Transmission or Recurrence? A Historical Dilemma of Iatrogenic Infections Due to Cytomegalovirus

This article traces the changes in thought regarding the etiology of iatrogenic infections due to cytomegalovirus from the 1960s to the 1990s. Initial investigations using serologic and culture methods focused on how the virus was acquired. Following the application of molecular tools, theories on disease causality expanded beyond concerns of the microorganism itself to include aspects of the virus–host interaction and the host response. Eventually, the insights gained from the investigations into the etiology of iatrogenic cytomegalovirus disease were applied to other intracellular viruses. In addition, recognition of the factors responsible for reactivation of latent viruses had not only theoretical value, but also practical consequences.