection.

Normal Findings ⬆ ⬇

Procedure ⬆ ⬇

  1. Collect a 7-mL blood serum sample in a red-topped tube. Observe standard precautions.

  2. Label the specimen with the patient’s name, date, and test(s) ordered and place in a biohazard bag for transport to the laboratory.

  3. It is recommended that posttransplantation titers be monitored at weekly intervals, particularly following bone marrow transplantation.

Clinical Implications ⬆ ⬇

  1. Infants who acquire CMV during primary infection of the mother are prone to develop severe cytomegalic inclusion disease (CID). CID may be fatal or may cause neurologic sequelae such as intellectual disability, deafness, microcephaly, or motor dysfunction.

  2. Transfusion of CMV-infected blood products or transplantation of CMV-infected donor organs may produce interstitial pneumonitis in an immunocompromised recipient.

  3. When testing for IgG antibody, seroconversion or a significant rise in titer between acute and convalescent sera may indicate presence of a current or recent infection.

  4. Although the presence of IgM antibodies suggests current or recent infection, low levels of IgM antibodies may occasionally persist for more than 12 months after infection.

Interventions ⬆

Pretest Patient Care

  1. Explain test purpose and procedure.

  2. Follow guidelines in Chapter 1 for safe, effective, informed pretest care.

Posttest Patient Care

  1. Review test results; report and record findings. Modify the nursing care plan as needed. Counsel the patient regarding abnormal findings; explain the need for possible follow-up testing and treatment. See Interpreting Results of Immunologic Tests.

  2. Follow guidelines in Chapter 1 for safe, effective, informed posttest care.