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.
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ROGERS, M. F., MORENS, D. M., STEWART, J. A., KAMINSKI, R. M., SPIRA, T. J., FEORINO, P. M., LARSEN, S. A., FRANCIS, D. P., WILSON, M., KAUFMAN, L.
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deSHAZO, R. D., ANDES, W. A., NORDBERG, J., NEWTON, J., DAUL, C., BOZELKA, B.
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