Identification of human immunodeficiency virus in the heart of a patient with acquired immunodeficiency syndrome.

A 35-year-old homosexual white male diagnosed as having human immunodeficiency virus (HIV) infection presented with recurrent pericardial effusion, and HIV was isolated from the pericardial fluid. Autopsy revealed an extensive gross infiltrative lesion in the left ventricle of the heart. Microscopic examination of the myocardium demonstrated multifocal atypical lymphoid cell infiltrations associated with scattered foci of myocardial necrosis. The atypical lymphoid cells were immunoreactive to UCHL-1, a T cell antigen antibody. HIV was immunocytochemically identified in the cardiac lymphocytic infiltrate with anti-p24 monoclonal antibodies. This finding was supported by ultrastructural examination and in situ hybridization study.