Bélec L, Gray F, Mikol J, Scaravilli F, Mhiri C, Sobel A, Poirier J
Département de Pathologie (Neuropathologie), Hôpital Henri Mondor, Créteil, France.
Acta Neuropathol. 1990;81(1):99-104. doi: 10.1007/BF00662645.
A 25-year-old homosexual male with AIDS presented with a cauda equina syndrome clinically suggestive of cytomegalovirus (CMV) myeloradiculitis. He was treated with ganciclovir with transient improvement of neurological signs and died 4 months after onset of neurological signs. Neuropathological examination revealed human immunodeficiency virus (HIV) encephalitis, CMV subependymal encephalitis and CMV myeloradiculitis. The latter was characterised by myelin loss, Schwann cell proliferation and presence of CMV early antigens in the nuclei of S-100 protein-positive cells in the spinal roots. In the subependymal regions, morphologically characteristic multinucleated giant cells, positive for CD68, contained early CMV antigens (E13) in their nuclei and HIV antigens (gp41 and p24) in their cytoplasm. The observation that HIV and CMV can co-infect the same cell in vivo raises the possibility of a direct synergistic interaction of both viruses at cell level. This suggests that CMV may play a role as a co-factor in the pathogenesis of HIV encephalopathy.
一名25岁患艾滋病的同性恋男性，临床出现马尾综合征，提示巨细胞病毒（CMV）脊髓神经根炎。他接受了更昔洛韦治疗，神经体征有短暂改善，在神经体征出现4个月后死亡。神经病理学检查发现人类免疫缺陷病毒（HIV）脑炎、CMV室管膜下脑炎和CMV脊髓神经根炎。后者的特征是髓鞘脱失、施万细胞增殖，且在脊髓神经根中S-100蛋白阳性细胞的细胞核中有CMV早期抗原。在室管膜下区域，形态学上具有特征性的多核巨细胞，CD68呈阳性，其细胞核中含有CMV早期抗原（E13），细胞质中含有HIV抗原（gp41和p24）。HIV和CMV可在体内共同感染同一细胞这一观察结果增加了两种病毒在细胞水平直接协同相互作用的可能性。这表明CMV可能在HIV脑病的发病机制中作为一种辅助因子发挥作用。
