SIMULTANEOUS MEASUREMENT OF ANTIBODIES TO EPSTEIN-BARR-VIRUS, HUMAN HERPESVIRUS-6, HERPES-SIMPLEX VIRUS TYPE-1 AND TYPE-2, AND 14 ENTEROVIRUSES IN CHRONIC-FATIGUE-SYNDROME - IS THERE EVIDENCE OF ACTIVATION OF A NONSPECIFIC POLYCLONAL IMMUNE-RESPONSE

As a test of the hypothesis that elevated titers of viral antibodies i n patients with chronic fatigue syndrome (CFS) are due to a nonspecifi c polyclonal immune response, antibodies to Epstein-Barr virus (EBV), human herpesvirus 6 (HHV-6), and 14 enteroviruses in 20 patients with CFS and 20 age- and gender-matched controls were simultaneously measur ed. Similarly, titers of IgG to herpes simplex virus (HSV) types 1 and 2 were measured in 18 of these cases and in the respective controls. IgG to EBV viral capsid antigen (VCA.) was present at titers greater t han or equal to 1:320 in 55% of cases vs. 15% of controls (P =.02). Th e geometric mean titers of early antigen antibody to EBV, HHV-6 IgG, a nd HSV-1 and HSV-2 IgG were not significantly different among cases an d controls. Of the 14 enteroviral antibodies tested for, only those to coxsackieviruses B1 and B4 were present at significant titers (greate r than or equal to 1:8) in cases vs. controls (P = .02 and P = .001, r espectively). Of the cases, 19 (95%) had either an EBV VCA IgG titer g reater than or equal to 1:320 or a coxsackievirus B1 or B4 antibody ti ter greater than or equal to 1:8, a percentage significantly higher th an that of controls (40%; P = .0004). Titers of EBV VCA IgG and coxsac kievirus B1 and B4 antibodies were simultaneously elevated in only 20% of cases. There was no correlation between elevated titers of EBV VCA Ige and IgG to HHV-6, HSV-1, and HSV-2 or antibody to coxsackieviruse s B1 and B4 in the cases. The prevalence of reported allergies to medi cations or other substances was identical in both groups (60%). These findings suggest that in the majority of cases of CFS, elevation of vi ral antibody titers is not due to a nonspecific polyclonal immune resp onse.