Serologic and Virologic Epidemiology of Epstein-Barr Virus: Relevance to Chronic Fatigue Syndrome

Abstract

Patients considered to have chronic fatigue syndrome (CFS) have been reported to exhibit an increased antibody response to Epstein-Barr virus (EBV) early antigen complex and capsid antigen, findings that suggest some relationship between EBV and CFS. However, the serologic findings have not been totally consistent among different study groups, and the antibody patterns in asymptomatic individuals may be similar. Moreover, patients with symptomatology indicative of CFS do not appear to have an abnormal burden of EBV in body fluids and manifest only a variable, mild degree of EBV-specific cell-mediated responses. The evidence is growing that the serologic findings of an enhanced EBV state in individuals with CFS-like manifestations, as well as the subsequent reports of increased antibody titers to other viruses, reflect a generalized underlying immunologic dysfunction in these patients. Future studies with criteria-defined CFS study groups in which determinations are made of antibody responses to newly identified EBV-associated nuclear antigen components and distinct EBV proteins in addition to specific virologic and immunologic analyses of EBV may be worthwhile as a means of clarifying the association between EBV and CFS.