Simultaneous measurement of Ab to EBV, HHV6, HSV 1, 2, & 14 enteroviruses in Chronic Fatigue Syndrome (CFS): is there evidence of activation of a nonspecific polyclonal immune response?

As a test of the hypothesis that elevated titers of viral antibodies

in patients with chronic fatigue syndrome (CFS) are due to a

nonspecific polyclonal immune response, antibodies to

Epstein-Barr virus (EBV), human herpesvirus 6 (HHV-6), and 14

enteroviruses in 20 patients with CFS and 20 age- and

gender-matched controls were simultaneously measured.

Similarly, titers of IgG to herpes simplex virus (HSV) types 1

and 2 were measured in 18 of these cases and in the respective

controls.

IgG to EBV viral capsid antigen (VCA) was present at

titers > or = 1:320 in 55% of cases vs. 15% of controls (P =

.02). The geometric mean titers of early antigen antibody to

EBV, HHV-6 IgG, and HSV-1 and HSV-2 IgG were not significantly

different among cases and controls. Of the 14 enteroviral

antibodies tested for, only those to coxsackieviruses B1 and

B4 were present at significant titers (> or = 1:8) in cases

vs. controls (P = .02 and P = .001, respectively). Of the

cases, 19 (95%) had either an EBV VCA IgG titer > or = 1:320

or a coxsackievirus B1 or B4 antibody titer > or = 1:8, a

percentage significantly higher than that of controls (40%; P

= .0004). Titers of EBV VCA IgG and coxsackievirus B1 and B4

antibodies were simultaneously elevated in only 20% of cases.

There was no correlation between elevated titers of EBV VCA

IgG and IgG to HHV-6, HSV-1, and HSV-2 or antibody to

coxsackieviruses B1 and B4 in the cases. The prevalence of

reported allergies to medications or other substances was

identical in both groups (60%). These findings suggest that in

the majority of cases of CFS, elevation of viral antibody

titers is not due to a nonspecific polyclonal immune response.

Manian FA

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