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*****NEW ENGLAND JOURNAL OF MEDICINE*****

Siegal FP C Hammer GS Brown AE Kornfeld SJ Gold J Hassett J

Hirschman SZ Cunningham-Rundles C Adelsberg BR et al

Severe acquired immunodeficiency in male homosexuals, manifested by

chronic perianal ulcerative herpes simplex lesions.

In: N Engl J Med (1981 Dec 10) 305(24):1439-44

ISSN: 0028-4793

Four homosexual men presented with gradually enlarging perianal

ulcers, from which herpes simplex virus was cultured. Each patient

had a prolonged course characterized by eight loss, fever, and

evidence of infection by other opportunistic microorganisms including

cytomegalovirus, Pneumocystis carinii, and Candida albicans. Three

patients died; Kaposi's sarcoma developed in the fourth. All were

found to have depressed cell-mediated immunity, as evidenced by skin

anergy, lymphopenia, and poor or absent responses to plant lectins

and antigens in vitro. Natural-killer-cell activity directed against

target cells infected with herpes simplex virus was depressed in all

patients. The absence of a history of recurrent infections or of

histologic evidence of lymphoproliferative or other neoplastic

diseases suggests that the immune defects were acquired.

s. fuchs dc

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