COMPARISON OF COXSACKIE-B NEUTRALIZATION AND ENTEROVIRAL PCR IN CHRONIC FATIGUE PATIENTS

Coxsackie B enteroviruses have been implicated repeatedly as agents as sociated with chronic fatigue syndrome (CFS). The objective of this st udy was to compare the serological evidence for the presence of Coxsac kie B virus neutralising antibody, with the polymerase chain reaction (PCR) detecting a portion of the 5' nontranslated region (NTR) of the enterovirus genome. Serum samples from 100 chronic fatigue patients an d from 100 healthy comparison patients were used in this study. In the CFS study group, 42% patients were positive for enteroviral sequences by PCR, compared to only 9% of the comparison group. Using the neutra lisation assay, 34% of study patients were positive, compared to 41% o f comparison patients. In the study group, 66/100 patient results corr elated, i.e., they were either positive/positive or negative/negative for both tests. Of those that did not correlate, the majority were PCR -positive/Coxsackie B antibody-negative (21/34). In the comparison gro up, 58/100 patient results correlated. Of those that did not, the majo rity were PCR-negative/Coxsackie B antibody-positive (37/42). The Coxs ackie B antibody neutralisation assay was not able to differentiate th e CFS study group from the healthy comparison group, and thus the clin ical relevance of this assay may be questioned. The PCR assay did diff erentiate the two groups with significantly more CFS patients having e vidence of enterovirus than the comparison group. (C) 1995 Wiley-Liss, Inc.