[Frontiers in Bioscience 1, e42-54, August 1,1996]
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CAVEAT LECTOR



MYCOPLASMAS AND HIV INFECTION: FROM EPIDEMIOLOGY TO THEIR INTERACTION WITH IMMUNE CELLS

Catherine Brenner, Olivier Neyrolles, Alain Blanchard

Institut Pasteur, Unité d'Oncologie Virale, Département SIDA et Rétrovirus, 28, rue du Dr. Roux, 75724 Paris Cedex 15, France

Received 07/05/96; Accepted 07/09/96; On-line 08/01/96

8. PERSPECTIVE

Other than the association between M. fermentans and AIDS-associated nephropathy, the pathogenic potential of this mycoplasma in AIDS patients is not defined. In patients not infected with HIV, there are reports indicating it is associated with a flu-like illness, with respiratory distress syndrome and/or systemic disease with multiple organ failure (17, 55, 84). In a few of the described cases, erythromycin treatment was ineffective whereas administration of doxycycline, at least in one patient, was followed by cure (17); these observations correspond to the antibiotic sensitivity of M. fermentans (resistant to erythromycin and sensitive to doxycycline) consistent with an aetiologic role for the mycoplasma in these patients' diseases. Finally the pathogenic role of this mycoplasma in HIV-seropositive subjects with respiratory disease or with various types of arthritis is being investigated by several groups.

One of the major difficulties in evaluating the pathogenic role of M. penetrans in humans is that its cannot easily be recovered or cultured from clinical samples. Although it has been detected in a large number of patients, its presence is not associated with any particular disease or symptoms. Presumably M. penetrans like most mycoplasma species, can behave as a commensal. In view of its cytopathic properties, it would be surprising if M. penetrans were not also an opportunistic agent at least.

The putative involvement of M. penetrans and M. fermentans as cofactors of HIV disease is currently being tested by epidemiological longitudinal studies and using the SIV infected macaque model.

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