Comparison of coxsackie B neutralisation & enteroviral PCR in chronic fatigue patients

Coxsackie B enteroviruses have been implicated repeatedly as agents
associated with chronic fatigue syndrome (CFS). The objective
of this study was to compare the serological evidence for the
presence of Coxsackie B virus neutralising antibody, with the
polymerase chain reaction (PCR) detecting a portion of the 5'
nontranslated region (NTR) of the enterovirus genome. Serum
samples from 100 chronic fatigue patients and from 100 healthy
comparison patients were used in this study. In the CFS study
group, 42% patients were positive for enteroviral sequences by
PCR, compared to only 9% of the comparison group. Using the
neutralisation assay, 34% of study patients were positive,
compared to 41% of comparison patients. In the study group,
66/100 patient results correlated, i.e., they were either
positive/positive or negative/negative for both tests. Of
those that did not correlate, the majority were
PCR-positive/Coxsackie B antibody-negative (21/34). In the
comparison group, 58/100 patient results correlated. Of those
that did not, the majority were PCR-negative/Coxsackie B
antibody-positive (37/42). The Coxsackie B antibody
neutralisation assay was not able to differentiate the CFS
study group from the healthy comparison group, and thus the
clinical relevance of this assay may be questioned. The PCR
assay did differentiate the two groups with significantly more
CFS patients having evidence of enterovirus than the
comparison group.

Nairn C, Galbraith DN, Clements GB

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