Human Cytomegalovirus Infections and Mechanisms of Disease
William Britt
from: Cytomegaloviruses: Molecular Biology and Immunology (Edited by: Matthias J. Reddehase). Caister Academic Press, U.K. (2006)
Abstract
The pathogenesis of infections with human cytomegalovirus (HCMV) have been modeled in small animals and primates utilizing the respective CMVs. In most cases, acute infection is associated with significant levels of virus replication and dissemination to multiple organs. In the immunocompetent animal, such infections are rapidly controlled by a number of effector functions of the innate and adaptive immune response. The pathogenesis of acute HCMV infections can be readily explained by the control of virus replication and the resolution of virus-induced cytopathology. There appears to be a linkage between levels of virus replication, organ dysfunction, and disease in patients as well as in experimental models with acute CMV infections. In contrast, chronic infections with CMV have as a major component of their pathogenesis a bi-directional relationship between viral gene expression and the host inflammatory response such that viral persistence is facilitated by the host inflammatory response and the host inflammatory response is fueled by the presence of the virus. In these cases, disease can be attributed to both viral and host functions. The viral gene products that appear to play a role in chronic inflammation have evolved with CMVs and are likely unimportant for replication in vitro. As such, defining the role of these viral functions in disease associated with chronic HCMV infections almost certainly will require relevant animal models read more ...
