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Role for chronic infections in atherosclerosis?

To the Editor:

The study by Espinola-Klein et al1 showed a significant association between infectious burden ( C pneumoniae, H pylori, cytomegalovirus, herpes simplex virus 2 ) and the extent of atherosclerosis; moreover, the risk for future death was increased by the number of infectious pathogens, especially in patients with advanced atherosclerosis. The specific IgG or IgA antibodies used in the study, however, do not necessarily distinguish between persistence of infections and only a previous contact. Other more sensitive markers of actual infections are available: specific IgG-containing immune complexes for C pneumoniae 2; the 13 …