Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.
CYTOMEGALOVIRUS INFECTION IN HEALTHY AND IMMUNE DEFICIENT HOMOSEXUAL MEN
Aids and Infections of Homosexual Men. Second Edition. Ma P and Armstrong D, eds. Boston, Butterworths, p. 119-30 1989.. Unique Identifier : AIDSLINE ICDB/90659643 Drew WL; Mintz L; Univ. of California, San Francisco, CA
Abstract:
In the past several years, increasing attention has focused on cytomegalovirus (CMV) infections in homosexual men and the role these infections might play in the pathogenesis of AIDS and Kaposi's sarcoma (KS). Data from a questionnaire study suggest that exposure of the anorectal mucosa to CMV-infected semen constitutes the major route of acquisition of CMV infection by homosexual men. The contribution of CMV to AIDS, KS, and Pneumocystis carinii pneumonia in homosexual men is reviewed. Data obtained by the authors suggest that CMV infection may be an important cofactor in the genesis of AIDS and may enhance susceptibility to infection by HIV. Furthermore, CMV infection may help convert HIV infection from a latent state to active viral replication. In another study, CMV was recovered from lung tissue in 88% of homosexual men with P carinii pneumonia, suggesting an association between the two agents. Histologic studies suggest that the macrophage is an important component of the host response to P carinii; it may be that CMV infection of alveolar macrophages impairs their ability to interact with P carinii. Various lines of evidence support a possible cofactor role for CMV in KS: (1) CMV stimulates synthesis of cellular DNA, RNA, and enzymes in host cells and transforms human embryo fibroblasts; (2) CMV-antibody prevalence was higher in 46 elderly European and American patients with KS than in age-matched control groups; (3) the CMV genome and antigens have been demonstrated in KS tissue; and (4) epidemiologic evidence shows extremely high rates of CMV infection in homosexual men with AIDS and a markedly higher prevalence of KS among homosexual compared to heterosexual patients with AIDS. A correlation has been noted between declining levels of KS as a presenting symptom in homosexuals with AIDS and a decline in CMV infections in homosexual men. Although this may be a coincidence, it also suggests that CMV may play a cofactor role in KS. (43 Refs)
Keywords: Acquired Immunodeficiency Syndrome/COMPLICATIONS/*TRANSMISSION Cytomegalovirus Infections/COMPLICATIONS/*TRANSMISSION Follow-Up Studies *Homosexuality Human Male Opportunistic Infections/COMPLICATIONS/*TRANSMISSION Pneumonia, Pneumocystis carinii/COMPLICATIONS Risk Factors Sarcoma, Kaposi's/COMPLICATIONS Sexually Transmitted Diseases, Viral/TRANSMISSION Skin Neoplasms/COMPLICATIONS MONOGRAPH REVIEW
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Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.
