Chronic fatigue. A prospective clinical and virologic study

D. Gold, R. Bowden, J. Sixbey, R. Riggs, W. J. Katon, R. Ashley, R. M. Obrigewitch and L. Corey
Department of Medicine, University of Washington School of Medicine, Seattle.

To evaluate the clinical and virologic course of patients with chronic fatigue who had elevated Epstein-Barr virus (EBV) titers, we prospectively followed up 26 patients with serial cultures for EBV in blood and saliva and serial EBV serologic and clinical and psychiatric evaluations, and we compared these results with those for healthy controls. The frequency of isolating EBV in blood or demonstrating EBV infection by in situ hybridization in blood lymphocytes or in saliva was similar in patients and controls. The prevalence and titers of antibody to human herpesvirus type 6 were also similar in the two populations. Patients with chronic fatigue did demonstrate higher in vitro natural killer activity and lower in vitro interleukin 2 production than controls, and patients had a high frequency of DSM-III depressive illness. Over 50% of patients with chronic fatigue improved over the course of follow-up. Improvement was not associated with any discernible change in titers of EBV proteins. No evidence of ongoing EBV infection with either transforming or nontransforming strains was demonstrated in this population of patients with chronic fatigue. Clinically, most patients gradually improve over time.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Post-infective and chronic fatigue syndromes precipitated by viral and non-viral pathogens: prospective cohort study
Hickie et al.
BMJ 2006;333:575.
ABSTRACT | FULL TEXT  

Chronic Fatigue Syndrome
Natelson
JAMA 2001;285:2557-2559.
FULL TEXT  

Gender Biases Underlying the Social Construction of Illness States: The Case of Chronic Fatigue Syndrome
Richman and Jason
Current Sociology 2001;49:15-29.
ABSTRACT  

Disturbed Neuroendocrine-Immune Interactions in Chronic Fatigue Syndrome
Kavelaars et al.
J. Clin. Endocrinol. Metab. 2000;85:692-696.
ABSTRACT | FULL TEXT  

Functional Somatic Syndromes
Barsky and Borus
ANN INTERN MED 1999;130:910-921.
ABSTRACT | FULL TEXT  

Human Herpesviruses in Chronic Fatigue Syndrome
Wallace et al.
CVI 1999;6:216-223.
ABSTRACT | FULL TEXT  

Chronic fatigue syndrome: prevalence and outcome
Lawrie and Pelosi
BMJ 1994;308:732-733.
FULL TEXT  

Longitudinal study of outcome of chronic fatigue syndrome
Wilson et al.
BMJ 1994;308:756-759.
ABSTRACT | FULL TEXT  

Neurasthenia and Chronic Fatigue: Theory and Practice in Britain and America
Wessely
Transcultural Psychiatry 1994;31:173-209.
ABSTRACT  

Are You and Your Waiting Room's Televised "Expert" Saying the Same Thing?
Hickson and Clayton
CLIN PEDIATR 1993;32:172-174.
 

EPSTEIN-BARR VIRUS IS NOT A FREQUENT CAUSE OF CHRONIC FATIGUE
JWatch General 1990;1990:7-7.
FULL TEXT