CMV is the short form for cytomegalovirus. CMV is a virus that can be spread through sexual intercourse, by direct contact with infected blood and secretions or
by sharing used needles. Most people have been exposed to CMV at some time in their lives. The virus is usually harmless unless you have HIV or another disease that weakens your immune system. CMV can infect
different parts of your body, including your eyes, lungs, digestive system and brain. The symptoms are different depending on where the infection is.
Symptoms: What do I look for?
CMV retinitis:
The most common place for CMV infection is in the retina of your eye. This is called CMV retinitis. Symptoms can include blurred vision, decreased vision, or "floaters" (distinct grey patches in front of your eye or eyes). It is not necessarily painful. Because CMV can cause blindness, it is crucial to report visual changes to your doctor so that if these symptoms are caused by CMV, treatment can be started immediately.
Gastrointestinal CMV:
The second most common place to find CMV is in your digestive system. This includes your esophagus (the tube that connects your mouth and stomach), your stomach and your small and large intestine (bowels). Symptoms include painful and/or difficult swallowing, heartburn, stomach pain, and /or bloating, fever, watery diarrhea, weight loss and loss of appetite.
CMV Pneumonitis: CMV can also infect your lungs (this is called CMV pneumonitis). The symptoms can include fever, dry cough and shortness of breath.
CMV of the Brain and Spinal Cord:
CMV infection of the brain and spinal cord is rare, but symptoms can include headaches, confusion, decreased memory and nerve problems such as pain or weakness in the legs.
Can CMV be prevented?
At this time, there is no effective way of preventing CMV infection.
How is CMV treated?
The two drugs which have been approved for the treatment of CMV are ganciclovir (Cytovene) and foscarnet
(Foscavir). These drugs do not kill the virus, but they slow down the spread of CMV to healthy cells. You will need to receive the drug for life. You will be started on a higher daily dose of the drug, given
intravenously for the first 2-3 weeks, after which the dose will be reduced and given less frequently. At this time, oral ganciclovir may sometimes be considered for maintenance therapy. Because CMV may
cause blindness, it is crucial to report visual changes to your doctor so that treatment can be started immediately.
References
Siegel, Jean (Ed.). 1989.
Cytovene--Product monograph. Palo Alto: Syntex Laboratories Inc. The College of Family Physicians of Canada. (1993). A Comprehensive guide for the care of persons with HIV disease. Module 1: Adults-Men, women, adolescents. Ottawa: Health Canada.
Whitehead, Mark and Patterson, Brent. (1993). Managing
you health: A guide for people living with HIV or AIDS. Toronto: Community AIDS Treatment Infomation Exchange & Toronto People with AIDS Foundation.
