Original article| Volume 18, ISSUE 2, P143-150, March 1989

Active Epstein-Barr virus infection in post-viral fatigue syndrome

      This paper is only available as a PDF. To read, Please Download here.


      Serological evidence of active infection with Epstein-Barr virus (EBV) was found in 25 of 124 patients (20%) with the post-viral fatigue syndrome (PVFS). In another study on the same group of patients around 50 % were found to have evidence of chronic enterovirus infection. No overlap was found between those patients with enterovirus infection and those with active EBV infection. We suggest that there are multiple causes of PVFS and that, in the absence of coexisting immunosuppressive disease which may itself reactivate the virus, EBV may be the aetiological agent in a predominantly female subgroup of patients with PVFS. Furthermore, the disease process in this subgroup may be immunopathological in nature.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Infection
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Youssef GE
        • Bell EJ
        • Mann GF
        • et al.
        Chronic enterovirus infection in patients with postviral fatigue syndrome.
        Lancet. 1988; i: 146-150
        • Niederman JC
        • Evans AS
        • Subrahmanyan L
        • McCollum RW
        Prevalence, incidence and persistence of EB virus antibody in young adults.
        New Engl J Med. 1970; 282: 361-365
        • Weisenburgen DD
        • Purtilo DT
        Failure in immunological control of the virus infection: Fatal infectious mononucleosis.
        in: Epstein MA Achong BG The Epstein-Barr virus: Recent advances. W Heinemann, Washington DC1986: 127
        • Borysiewicz LK
        • Haworth SJ
        • Cohen J
        • Mundin J
        • Rickinson A
        • Sissons JGP
        Epstein-Barr virus specific immune defects in patients with persistent symptoms following infectious mononucleosis.
        Q J Med. 1986; 58: 111-121
        • Sixbey JW
        • Nedrud JG
        • Raab-Traub N
        • Hanes RA
        • Pagano JS
        Epstein-Barr virus replication in oropharyngeal epithelial cells.
        New Engl J Med. 1984; 310: 1225-1230
        • Golden HD
        • Chang RS
        • Prescott W
        • Simpson E
        • Cooper TY
        Leukocyte-transforming agent; prolonged excretion by patients with mononucleosis and excretion by normal individuals.
        J Infect Dis. 1973; 127: 471-473
        • Moss DJ
        • Rickinson AB
        • Pope JH
        Long term T cell mediated immunity to Epstein-Barr virus in man. I. Complete regression of virus-induced transformation in cultures of seropositive donor leucocytes.
        Int J Cancer. 1978; 22: 662-668
        • Crawford DH
        • Edwards JMB
        • Sweny P
        • Hoffbrand AV
        • Janossy G
        Studies on long term T-cell mediated immunity to Epstein-Barr virus in immunosuppressed renal allograft recipients.
        Int J Cancer. 1981; 28: 705-709
        • Crawford DH
        • Thomas JA
        • Janossy G
        • et al.
        Epstein-Barr virus nuclear antigen positive lymphoma after cyclosporin A treatment in a patient with renal allograft.
        Lancet. 1980; i: 1355-1356
        • Crawford DH
        • Edwards JMB
        Epstein-Barr virus.
        in: Zuckerman AJ Banatvala JE Pattison JE Principles and practice of clinical virology. Wiley, London1987: 111-133
        • Henle W
        • Henle G
        • Anderson J
        • et al.
        Antibody responses to Epstein-Barr virus determined nuclear antigen EBNA-1 and EBNA-2 in acute and chronic Epstein-Barr virus infection.
        in: Proc Natl Acad Sci USA. 84. 1987: 570-574
        • Tosato G
        • Straus S
        • Henle W
        • Pike SE
        • Blaese RM
        Characteristic T cell dysfunction in patients with chronic active Epstein-Barr virus infection (chronic infectious mononucleosis).
        J Immunol. 1985; 134: 3082-3088
        • Holmes GP
        • Kaplan JE
        • Gantz NM
        • et al.
        Chronic fatigue syndrome: A working case definition.
        Ann Intern Med. 1988; 108: 387-389
        • Straus SE
        • Tosato G
        • Armstrong G
        • et al.
        Persisting illness and fatigue in adults with evidence of Epstein-Barr virus infection.
        Ann Intern Med. 1985; 102: 7-16
        • Behan PO
        • Behan WMH
        • Bell EJ
        The post-viral fatigue syndrome — an analysis of the findings in 50 cases.
        J Infect. 1985; 10: 211-222
        • Krueger GRF
        • Koch B
        • Ablashi DV
        Persistent fatigue and depression in a patient with antibody to human B-lymphotropic virus.
        Lancet. 1987; ii: 36
        • Henle G
        • Henle W
        Immunofluorescence in cells derived from Burkitt's lymphoma.
        J Bacteriol. 1966; 91: 1248-1256
        • Henle W
        • Henle G
        • Zajac BA
        • Pearson G
        • Waubke R
        • Scriba M
        Differential reactivity of human serums with early antigens induced by Epstein-Barr virus.
        Science. 1970; 169: 188-190
        • Reedman BM
        • Klein G
        Cellular localisation of an Epstein-Barr virus (EBV) associated complement-fixing antigen in producer and non-producer lymphoblastoid cell lines.
        Int J Cancer. 1973; 11: 499-520
        • Welinder C
        • Larsson NG
        • Szigeti R
        • et al.
        Stable transfection of a human lymphoma line by sub-genomic fragments of Epstein-Barr virus DNA to measure humoral and cellular immunity to the corresponding proteins.
        Int J Cancer. 1987; 40: 389-395
        • Davidsohn I
        • Henry JB
        Clinical diagnosis by laboratory methods.
        14th ed. Saunders, Chichester1969
        • Grist NR
        • Bell EJ
        • Follett EAC
        • Urquhart GED
        Diagnostic methods in clinical virology.
        3rd ed. Blackwell, Philadelphia1979
        • Ragona G
        • Sirianni MC
        • Soddu S
        • et al.
        Evidence for disregulation in the control of Epstein-Barr virus latency in patients with AIDS-related complex.
        Clin Exp Immunol. 1986; 66: 17-24
        • Holmes GP
        • Kaplan JE
        • Stewart JA
        • Hunt B
        • Pinsky PF
        • Schonberger LB
        A cluster of patients with a chronic mononucleosis-like syndrome.
        in: Is Epstein-Barr virus the cause?JAMA. 257. 1987: 2297-2302
        • Smedley H
        • Katrak M
        • Sikora K
        • Wheeler T
        Neurological effects of recombinant human interferon.
        Br Med J. 1983; 286: 262-264
        • Morag A
        • Tobi M
        • Ravid Z
        • Revel M
        • Schattner A
        Increased (2′-5′)-oligo-A synthetase activity in patients with prolonged illness associated with serological evidence of persistent Epstein-Barr virus infection.
        Lancet. 1982; i: 744