HIV-1 AND HHV-6 ANTIGENS AND TRANSCRIPTS IN RETINAS OF PATIENTS WITH AIDS IN THE ABSENCE OF HUMAN CYTOMEGALOVIRUS

Purpose. The purpose of this study was to define the agents involved i n the development of acquired immune deficiency syndrome (AIDS)-associ ated retinitis, To achieve this goal, the authors determined the frequ ency and proximity of the simultaneous presence of human immunodeficie ncy virus (HIV)-1, human herpesvirus (HHV)-6, and human cytomegaloviru s (HCMV) in retinas of patients with AIDS with and without AIDS-associ ated retinitis. Methods. Retinal sections from 50 globes from patients with AIDS were analyzed for the presence of viral antigens and transc ripts. Group 1 contained 13 globes from patients with HCMV infection. Group 2 contained 20 globes from patients with retinal lesions of unce rtain etiology in which HCMV antigen and transcripts were not detected . Group 3 contained 17 globes from patients with no retinal lesions. R esults. Retinal sections from all 13 globes (group 1) were positive fo r HCMV antigens and HIV-1 antigens and transcripts. Six of the 13 reti nas were also positive for HHV-6 antigens and transcripts. Sections fr om 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 a nd transcripts. Multiple areas in sections from two of the HIV-1-posit ive retinas showed coinfection with HHV-6. All 17 globes (group 3) wer e 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 nega tive donors. Conclusion. The coexistence of HIV-1 and HHV-6 activity i n more than 50% of retinas without HCMV infection suggests that HIV-1 and HHV-6 alone or in combination may predispose retinal tissue to oth er opportunistic agents such as HCMV during the development of AIDS as sociated retinitis.