CFS and Epstein Barr Virus

The following is modified from “Chronic Fatigue Syndrome” authored by Michael T. Murray and published by Prima Publishing.

CFS (Chronic Fatigue Syndrome) & Epstein Barr Virus (EBV)

Many research studies have focused on identifying an infectious agent as the cause of CFS.  While still controversial, the Epstein-Barr virus (EBV) has emerged as the leading culprit.

EBV is a member of the Herpes group of viruses, which include Herpes Simplex types 1, and 2, Varicella zoster virus (Chicken Pox), Cytomegalovirus, and Pseudorabies virus.  A common aspect of these viruses is their ability to establish a lifelong latent infection after the initial infection.  Latent infections are generally kept in check by a normal immune system, but when the immune system is compromised in any way, these viruses can become active in viral replication and spread.  This is commonly observed with Herpes infections, especially in immunocompromised individuals such as those with AIDS, cancer, or drug-induced immunosuppression.

Infection with EBV is widespread among humans.  By the end of early adulthood almost everyone will have in their blood detectable antibodies to the EBV, indicating past infection.  When the primary infection occurs in childhood there are usually no symptoms, but in adolescence or early adulthood, the clinical manifestations of infectious mononucleosis develop in approximately 50% of cases.  Although reports of prolonged or recurrent mononucleosis-like syndrome began appearing in the 1940’s and 1950’s, it wasn’t until the 1980’s that evidence implicated EBV in this broad clinical spectrum of chronic fatigue and associated symptoms.  Numerous studies of patients presenting these symptoms have now demonstrated persistently elevated titers (levels) of serum antibodies against the Epstein-Barr Virus.

Current knowledge about EBV infection can be summarized as follows:

  1. EBV and the Herpes group of viruses produce latent lifelong infections.
  2. The host’s immune system (T lymphocytes, interferon, and other lymphokines) normally holds the latent infection in check.
  3. Any compromise in the immune system can lead to reactivation of the virus and recurrent infection.
  4. The infection itself can compromise and/or disrupt immunity, thereby leading to other diseases.
  5. Elevated EBV antibodies are observed in a significant number of diseases characterized by immunological dysfunction.
  6. Elevated antibody titers to the Herpes group viruses, Measles, and other viruses have been observed in patients suspected of having CFS and who also display elevated EBV antibody titers.

EBV antibody testing (and antibody testing for other Herpes group viruses and measles) may be useful as a measure of immune function and overall host resistance, but should not be exclusively relied upon for diagnosis of CFS.  This search for a viral agent is consistent with the common current medical approach:  to focus on the infectious organism rather than on reducing the susceptibility and supporting the individual’s immune system to deal with the organism effectively.

Organisms proposed as Causative Agents in CFS

  • Epstein-Barr virus
  • Human herpes virus-6
  • Inoue-Melnich virus
  • Brucella
  • Borrelia bugdorferi
  • Giardia lamblia
  • Cytomegalovirus
  • Enterovirus
  • Retrovirus

Modified from “Chronic Fatigue Syndrome” by Michael Murray, N.D. and from Prima Publishing.

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