Chronic fatigue. A prospective clinical and virologic study

Abstract

To evaluate the clinical and virologic course of patients with chronic fatigue who had elevated Epstein-Barr virus (EBV) titers, we prospectively followed up 26 patients with serial cultures for EBV in blood and saliva and serial EBV serologic and clinical and psychiatric evaluations, and we compared these results with those for healthy controls. The frequency of isolating EBV in blood or demonstrating EBV infection by in situ hybridization in blood lymphocytes or in saliva was similar in patients and controls. The prevalence and titers of antibody to human herpesvirus type 6 were also similar in the two populations. Patients with chronic fatigue did demonstrate higher in vitro natural killer activity and lower in vitro interleukin 2 production than controls, and patients had a high frequency of DSM-III depressive illness. Over 50% of patients with chronic fatigue improved over the course of follow-up. Improvement was not associated with any discernible change in titers of EBV proteins. No evidence of ongoing EBV infection with either transforming or nontransforming strains was demonstrated in this population of patients with chronic fatigue. Clinically, most patients gradually improve over time.

Genetic evaluation of AMPD1, CPT2, and PGYM metabolic enzymes in patients with chronic fatigue syndrome

“…However, this is unlikely to reflect the real situation due to the small number of subjects reporting alternative trigger factors. Despite a number of publications showing that viral infections only explain a small proportion of CFS cases (Gold et al, 1990;Heneine et al, 1994;Mawle et al, 1995), we found that the proportion of patients reporting viral infection as a trigger factor (76%) was high. This suggested a possible relationship between carnitine deficiency and infections (Mintz, 1995;Famularo et al, 2004).…”

Human Herpesvirus 6 and Chronic Fatigue Syndrome

“…Gold et al (20) did not find any difference in the HHV-6 titres between their patients and controls. This may be explained by the fact that only six of their 26 patients fulfilled the CDC criteria: most of their patients were probably similar to group B of the present study.…”

A síndrome da fadiga crônica: apresentação e controvérsias

“…Segundo Wessely (1989), a história da síndrome da fadiga crônica começou com a publicação, no início dos anos 80, de algumas séries de casos que descreviam uma doença com sintomas semelhantes aos efeitos retardados de uma infecção viral, manifestada por fadiga e outros sintomas, em grande parte subjetivos e aparentemente associados a evidências serológicas de infecções prolongadas pelo vírus Epstein-Barr (EB) -muito embora alguns estudos, como o de Gold et al (1990), não tenham demonstrado correlação entre parâmetros serológicos da atividade desse vírus e a condição clínica em questão.…”