Abstract
Frequency of active human herpesvirus-6, -7 (HHV-6, HHV-7) and parvovirus B19 (B19) infection/coinfection and its association with clinical course of ME/CFS was evaluated. 108 ME/CFS patients and 90 practically healthy persons were enrolled in the study. Viral genomic sequences were detected by PCR, virus-specific antibodies and cytokine levels—by ELISA, HHV-6 variants—by restriction analysis. Active viral infection including concurrent infection was found in 64.8% (70/108) of patients and in 13.3% (12/90) of practically healthy persons. Increase in peripheral blood leukocyte DNA HHV-6 load as well as in proinflammatory cytokines' levels was detected in patients during active viral infection. Definite relationship was observed between active betaherpesvirus infection and subfebrility, lymphadenopathy and malaise after exertion, and between active B19 infection and multijoint pain. Neuropsychological disturbances were detected in all patients. The manifestation of symptoms was of more frequent occurrence in patients with concurrent infection. The high rate of active HHV-6, HHV-7 and B19 infection/coinfection with the simultaneous increase in plasma proinflammatory cytokines' level as well as the association between active viral infection and distinctive types of clinical symptoms shows necessity of simultaneous study of these viral infections for identification of possible subsets of ME/CFS.
Highlights
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/ CFS) is a disease characterized by profound disabling fatigue lasting at least 6 months and accompanied by a combination of nonspecific symptoms
The rate of active viral infection was significantly higher in patients comparing to the rate in the practically healthy persons (70/108 and 12/90, resp.; Odds ratio 0.14, 95% CI 0.07–0.26, P = 0.0001)
In the patients significant difference was detected between the frequency of single active and concurrent active viral infection (41/70, 58.6% and 29/70, 41.4%, resp.; Odds ratio 2.0, 95% CI 1.02–3.92, P = 0.044)
Summary
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/ CFS) is a disease characterized by profound disabling fatigue lasting at least 6 months and accompanied by a combination of nonspecific symptoms. According to the 1994 US Center’s for Disease Control and Prevention (CDC) case definition, which at present, is widespread in research and clinical practice, at least four out of eight symptoms (impaired memory or concentration, sore throat, tender cervical or axillary lymph nodes, muscle pain, multi-joint pain, new headaches, sleep disturbances and post-exertion malaise) should be present in cases of ME/CFS [1]. The observation that many cases of the disease begin with a flulike illness has prompted the hypothesis that viral infections are implicated in this disorder. The major hypothesis of the pathogenesis of the disease is that persistent viral infections may trigger and lead to chronic activation of the immune system with abnormal
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