Human cytomegalovirus (CMV) possesses the largest genome of the herpesviruses (~240 kbp), and its replication, although slow, is similar to HSV with the sequential appearance of immediate early, early and late gene products. In addition to nuclear inclusions (“owl eye cells”), CMV produces perinuclear cytoplasmic inclusions and enlargement of the cell (cytomegaly), a property that gives the virus its name. Based on genomic and phenotypic heterogeneity, innumerable strains of CMV exist, and restriction endonucle-ase analysis of viral DNA has been useful for distinguishing strains epidemiologically. Antigenic variations have been observed but are not of clinical importance.
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