Cytomegalovirus (CMV)

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Cytomegalovirus (CMV)

Intro & History
Cytomegalovirus (CMV), a member of the herpesviridae family, is a prevalent viral pathogen called human herpes virus 5 (HHV5)[5]. It can infect many organs and is commonly asymptomatic[1]. Once infected with CMV, patients will carry the infection for life, as the virus could remain latent in white blood cells of our body with and without the demonstration of symptoms[1]. The virus can be reactivated during other illness or stress, this may occur with or without symptoms[1]. CMV carriers shed the virus through body secretions, such as breast milk, saliva, semen etc[1]. So CMV can be contracted from close contact with people secreting the virus.

CMV came into medical attention in 1910 when owl eyes inclusions
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The virion is 180nm in diameter, with its double stranded DNA, icosahedral nuclear capsid, tegument and a lipid bilayer envelope[2]. CMV invade cells by fusing its glycoprotein from the envelop with the cell membrane, and releasing its tegument and DNA into the cell[2]. When CMV infect cells, a formation of distinctive inclusion called “owl’s eyes” can be observed through microscopy[1].

Glycoprotein B (gB) of the virion envelope is responsible for fusion of infected cells and host-cell entry and cell-to-cell transmission[3]. Upon infection, viral lytic gene expression induces replication of the DNA and form viral particles[3]. The gene can also be silenced in some cell types, which results in latent infections[3].
Pp65, a tegument protein allows the virion to evade the immune system by blocking the viral proteins from MHC I molecules[7]. Pp65 can also bind to NKp30 receptor to inhibit NK cell destroying the infected cells[7].

Viraemia enables the spreading to any organs in the body[1]. CMV infections are commonly asymptomatic, but can presented as mononucleosis syndrome, fever, malaise, antibiotic rash etc[5]. CMV infection increases mortality, as it affects the cell-mediated immunity, cytokines and NK cells[1]. Infection could cause rejection in transplant patients and life-threatening in immunocompromised

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