Significance of gastrointestinal cytomegalovirus infection in homosexual males.

Gastrointestinal cytomegalovirus (CMV) infection usually occurs in immunosuppressed patients and has recently been reported in patients with the acquired immune deficiency syndrome (AIDS). Serological evidence of CMV infection and a variety of traumatic and infectious gastrointestinal disorders are known to occur in nonimmunosuppressed homosexual males. However, the significance of gastrointestinal CMV infection in nonimmunosuppressed homosexual males is not well known. Three unusual cases of gastrointestinal CMV infection in homosexual males are presented. Infection of a Kock pouch in one patient and an anal ulcer in another, occurred as part of a CMV mononucleosis syndrome. In the third patient, CMV was found in an acutely inflamed appendix. Although gastrointestinal CMV infection has been reported frequently in patients with AIDS, our patients showed no evidence of immunosuppression or AIDS 6 wk to 1 year later. Gastrointestinal CMV infection in homosexual males with gastrointestinal disease should not be considered indicative of AIDS.