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Persisting Illness and Fatigue in Adults with Evidence of Epstein-Barr Virus Infection

STEPHEN E. STRAUS, M.D.; GIOVANNA TOSATO, M.D.; GARY ARMSTRONG, B.S.M.T.; THOMAS LAWLEY, M.D.; OLIVIA T. PREBLE, Ph.D.; WERNER HENLE, M.D.; RICHARD DAVEY, M.D.; GARY PEARSON, Ph.D.; JAY EPSTEIN, M.D.; IRENA BRUS, M.D.; and R. MICHAEL BLAESE, M.D.
[+] Article and Author Information

Grant support: in part by grant R07439 from the Uniformed Services University of the Health Sciences. Dr. Preble is the recipient of grant CA34994, and Dr. Henle of grant CA33324, from the National Institutes of Health.

▸Requests for reprints should be addressed to Stephen E. Straus, M.D.; Medical Virology Section, Building 10, Room 11N-113, National Institutes of Health; Bethesda, MD 20205.


Bethesda, Maryland; Rochester, Minnesota; New York, New York; and Philadelphia, Pennsylvania


© 1985 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1985;102(1):7-16. doi:10.7326/0003-4819-102-1-7
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Clinical, serologic, virologic, and immunologic evaluations for 31 adults with chronic illness and fatigue suggested that 23 had persisting Epstein-Barr virus infection. Among these 23 patients, cellular immune mechanisms were generally normal, but 4 had mild immunoglobulin deficiencies. However, 20 patients had abnormal serologic profiles specific for Epstein-Barr virus shown by significantly elevated titers of antibodies to the viral capsid antigen or early antigen, or by a deficiency of late-appearing antibodies. In 11 of 15 patients tested, circulating immune complexes were found. Circulating interferon was not found in 18 patients tested, but the activity of 2-5 oligoadenylate synthetase, an interferon-induced enzyme, was increased in 5 patients studied. Of 19 patients, 18 had persisting suppressor T-cell activity typically found in patients recovering from acute infectious mononucleosis. We believe that the Epstein-Barr virus may be associated with chronic illness in adults.

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