Cytomegalovirus and cardiovascular disease

Cytomegalovirus (CMV) infection in people who develop AIDS may be involved in the development of heart disease that occurs in some of these patients. In addition, several viruses, including CMV, are likely involved in some cases of myocarditis and dilated cardiomyopathy, especially in people with other immune damage and particularly in heart transplant patients who are immunosuppressed. While 70% of Americans have been infected with CMV, in only a small number does it play a role in myocarditis and perhaps arteriosclerosis. There is limited epidemiologic evidence that CMV is specifically the cause of some primary coronary atheromas. However, in spite of considerable research, controversy remains concerning the role of CMV in the pathogenesis of cardiovascular diseases. As the prevalence of CMV infection is high, even a weak association with heart disease would be of public health significance. Even if CMV is responsible for only a small percentage of atherosclerosis cases, the benefits of its treatment or prevention would be tremendous. The studies reviewed provide a basis f or further investigation into the role of CMV in atherosclerosis and its control by means of vaccination or antiviral therapy.