Cytomegalovirus (called CMV for short), is a virus in the herpesvirus family. In severe cases, it can cause organ damage and failure. This is especially true for those who are immunocompromised, for example people who’ve had organ transplants or who are living with HIV.
When the CMV virus leads to liver problems, it’s called CMV hepatitis. If left untreated, CMV hepatitis can cause liver inflammation, failure, and death.
CMV hepatitis is rare in people with healthy immune systems. If you’re immunocompromised, talk with a doctor about your risk of CMV hepatitis and how to best monitor for any signs or symptoms.
In this article, we take a closer look at CMV hepatitis, including its symptoms, diagnosis, and treatment.
CMV is a common virus in the herpesvirus family. Other viruses in this family include Epstein-Barr and chickenpox (varicella).
Most healthy people that become infected with CMV typically have no long-term health effects. They may have no symptoms or only mild symptoms such as:
- sore throat
- swollen glands
Like other viruses in the herpesvirus family, CMV goes latent after initial infection in most people. Going latent means that the virus stays in your cells but causes no damage or sign of illness.
It’s worth noting that those with latent disease may occasionally shed the virus in saliva or urine. In healthy individuals, this shedding usually doesn’t cause symptoms. However, shedding may cause symptoms in people who are immunocompromised. These symptoms are treated as a reactivation of the disease.
Dangers of CMV for those with weakened immune systems
For people with weakened immune systems, the CMV virus is opportunistic, meaning it can spread to and cause damage in different areas of the body.
In addition to CMV hepatitis, which affects the liver, other types of CMV diseases in people who are immunocompromised include:
- CMV retinitis: where the virus infects and damages the retina
- CMV colitis: where the virus
infects and damages the lining of the large intestine (colon) and rectum
- CMV pneumonitis: where the virus infects and damages the lungs
How CMV is transmitted
CMV is transmitted through contact with infected bodily fluids. This can include:
- breast milk
CMV often spreads within families and at daycare centers. Infants and children who are healthy typically show no, or few, symptoms after being infected.
Hepatitis means inflammation of the liver. The liver helps the body process nutrients, filter the blood, and fight infections. Any damage or inflammation can impact its functioning.
Although different things can cause hepatitis, the most common cause is a virus, such as CMV. Symptoms of CMV hepatitis in adults and children include:
- pain in the right upper quadrant of the abdomen
People of all ages can be infected with CMV. According to the
For most people, it’s nothing to worry about because a healthy person’s immune system typically prevents the virus from causing illness. However, there are some populations who are at higher risk for serious complications from CMV,
- infants infected in utero
- very low birth weight and premature babies
- people who are immunocompromised, such as those who’ve received organ or bone marrow transplants, or people living with HIV
- people who are on immunocompromising medications like steroids
Doctors typically use lab tests of blood and other bodily fluids to diagnose CMV hepatitis.
CMV hepatitis is
Abnormal liver function or symptoms consistent with CMV hepatitis can prompt healthcare professionals to obtain further tests, including:
The above tests are used to help differentiate between an active disease, a latent disease, and a past exposure.
CMV DNA PCR is usually the most sensitive and specific test available to detect active disease, while antibodies can indicate previous exposure.
A viral culture can take time to get a result (1 to 3 weeks) and you can get false negatives if the sample is obtained too early.
While most healthy people don’t need any treatment for CMV infection, some people do, especially if they’re immunocompromised.
For CMV hepatitis, the main focus is prevention. This can be done with either
- Prophylaxis treatment. After an organ transplant, antivirals are typically prescribed for at least 3 months.
- Preemptive treatment. People who’ve undergone a transplant or who are immunocompromised are closely monitored for CMV and antiviral treatment is started before symptoms occur.
Antiviral drugs used for CMV hepatitis include:
- intravenous ganciclovir
Cytomegalovirus (CMV) is a common virus in the herpesvirus family. It can lead to liver problems (called CMV hepatitis) for those with weakened immune systems.
In people with healthy immune systems,
If you’re at risk for CMV or CMV hepatitis, talk with a doctor. Discuss your specific risks and what you can do to help reduce the risks of infection.