Cytomembranous inclusions observed in acquired immunodeficiency syndrome. Clinical and experimental review.

Two types of cytomembranous inclusions commonly occur in patients with acquired immunodeficiency syndrome (AIDS) and AIDS-related conditions: tubuloreticular inclusions (TRI) and cylindrical confronting cisternae (CCC). CLinical and experimental studies both indicate that the occurrence of TRI in AIDS, systemic lupus erythematosus, or viral infections is directly related to endogenous systemic or local elevations of type I interferons (interferons alpha or beta). Moreover, these inclusions develop in patients or rhesus monkeys undergoing interferon alpha treatment. Rarely had CCC been reported in human tissue before the AIDS epidemic, but they were well known to develop in the hepatocytes of chimpanzees after experimental inoculation with human non-A, non-B hepatitis agent. In AIDS, CCC frequently coexist with TRI, and their appearance is associated with disease progression. A relationship of CCC to type I interferons is indicated by recent in vitro investigations, but clinical discordances in their appearance of TRI, and CCC suggest some differences in their pathogenesis, possibly related to cellular susceptibility or etiologic cofactors.