Cardiac myocytes and dendritic cells harbor human immunodeficiency virus in infected patients with and without cardiac dysfunction: Detection by multiplex, nested, polymerase chain reaction in individually microdissected cells from right ventricular endomyocardial biopsy tissue

      This paper is only available as a PDF. To read, Please Download here.


      Two hundred fifteen patients infected with human immunodeficiency viras (HIV) participated in a prospective longitudinal study of HIV-related heart disease. Evaluation included signal-averaged etectrocardiography and echocardiography. Fifteen patients underwent endomyocardial biopsy, 5 had cardiovascular symptoms and 10 did not. Cardiac myocytes or dendritic cells were prepared by individual cell microdissection to sort them from other cell types such as interstitial cells or circulating blood elements. HIV proviral sequences were amplified in samples of 15 to 20 cells of each type by multiplex, nested, polymerase chain reaction and hybridized to 32P-labeled probes specific for regions within the gag and pol genes of HIV-1. The results showed the presence of HIV sequences in myocytes of 2 of 5 patients with cardiac symptoms and in 6 of 10 without. Thus, symptomatic HIV cardiomyopathy did not appear to be a direct consequence of the viras on myocardial cells. In dendritic cells, HIV sequences were detected in 5 of 5 patients with cardiac symptoms and in 8 of 10 with apparently normal ventricular function. Furthermore, dendritic cells were somewhat more numerous in the myocardium of symptomatic than asymptomatic patients. Our studies are the first to directly detect the HIV genome in purified cardiac myocytes from patients with and without cardiac dysfunction. Our findings do not support a direct role of the viras in myocardial dysfunction. However, the results do suggest that the interstitial dendritic cells may be involved in some manner in the development of cardiac dysfunction observed in HIV-infected patients.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Anderson DW
        • Virmani R
        Emerging patterns of heart disease in human immunodeficiency virus infection.
        Hum Pathol. 1990; 21: 253-259
        • Calabrese LH
        • Proffitt MR
        • Yen-Lieberman B
        • Hobbs RE
        • Ratliff NB
        Congestive cardiomyopathy and illness related to the acquired immunodeficiency syndrome (AIDS) associated with isolation of retrovirus from myocardium.
        Ann Intern Med. 1987; 107: 691-692
        • Dittrich H
        • Chow L
        • Denaro F
        • Spector S
        Human immunodeficiency virus, coxsackievirus, and cardiomyopathy.
        Ann Intern Med. 1988; 108: 308-309
        • Flomenbaum M
        • Soeiro R
        • Udem SA
        • Kress Y
        • Factor SM
        Proliferative membranopathy and human immunodeficiency virus in AIDS hearts.
        J Acquir Immune Defic Syndr. 1989; 2: 129-135
        • Shibata D
        • Klatt EC
        Analysis of human immunodeficiency virus and cytomeg alovirus infection by polymerase chain reaction in the acquired immunodeficiency syndrome. An autopsy study.
        Arch Pathol Lab Med. 1989; 113: 1239-1244
        • Grody WW
        • Lewis W
        Infection of the heart by the human immunodeficiency virus.
        Am J Cardiol. 1990; 66: 203-206
        • Lipshultz SE
        • Fox CH
        • Perez-Atayde AR
        • Sanders SP
        • Colan SD
        • McIntosh K
        • Winter HS
        Identification of human immunodeficiency virus-1 RNA and DNA in the heart of a child with cardiovascular abnormalities and congenital acquired immune deficiency syndrome.
        Am J Cardiol. 1990; 66: 246-250
        • Steinberg JS
        • Bigger JT
        Importance of the endpoint noise reduction in analysis of the signal-averaged electrocardiogram.
        Am J Cardiol. 1989; 63: 556-560
        • Simson MB
        Use of signals in the terminal QRS complex to identify patients with ventricular tachycardia after myocardial infarction.
        Circulation. 1981; 64: 235-242
      1. Molecular Cloning. A Laboratory Manual. Cold Spring Harbor, New York1989
        • Mullis K
        • Faloona FA
        Specific synthesis of DNA in vitro via a polymerasecatalyzed chain reaction.
        in: Methods in Enzymology Recombinant DNA. Part F. 155. 1989: 335-350
      2. Innis MA Gelfand DH Sninsky JJ White TJ PCR Protocols. A Guide to Methods and Applications. Academic Press, San Diego1990
        • Sanchez-Pescador R
        • Power MD
        • Barr PJ
        • Steimer KS
        • Stempien MM
        • Brown-Shimer SL
        • Gee WW
        • Renard A
        • Randolph A
        • Levy JA
        • Dina D
        • Luciw PA
        Nucleotide sequence and expression of an AIDS-associated retrovirus (ARV-2).
        Science. 1985; 227: 484-492
        • Yamauchi-Takihara K
        • Sole MJ
        • Liew J
        • Ing D
        • Liew CC
        Characterization of human cardiac myosin heavy chain genes.
        in: Proc Natl Acad Sci USA. 6. 1989: 3504-3508
        • Laure F
        • Courgnaud V
        • Rouzioux C
        • Blanche S
        • Veber F
        • Burgard M
        • Jacomet C
        • Griscelli C
        • Brechot C
        Detection of HIV1 DNA in infants and children by means of the polymerase chain reaction.
        Lancet. 1988; 2: 538-541
        • Aretz HT
        Myocarditis: the Dallas criteria.
        Hum Pathol. 1987; 18: 619-624
        • Clapham PR
        • Weber JN
        • Whitby D
        • McIntosh K
        • Dalgleish AG
        • Maddon PJ
        • Deen KC
        • Sweet RW
        • Weiss RA
        Soluble CD4 blocks the infectivity of diverse strains of HIV and SIV for T cells and monocytes but not for brain and muscle cells.
        Nature. 1989; 337: 368-370
        • Ikeuchi K
        • Kim S
        • Byrn RA
        • Goldring SR
        • Groopman JE
        Infection of nonlymphoid cells by human immunodeficiency virus type 1 or type 2.
        J Virol. 1990; 64: 4226-4231
        • Hofman FM
        • Danilovs JA
        • Taylor CR
        HLA-DR (Ia)-positive dendritic-like cells in human fetal nonlymphoid tissues.
        Transplantation. 1984; 37: 590-594
        • Rose ML
        • Coles MI
        • Griffin RJ
        • Pomerance A
        • Yacoub MH
        Expression of class I and class II major histocompatibility antigens in normal and transplanted human heart.
        Transplantation. 1986; 41: 776-780
        • Sell KW
        • Tadros T
        • Wang YC
        • Hertzler G
        • Knopf WD
        • Murphy DA
        • Ahmed-Ansari A
        Studies of major histocompatibility complex class I/II expression on sequential human heart biopsy specimens after transplantation.
        J Heart Transplant. 1988; 7: 407-418
        • Herskowitz A
        • Ahmed-Ansari A
        • Neumann DA
        • Beschorner WE
        • Rose NR
        • Soule LM
        • Burek CL
        • Sell KW
        • Baughman KL
        Induction of major histocompatibility complex antigens within the myocardium of patients with active myocarditis: a nonhistologic marker of myocarditis.
        J Am Coll Cardiol. 1990; 15: 624-632
        • Chang SC
        • Hsu HK
        • Perng RP
        • Shiao GM
        • Lin CY
        Increased expression of MHC class II antigens in rejecting canine lung allografts.
        Transplantation. 1990; 49: 1158-1163
        • Nicod LP
        • Galve-de Rochemonteix B
        • Dayer JM
        Dissociation between allogeneic T cell stimulation and interleukin-1 or tumor necrosis factor production by human lung dendritic cells.
        Am J Respir Cell Mol Biol. 1990; 2: 515-522
        • McCall JL
        • Yun K
        • Funamoto S
        • Parry BR
        In vivo immunohistochemical identification of tumor necrosis factor/cachectin in human lymphoid tissue.
        Am J Pathol. 1989; 135: 421-425
        • Larrick JW
        • Morhenn V
        • Chiang YL
        • Shi T
        Activated Langerhans cells release tumor necrosis factor.
        J Leukoc Biol. 1989; 45: 429-433
        • Gulik T
        • Chung MK
        • Pieper SJ
        • Lange LG
        • Schreiner GF
        Interleukin 1 and tumor necrosis factor inhibit cardiac myocyte β-adrenergic responsiveness.
        in: Proc Natl Acad Sci. 86. 1989: 6753-6757
        • Chung MK
        • Gulick TS
        • Rotondo RE
        • Schreiner GF
        • Lange LG
        Mechanism of cytokine inhibition of β-adrenergic agonist stimulation of cyclic AMP in rat cardiac myocytes. Impairment of signal transduction.
        Circ Res. 1990; 67: 753-763
        • Cunnion RE
        • Parrillo JE
        Myocardial dysfunction in sepsis.
        Chest. 1989; 95: 941-945
        • Hegewisch S
        • Weh HJ
        • Hossfeld DK
        TNF-Induced cardiomyopathy.
        Lancet. 1990; 335: 294-295