EBV Reactivation: New Evidence for Role in Chronic Fatigue Syndrome

Recent research shores up the theory of Epstein-Barr virus (EBV) reactivation as a possible cause of some cases of chronic fatigue syndrome (ME/CFS.)

EBV is in the herpesvirus family. All herpesviruses stay in your system forever, but generally remain dormant most of the time. When they do become active, specialized cells in the immune system, including B-cells and T-cells, typically don't have a problem knocking them back down again.

Most people aren't even aware that this process is going on. That's because B- and T-cells, in a healthy immune system, remember the virus and can rapidly assemble an army of antibodies to keep it in check.

In this study, however, scientists found evidence that the B- and T-cells of many people with ME/CFS were unable to remember EBV, meaning a reactivated virus would be better able to gain a foothold and cause symptoms.

Researchers found this impaired cellular memory in 76% of the 400+ study participants. Along with showing what may cause and sustain some cases of ME/CFS, researchers say this work could lead to a long-sought diagnostic marker.

More About EBV

EBV is a nasty bug. It's best known for causing infectious mononucleosis, called mono or the "kissing disease." Symptoms of mono include:

  • Fatigue
  • Sore throat
  • Headache
  • Fever
  • Muscle aches
  • Swollen lymph nodes
  • Sensitivity to light
  • Shortness of breath

    Recovery from mono is known to take a long time, and recurrences are marked by extreme fatigue.

    Some researchers have long believed it's no coincidence that those are also symptoms of ME/CFS, but since a large portion of the population carries EBV and only a small portion develop ME/CFS, it's been hard to explain (until now) how EBV could contribute to the illness.

    Other studies have shown that a significant number of juvenile ME/CFS cases followed mono, and many adolescents whom doctors deem unrecovered from mono fit the ME/CFS diagnostic criteria. It seems that the harder EBV hits, the more likely it is to cause prolonged illness. (Read more about these findings from Cort Johnson at Health Rising.)

    In addition to mono, EBV is linked to certain types of cancer, which could explain the higher incidence of cancer-related illness and death some ME/CFS experts have observed. EBV may also play a role in multiple sclerosis. New research also suggests it can mimic acute leukemia.

    With this new discovery of impaired cellular memory, we may have filled a significant gap in knowledge about how EBV could be triggering ME/CFS and contributing to on-going symptoms. While more work is needed to verify this study, it could prompt more doctors to prescribe anti-viral medications (such as valacyclovir or valganciclovir) for ME/CFS patients with high EBV titers.

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