Cytomegalovirus (CMV) Antibodies, IgM & IgG

Test Code
CVGM


Alias/See Also
Epic: LAB3755


Preferred Specimen

Specimen Type: Serum
Collection Container
Serum gel
Specimen Volume: 3 mL





Minimum Volume

0.5 mL




Instructions
Centrifuge and separate cells after clot formation and within 4 hours of collection.


Transport Container
Plastic vial


Specimen Stability

Room temperature: Unacceptable
Refrigerated: 48 hours
Frozen: >2 days




Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)

Unlabeled, mislabeled, wrong tube type, QNS, hemolysis index >1000, gross lipemia ( Trig >3000mg/dL), gross icterus (bilirubin >20 mg/dL)samples and any sample from which the lipid layer has not been removed.




Methodology

Chemiluminescent Immunoassay (CLIA)



Setup Schedule

Daily




Report Available

1 day




Reference Range
Cytomgalovirus IgM: Negative
Cytomgalovirus IgG: Negative


Clinical Significance
Human cytomegalovirus (hCMV) is a herpes virus. It is ubiquitous, species-specific, and spread by close human contact .
Primary infection may be acquired through different transmission routes and in different periods of life (e.g., congenital, perinatal and post-natal infections). Following primary infection, hCMV enters a latency phase during which the virus can be found in B lymphocytes. Subsequent reactivation of viral replication (secondary infection) may take place concomitantly with changes in the relationship between host and virus. Reinfection with exogenous virus can occur in subjects with deficiency of cellular immunity even when antibodies to hCMV are already present .
hCMV infection may be transmitted transplacentally (congenital) or at birth (perinatal). If seronegative women contract primary hCMV infection during pregnancy, the infection is transmitted to the fetus in about 40% of the cases and sequelae may be spontaneous abortion, stillbirth or neonatal malformation. The clinical picture of congenital hCMV infection may be mild to severe and includes psychomotor retardation, deafness, retinochoroiditis, microcephaly, hydrocephalus, cardiac disease, hepatitis, hepatosplenomegaly, or thrombocytopoenia .
Most individuals (40-90%) acquire primary hCMV infection during childhood or adulthood. Post-natal infections are transmitted through close contact with infected biological fluids (urine, saliva, breast milk, semen, cervical secretions, feces), infected blood products, and, occasionally, organ transplants. In immunocompetent individuals, the clinical picture of post-natal hCMV infection is usually mild or asymptomatic. The most common signs include fever, malaise, and increased serum transaminase levels without jaundice .
By contrast in immunocompromised patients (organ transplant recipients, patients with AIDS, lymphoproliferative diseases, or cancer), symptoms may be severe because of disseminated and/or visceral infection, and may include splenomegaly, pneumonia, hemolytic anemia, myocarditis and encephalitis. In these patients the disease may be fatal .
The immune response to hCMV involves synthesis of IgM antibodies some weeks after infection by hCMV, and later, IgG antibodies. Levels of IgM to hCMV usually increase for some weeks and decrease slowly thereafter, in four to six months. Occasionally, IgM may circulate for years. IgG antibodies rise gradually and persist for the rest of the host life.
A specific IgM assay is useful in diagnosing acute hCMV infection. However, it is not always possible to distinguish between primary and secondary infection, because reactivation may induce synthesis of IgM in immunocompromised patients.



Performing Laboratory

Inova Laboratories

2832 Juniper Street

Fairfax, VA 22031



Additional Information
IL CMV IgG Diasorin Liaison Job Aid
IL CMV IgM Diasorin Liaison Job Aid

Last Updated: March 27, 2023
Last Review: N. Wolford, March 27, 2023


The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.