I: Human Cytomegalovirus.- 1. History of Human Cytomegalovirus.- 1.1. Period of Cytopathology (1905-1956).- 1.2. Virological Period.- 2. Characteristics of Cytomegalovirus.- 2.1. Herpesviruses.- 2.2. Cytomegalovirus and Other Human Herpesviruses.- 2.3. The Structure of Cytomegalovirus.- 2.3.1. DNA of Human Cytomegalovirus.- 2.3.2. Virion and Dense Body Proteins and Glycoproteins.- 2.3.3. Defective Interfering Particles and Their DNA.- 2.4. Morphological Events of Replication.- 2.4.1. Early Antigens and Cytopathology.- 2.4.2. Nuclear Changes and Nucleocapsid Formation.- 2.4.3. Cytoplasmic Inclusions and Dense Bodies.- 2.5. Biochemical Events of Replication.- 2.5.1. Protein Synthesis.- 2.5.2. Stimulation of Cell DNA and RNA.- 2.5.3. Induction of Enzymes.- 2.5.4. Induction of Fc Receptors by Human Cytomegalovirus.- 2.6. Stability of Human Cytomegalovirus.- 2.6.1. Stability of Cytomegalovirus at Different Temperatures.- 2.6.2. Stability of Cytomegalovirus in Urine or Blood.- 3. Human Cytomegalovirus Infections in Cells and Tissues.- 3.1. Virological Diagnosis of Human Cytomegalovirus Infection.- 3.1.1. Virological Diagnosis in the Presence of Antibody.- 3.2. Abortive or Persistent Infections in Partially Permissive Cells.- 3.2.1. Infections in Nonhuman Cells.- 3.2.2. Infection in Human Epithelial Cells.- 3.2.3. Persistent Infection in Human Cells.- 3.3. Human Cytomegalovirus and Oncogenic Transformation.- 3.4. Relationship of Human Cytomegalovirus to Cancer.- 4. Serologic Tests for Human Cytomegalovirus Infections.- 4.1. Introduction.- 4.2. Complement-Fixation Test.- 4.2.1. The Nature of Complement-Fixation Antigen.- 4.2.2. The Nature of Complement-Fixation Antibody.- 4.2.3. Constancy of the Complement-Fixation Titer.- 4.2.4. The Complement-Fixation Test in Cytomegalovirus Infections.- 4.3. Neutralization Tests.- 4.4. Fluorescent Antibody Techniques.- 4.4.1. Immunoglobulin M Antibody Test.- 4.4.2. Immunoglobulin A in Cytomegalovirus Infection.- 4.4.3. Membrane Antigens.- 4.4.4. Early Antigen.- 4.4.5. Pre-Early Antigen Test.- 4.5. Platelet Agglutination Test for Cytomegalovirus Antibody.- 4.6. Indirect Hemagglutination Test.- 4.7. Immune Adherence Hemagglutination Assay.- 4.8. Enzyme-Linked Immunosorbent Assay.- 4.9. Radioimmunoassay.- 4.10. Detection of Antibodies by Counterimmunoelectrophoresis.- 4.11. Detection of Antibodies by Gel Precipitins.- 4.12. Cytolytic Antibody.- 4.13. Patterns of Serologic Responses to Human Cytomegalovirus Infections.- 5. Variants of Human Cytomegalovirus.- 5.1. Variants According to Neutralization Tests.- 5.2. Development of Specific Animal Antiserum.- 5.3. Variants According to Complement-Fixation Tests.- 5.4. Variants According to Kinetic Neutralization Tests.- 5.5. Heterogeneity of Individual Responses.- 5.6. Variants According to Immunodiffusion.- 5.7. Variants According to DNA Structure.- 6. Epidemiology of Cytomegalovirus Infection in Man.- 6.1. The Distribution of Human Cytomegalovirus Infections.- 6.1.1. Prevalence of Antibodies in the General Population.- 6.1.2. The Effect of Age.- 6.1.3. Frequency of Perinatal Infections.- 6.1.4. The Effect of HLA Type.- 6.1.5. Antibody and Latent Infection.- 6.2. The Mechanisms of Perinatal Transmission.- 6.2.1. Perinatal Transmission: Infected Cervix.- 6.2.2. Perinatal Transmission: Breast Milk.- 6.2.3. Perinatal Transmission: Other Factors.- 6.2.4. Transmission in Newborn Nursery.- 6.3. Cytomegalovirus Infection of the Uterine Cervix and in Pregnant Women.- 6.4. Venereal Transmission of Cytomegalovirus.- 6.4.1. Cytomegalovirus in Semen.- 6.5. Other Mechanisms of Transmission.- 6.6. Transmission of Cytomegalovirus by Blood.- 6.6.1. Prospective Studies of Cytomegalovirus Infections Transmitted by Blood.- 6.6.2. Attempts to Isolate Cytomegalovirus from Donors.- 6.6.3. Cytomegalovirus Infections Associated with Leucocyte Transfusions.- 7. Cell-Mediated Immunity to Cytomegalovirus Infection.- 7.1. Introduction.- 7.2. Tests for Cell-Mediated Immunity.- 7.2
Although there are a number of excellent current reviews on one or another aspect of cytomegalovirus, the last comprehensive treatment of this subject was that of Krech et al. (1971a). In view of the amazing advances in the virological, epidemiologic, and clinical knowledge of cytomegaloviruses, an up-to-date book is needed. Such a work should cover many areas of expertise and a voluminous technical literature. Each area might have been reviewed and analyzed by workers more expert than myself. However, I have embarked on the entire venture alone in order to attain unity and continuity in this book, characteristics that are not easily achieved in the more popular multiauthored works. I have tried to review the literature and to provide a critical summary for each area discussed. To do this, I provide as much of the primary data of the relevant works as needed and not just the qualitative conclusions. Inevitably, the flow of the narrative may be interrupted by dry facts and figures. However, such information is essential to make this a meaningful reference work. But for those not interested in such details, I have provided at what I hope are crucial points critiques and summaries. This book is not an exhaustive review of all the literature. This is probably no longer possible or even desirable. By selection, however, one runs the risk of having missed or ignored important papers. I am keenly aware of this, and I wish to apologize for such oversight, if that is possible.
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