title: Severe acquired immunodeficiency in male homosexuals, manifested by chronic perianal ulcerative herpes simplex lesions.
abstract: 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.
mesh_terms: D000328:Adult; D001004:Anus Diseases / Q000209:etiology*; D002177:Candidiasis / Q000150:complications; D002908:Chronic Disease; D003586:Cytomegalovirus Infections / Q000150:complications; D006561:Herpes Simplex / Q000209:etiology* / Q000276:immunology; D006716:Homosexuality; D006801:Humans; D007111:Immunity, Cellular; D007153:Immunologic Deficiency Syndromes / Q000209:etiology*; D007694:Killer Cells, Natural / Q000276:immunology; D008297:Male; D011020:Pneumonia, Pneumocystis / Q000150:complications; D012514:Sarcoma, Kaposi / Q000209:etiology; D018139:Simplexvirus / Q000302:isolation & purification; D014456:Ulcer / Q000209:etiology