HIV-1 and HHV-6 antigens and transcripts in retinas of patients with AIDS in the absence of human cytomegalovirus.

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Abstract

PURPOSE: The purpose of this study was to define the agents involved in the development of acquired immune deficiency syndrome (AIDS)-associated retinitis. To achieve this goal, the authors determined the frequency and proximity of the simultaneous presence of human immunodeficiency virus (HIV)-1, human herpesvirus (HHV)-6, and human cytomegalovirus (HCMV) in retinas of patients with AIDS with and without AIDS-associated retinitis. METHODS: Retinal sections from 50 globes from patients with AIDS were analyzed for the presence of viral antigens and transcripts. Group 1 contained 13 globes from patients with HCMV infection. Group 2 contained 20 globes from patients with retinal lesions of uncertain etiology in which HCMV antigen and transcripts were not detected. Group 3 contained 17 globes from patients with no retinal lesions. RESULTS: Retinal sections from all 13 globes (group 1) were positive for HCMV antigens and HIV-1 antigens and transcripts. Six of the 13 retinas were also positive for HHV-6 antigens and transcripts. Sections from 13 of the 20 globes (group 2) were positive for HIV-1 antigens and transcripts, and 5 of these 13 were also positive for HHV-6 antigens and transcripts. Multiple areas in sections from two of the HIV-1-positive retinas showed coinfection with HHV-6. All 17 globes (group 3) were positive for HIV-1 antigens and transcripts. Ten of these 17 retinas were also positive for HHV-6 antigens. Human cytomegalovirus antigens were not detectable in retinas from groups 2 and 3. No viral antigens or transcripts were detectable in retinal sections from 10 HIV-1 negative donors. CONCLUSION: The coexistence of HIV-1 and HHV-6 activity in more than 50% of retinas without HCMV infection suggests that HIV-1 and HHV-6 alone or in combination may predispose retinal tissue to other opportunistic agents such as HCMV during the development of AIDS-associated retinitis.