Chronic Fatigue Syndrome (CFS) is a complex disorder that’s as difficult to diagnose as it is to treat, mainly because we still don’t fully understand the cause. This leaves far too many patients with chronic fatigue syndrome symptoms undiagnosed and continuing to suffer. There is no simple blood test that can identify whether a person has CFS or not, but a new study indicates researchers might finally be getting somewhere, at least for diagnosing CFS in some patients.
While some studies have found that people with chronic fatigue syndrome symptoms tend to have higher blood levels of certain markers, such as blood markers for inflammation, oxidative stress, or previous infections, none of these markers are unique to CFS or can be used to diagnose it. However, in a preliminary study, a team of investigators from Ohio State University and Oakland University School of Medicine have discovered a potential method to diagnose CFS using a blood test.
The test looks for the presence of specific antibodies linked to the reactivation of latent Epstein-Barr virus. Epstein-Barr is a member of the herpes virus family and one of the most common human viruses. In the United States, as many as 95% of adults between 35 and 40 years of age have been infected with Epstein-Barr, which causes infectious mononucleosis in 35% to 50% of those exposed.
No clear connections between Epstein-Barr and CFS until now
In some people, chronic fatigue syndrome symptoms begin with a flu-like infection. Viruses like Epstein-Barr have therefore been studied as possible causes of CFS since the mid 1980’s. But the role of Epstein-Barr and other viruses in CFS remains controversial. Although it’s well-documented that small group of people with CFS experience an episode of infectious mononucleosis before the onset of chronic fatigue syndrome symptoms, researchers have not been able to make any clear connections between Epstein-Barr infection and development of CFS.
In everyone, the Epstein-Barr virus remains dormant or latent in a few cells in the throat and blood as well as in some cells of the body’s immune system for life. And it is not uncommon for dormant Epstein-Barr to be reactivated, meaning it starts to replicate again, without causing symptoms of illness.
A few early studies looked into the potential connection between Epstein-Barr and CFS and reported slightly higher levels of standard antibodies to EBV in patients with chronic fatigue syndrome symptoms compared with healthy individuals. However, over the years it’s become obvious that just because some patients with CFS have higher-than-normal levels of standard antibodies to Epstein-Barr in their blood doesn’t mean this virus is the cause of CFS. Healthy people sometimes also have high Epstein-Barr antibodies, while some people with CFS do not, making standard blood tests for Epstein-Barr antibodies not useful for diagnosing CFS.
Unusual “partial reactivation” of virus causes chronic fatigue syndrome symptoms in some
However, there seems to be something different about the latent Epstein-Barr virus reactivation in some patients with CFS. The virologists had previously identified a group of patients with classic chronic fatigue syndrome symptoms that responded very well to treatment with antiviral medication. By comparing these patients to CFS patients who didn’t respond to antiviral medication, the researchers found that the CFS patients who had responded to the antiviral treatment were experiencing an unusual “partial reactivation” of the Epstein-Barr virus.
In this group of CFS patients, a latent Epstein-Barr virus had begun to reactivate, but the newly awakened virus never reached its full potential to take over its host cells. Instead, the group of fatigued patients experienced a partial reactivation that stuck around for an abnormally long time. This partial reactivation was strong enough to trigger the generation at least two viral proteins, called DNA polymerase and dUTPase. The patients produced antibodies specifically designed to identify and neutralize those proteins. Control blood samples from healthy people showed no such antibodies.
Virus triggers inflammation and immune system “chaos” leading to CFS symptoms
Even though the CFS patients with these antibodies don’t show evidence of complete, active, Epstein-Barr re-infections (they tested negative for the most commonly measured active antibodies required to fight the Epstein-Barr virus,) the researchers believe these viral proteins are able to trigger inflammation and chaos within the immune system that leads to debilitating fatigue and other chronic fatigue syndrome symptoms. All patients in whom the antibodies linked to latent Epstein-Barr virus reactivation were detected had experienced classic CFS symptoms that resolved with long-term antiviral treatment.
New panel would identify subgroup of CFS patients with specific Epstein-Barr antibodies
Numerous types of blood tests are available to determine past or present viral infections, but until now none have been found to be useful in helping determine whether someone has CFS or not. In other words, until now no type of virus-related marker in the blood has been found that separates out those with CFS from those without. With their discovery, the investigative team envisions the development of a new antibody panel which could be used to identify the subgroup of CFS patients with elevated levels of these specific antibodies against DNA polymerase and dUTPase. As of now, antibodies to these viral proteins are not part of any current standard panel for past or present Epstein-Barr infections.
Some of the researchers involved the study are part owners of a company that has U.S. patents and pending patents for diagnosis and treatment of CFS based on their discovery of these non-standard antibodies. While this may be a conflict of interest, it is also a new direction which might offer hope to at least some CFS patients.
To learn more about how viral infections relate to fatigue, see our other informative article: Post Viral Fatigue – Could a Virus be to Blame for Your Extreme Fatigue? You can also learn about other causes of chronic fatigue and CFS, as well as natural strategies for beating fatigue, by browsing our additional Fatigue, Lack of Energy articles. Our resources will help you identify the true underlying cause of your fatigue and get it under control using natural health strategies recommended by leading integrative physicians and research study groups.
 Lerner AM, Ariza ME, et al. Antibody to epstein-barr virus deoxyuridine triphosphate nucleotidohydrolase and deoxyribonucleotide polymerase in a chronic fatigue subset. PLoS One. 2012;7(11):e47891.