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child adoption dilema

Respected Sir or Madam,

Greetings from New Delhi, India.

We are planning to adopt a child. However, few of the blood tests (from TORCH Panel) conducted on the prospective child (now at the age of 4 completed months) are a concern.

Cytomegalovirus, CMV Antibody, IgM – Negative (0.03)
Cytomegalovirus, CMV Antibody, IgG – Positive (16 UA/ml)
Herpes Simplex 1&2 IgM – Negative (0.17)
Herpes Simplex 1&2 IgG – Positive (1.14)

All other blood tests conducted now at four months of age are normal.

We have details of the abandoned child from day 3 of his birth. Since then to till now, we have not observed any of the usual clinical features / symptoms of CMV and HSV 1 &2. The child is physically healthy, alert & active, normal feed. Child never had fever, jaundice, or any symptoms of pneumonia. Child once had seasonal cold and cough. Never had seizures or observed any cold-sores.

Selected parameters on Day 3 of the birth:
• General condition, vitals: stable;
• Chest X-ray – Normal;
• CNS – AF/AL – Normal. USA and NNR - Positive
• Weight: 2.08 kilograms; (Current weight 5.5 kilograms – after four completed months of age)
• Head circumference: 31 cms (39 cms now after four completed months of age)

We sincerely request medical experts to advice if any further tests are required and what could be long term complications which child could face with the current diagnosis?.

Thank you
Sincerely
Agrim
***@****
2 Responses
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1096512 tn?1384889778
Since HCMV is one of TORCH infections,the serology test may imply the following:

The enzyme-linked immunosorbent assay (or ELISA) is the most commonly available serologic test for measuring antibody to CMV. The result can be used to determine if acute infection, prior infection, or passively acquired maternal antibody in an infant is present. Other tests include various fluorescence assays, indirect hemagglutination, (PCR) and latex agglutination.nfectious CMV may be shed in the bodily fluids of any infected person, and can be found in urine, saliva, blood, tears, semen, and breast milk. The shedding of virus can occur intermittently, without any detectable signs or symptoms.

An ELISA technique for CMV-specific IgM is available, but may give false-positive results unless steps are taken to remove rheumatoid factor or most of the IgG antibody before the serum sample is tested. Because CMV-specific IgM may be produced in low levels in reactivated CMV infection, its presence is not always indicative of primary infection. Only virus recovered from a target organ, such as the lung, provides unequivocal evidence that the current illness is caused by acquired CMV infection. If serologic tests detect a positive or high titer of IgG, this result should not automatically be interpreted to mean that active CMV infection is present. However, if antibody tests of paired serum samples show a fourfold rise in IgG antibody and a significant level of IgM antibody, meaning equal to at least 30% of the IgG value, or virus is cultured from a urine or throat specimen, the findings indicate that an active CMV infection is present.

Long term complications include hepatitis like condition, immunocompromise,athereosclerosis like state,drug resistance or associated TORCH symptoms if one of the agent is positive in test results.
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Avatar universal
These are viruses present in 60% or more of children. The vast proportion of the population experience no ill effects at all with these viruses. Only those with serious immune issues will potentially experience ailments. Odds are you and your partner have either or both these viruses.

I wouldn't feel these results play a role in your decision. As indicated these test results would be very common in children available for adoption.

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