The Conditions of Primary Infection Define the Load of Latent Viral Genome in Organs and the Risk of Recurrent Cytomegalovirus Disease

Episode von Medizin - Open Access LMU - Teil 11/22 von Ludwig-Maximilians-Universität München · 1. Januar 1994

Recurrence of cytomegalovirus (CMV) from latency is a frequent cause of disease in immunocompromised

patients. To date, there is no explanation for the diversity in the clinical manifestations.

Primary infection can occur perinatally or later in life, and inevitably results in latent infection.

Seropositivity for antibodies against CMV is indicative of latent infection, but is insufficient

as a predictor for the risk of recurrence. As a model for this important medical problem, we

compared the risks of murine CMV recurrence from latency established after neonatal primary

infection and after infection at adult age. The risk of CMV recurrence was high only after neonatal

infection. The copy number of latent viral genome in tissues was identified as the key parameter

that determines the overall and organ-specific risks of recurrence. Latent CMV burden and risk

of recurrence were related to the extent of virus multiplication during primary infection. The

presence of latent CMV in multiple organs provides the molecular basis for stochastic events

of recurrence in single organs or in any combination thereof. These findings are discussed as

a concept of multifocal CMV latency and recurrence. It provides a rationale for the diversity

in the clinical outcome of CMV disease.

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