Vasilieva Elena, Gianella Sara, Freeman Michael L
Laboratory of Atherothrombosis, Moscow State University of Medicine and Dentistry, Moscow 127473, Russia.
Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA.
Pathog Immun. 2020 Sep 20;5(1):240-274. doi: 10.20411/pai.v5i1.382. eCollection 2020.
Cytomegalovirus (CMV), a ubiquitous human pathogen that is never cleared from the host, has long been thought to be relatively innocuous in immunocompetent adults, but causes severe complications including blindness, end-organ disease, and death in newborns and in immuno-compromised individuals, such as organ transplant recipients and those suffering from AIDS. Yet even in persons with intact immunity, CMV infection is associated with profound stimulation of immune and inflammatory pathways. Carriers of CMV infection also have an elevated risk of developing cardiovascular complications. In this review, we define the proposed mechanisms of how CMV contributes to cardiovascular disease (CVD), describe current approaches to target CMV, and discuss how these strategies may or may not alleviate cardiovascular complications in those with CMV infection. In addition, we discuss the special situation of CMV coinfection in people with HIV infection receiving antiretroviral therapy, and describe how these 2 viral infections may interact to potentiate CVD in this especially vulnerable population.
巨细胞病毒（CMV）是一种普遍存在的人类病原体，宿主无法将其清除。长期以来，人们一直认为它在免疫功能正常的成年人中相对无害，但在新生儿以及免疫功能低下的个体（如器官移植受者和艾滋病患者）中，会引发严重并发症，包括失明、终末器官疾病和死亡。然而，即使在免疫功能正常的人群中，CMV感染也与免疫和炎症途径的深度激活有关。CMV感染携带者发生心血管并发症的风险也会升高。在本综述中，我们阐述了CMV导致心血管疾病（CVD）的潜在机制，描述了当前针对CMV的方法，并讨论了这些策略如何可能或不可能减轻CMV感染患者的心血管并发症。此外，我们讨论了接受抗逆转录病毒治疗的HIV感染者中CMV合并感染的特殊情况，并描述了这两种病毒感染如何相互作用，从而在这个特别脆弱的人群中加剧CVD。
