Ocular, cerebral and systemic interrelationships of cytomegalovirus infection in a post-mortem study of AIDS patients

Purpose Eighty-six post-mortems of AIDS patients were reviewed microscopica lly and the presence of cytomegalovirus (CMV) infection in the viscera, bra in and eye was recorded. Methods Immunohistochemical stains and in situ hybridisation with a CMV pro be were performed. Results ann conclusion CMV infection was observed in 63% of the cases. Visc eral, cerebral and ocular involvement were overall 49%, 33% and 29%, respec tively. The visceral form with no concomitant ocular and/or cerebral infect ion was the main cause of death (31%) in the 54 CMV-infected patients. Alth ough CMV retinitis occurred mostly (20%) as a component of systemic disease , in 13% of the CMV-infected patients the eyes only were involved, while th ere were no cases with CMV limited to the brain. In the absence of systemic involvement, 9% of the cases showed concomitant ocular and cerebral infect ion, but because we failed to observe CMV optic neuritis without ocular inv olvement, retrograde viral spread from the brain through the optic nerve ap pears to be an infrequent mechanism of CMV retinitis.