Preferential Coxsackievirus Replication in Proliferating/Activated Cells: Implications for Virus Tropism, Persistence, and Pathogenesis

Coxsackieviruses cause substantial human morbidity and mortality, but the underlying molecular mechanisms of disease remain obscure. Here, we review the effects that the cell status—both cellular activation, and the cell cycle—may have on the outcome of virus infection. We propose that these viruses have evolved to undergo productive infection in cells at the G ₁ /S stage of the cell cycle, and to preferentially establish persistence/latent infection in quiescent cells, and we provide possible explanations for these outcomes. Finally, we consider the implications of these interactions for virus transmission and host pathology.