Document 0739
 DOCN  M9460739
 TI    Triple retinal infection with human immunodeficiency virus type 1,
       cytomegalovirus, and herpes simplex virus type 1. Light and electron
       microscopy, immunohistochemistry, and in situ hybridization.
 DT    9404
 AU    Rummelt V; Rummelt C; Jahn G; Wenkel H; Sinzger C; Mayer UM; Naumann GO;
       Department of Ophthalmology, University of Erlangen-Nurnberg,; Germany.
 SO    Ophthalmology. 1994 Feb;101(2):270-9. Unique Identifier : AIDSLINE
       MED/94159338
 AB    PURPOSE: This report describes the histopathologic and virologic
       findings of the retina from a 55-year-old bisexual patient with the
       acquired immune deficiency syndrome (AIDS), who had concurrent human
       immunodeficiency virus type 1 (HIV-1), cytomegalovirus (CMV), and herpes
       simplex virus type 1 (HSV-1) retinitis, and was treated with
       ganciclovir. METHODS: The eyes were obtained at autopsy and processed
       for light microscopy and transmission electron microscopy.
       Immunohistochemical stains for HSV-1, CMV, HIV-1, varicella zoster
       virus, and glial fibrillary acidic protein were carried out using the
       peroxidase-antiperoxidase and streptavidin-biotin-alkaline phosphatase
       techniques. For in situ hybridization, a radiolabeled CMV DNA probe
       (Eco-RI-Y fragment of strain AD 169) was used. RESULTS: Results of
       histopathologic examination showed a full-thickness necrotizing
       retinitis with cytomegalic and herpes viral intranuclear inclusions in
       cells of the neurosensory retina, retinal vascular endothelium, and the
       retinal pigment epithelium. Some areas of the retina were replaced by
       glial tissue. The choroid contained only a few chronic inflammatory
       cells. Immunoperoxidase studies disclosed CMV antigens diffusely
       distributed throughout all layers of the retina and the retinal pigment
       epithelium. Herpes simplex virus type 1 antigens were present in retinal
       cells and the retinal vascular endothelium. Human immunodeficiency virus
       type 1 antigens were found in mononuclear cells in all layers of the
       sensory retina. Dual infections with HIV-1 and CMV of individual
       multinucleated giant cells of glial origin were demonstrated
       immunohistochemically. Transmission electron microscopy showed herpes
       viral particles in the vascular endothelium of the retinal vessels and
       the choriocapillaris. Human immunodeficiency virus particles were
       identified in the endothelium of the choriocapillaris. CONCLUSIONS: The
       possibility of multiple viral infections of the retina, mimicking
       classic CMV retinitis, should be considered in the clinical and
       histologic differential diagnosis of necrotizing retinitis in patients
       with AIDS.
 DE    Antibodies, Viral/ANALYSIS  Case Report
       *Cytomegalovirus/GENETICS/IMMUNOLOGY/ULTRASTRUCTURE  Cytomegalovirus
       Retinitis/*COMPLICATIONS/IMMUNOLOGY/PATHOLOGY  DNA, Viral/ANALYSIS  Eye
       Infections, Viral/*COMPLICATIONS/PATHOLOGY  Herpes
       Simplex/*COMPLICATIONS/IMMUNOLOGY/PATHOLOGY  *Herpesvirus 1,
       Human/GENETICS/IMMUNOLOGY/ULTRASTRUCTURE  Human  HIV Antigens/ANALYSIS
       HIV Infections/*COMPLICATIONS/IMMUNOLOGY/PATHOLOGY
       *HIV-1/GENETICS/IMMUNOLOGY/ULTRASTRUCTURE  Immunoenzyme Techniques  In
       Situ Hybridization  Male  Middle Age  Retina/MICROBIOLOGY/ULTRASTRUCTURE
       Retinal Diseases/*MICROBIOLOGY/PATHOLOGY  Support, Non-U.S. Gov't
       JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).