Pneumocystis carinii pneumonia and mucosal candidiasis in previously healthy homosexual men: evidence of a new acquired cellular immunodeficiency. NLM AIDSLINE Important note: Information in this article was accurate in 1982. The state of the art may have changed since the publication date.

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Pneumocystis carinii pneumonia and mucosal candidiasis in previously healthy homosexual men: evidence of a new acquired cellular immunodeficiency.

N Engl J Med. 1981 Dec 10;305(24):1425-31. Unique Identifier : AIDSLINE MED/82057985
Gottlieb MS; Schroff R; Schanker HM; Weisman JD; Fan PT; Wolf RA; Saxon A

Abstract: Four previously healthy homosexual men contracted Pneumocystis carinii pneumonia, extensive mucosal candidiasis, and multiple viral infections. In three of the patients these infections followed prolonged fevers of unknown origin. In all four cytomegalovirus was recovered from secretions. Kaposi's sarcoma developed in one patient eight months after he presented with esophageal candidiasis. All patients were anergic and lymphopenic; they had no lymphocyte proliferative responses to soluble antigens, and their responses to phytohemagglutinin were markedly reduced. Monoclonal-antibody analysis of peripheral-blood T-cell subpopulations revealed virtual elimination of the Leu-3 / helper/inducer subset, an increased percentage of the Leu-2 + suppressor/cytoxic subset, and an increased percentage of cells bearing the thymocyte-associated antigen T10. The inversion of the T/ helper to suppressor/cytotoxic ratio suggested that cytomegalovirus infection was an important factor in the pathogenesis of the immunodeficient state. A high level of exposure of male homosexuals to cytomegalovirus-infected secretions may account for the occurrence of this immune deficiency.
Keywords: Adult Candidiasis/ETIOLOGY Candidiasis, Oral/*ETIOLOGY/IMMUNOLOGY Case Report Cytomegalovirus/ISOLATION & PURIF Cytomegalovirus Infections/COMPLICATIONS Esophageal Diseases/ETIOLOGY Herpes Simplex/COMPLICATIONS *Homosexuality Human *Immunity, Cellular Immunologic Deficiency Syndromes/*ETIOLOGY Lymphopenia/ETIOLOGY Male Pneumonia, Pneumocystis carinii/*ETIOLOGY/IMMUNOLOGY Rectal Diseases/ETIOLOGY Sarcoma, Kaposi's/ETIOLOGY Simplexvirus/ISOLATION & PURIF Skin Neoplasms/ETIOLOGY Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S. T-Lymphocytes/IMMUNOLOGY JOURNAL ARTICLE

KWDadultcandidiasis/etiologycandidiasis,oral/KWDetiology/immunologycasereportcytomegalovirus/isolation&purifcytomegalovirusinfections/complicationsesophagealdiseases/etiologyherpessimplex/complicationsKWDhomosexualityhumanKWDimmunity,cellularimmunologicdeficiencysyndromes/KWDetiologylymphopenia/etiologymalepneumonia,pneumocystiscarinii/KWDetiology/immunologyrectaldiseases/etiologysarcoma,kaposi's/etiologysimplexvirus/isolation&purifskinneoplasms/etiologysupport,non-uKWDsKWDgov'tsupport,uKWDsKWDgov't,pKWDhKWDsKWDt-lymphocytes/immunologyjournalarticle
820330
M8230005

Copyright © 1982 - National Library of Medicine. Reproduced under license with the National Library of Medicine, Bethesda, MD.

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