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Assessment of a Retrovirus Sequence and Other Possible Risk Factors for the Chronic Fatigue Syndrome in Adults

Ali S. Khan, MD; Walid M. Heneine, PhD; Louisa E. Chapman, MD, MSPH; Howard E. Gary, PhD; Toni C. Woods, MS; Thomas M. Folks, PhD; and Lawrence B. Schonberger, MD, MPH
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From the Centers for Disease Control and Prevention, Atlanta, Georgia. Requests for Reprints: Ali Khan, MD, Centers for Disease Control and Prevention, Mailstop A-32, 1600 Clifton Road, Atlanta, GA 30333. Acknowledgments: The authors thank Dr. David Connell of Abt Associates for his role in establishing the surveillance system that identified the CFS patients and for helping to recruit neighborhood controls; Drs. Brian W. J. Mahy, William C. Reeves, and James Dobbins for reviewing the study protocols and offering valuable suggestions; Dr. Joseph A. Wilber and Mr. J. David Smith of the Division of Public Health, Georgia State Department of Human Resources for supporting this study; Dr. Renu Lal for performing HTLV-I/II serologic testing; Mr. John O'Connor for providing editorial assistance; Ms. Lois Vernon for assisting in data management; the Atlanta CFS support group; and the participants in this study.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1993;118(4):241-245. doi:10.7326/0003-4819-118-4-199302150-00001
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Objective: To assess whether the human T-lymphotropic virus type 2 (HTLV-II) gag gene sequence, a purportedly new laboratory marker of the chronic fatigue syndrome (CFS), and other possible risk factors for CFS, particularly those associated with retroviral transmission, are associated with well-characterized CFS.

Design: Two matched case–control studies.

Setting: The metropolitan Atlanta area.

Patients: Twenty-one patients with CFS who were identified by the Centers for Disease Control and Prevention CFS surveillance system; 21 CDC employee controls (laboratory study) and 42 neighborhood controls (risk-factor study) who were matched to patients by age, race, and gender.

Measurements: Peripheral blood lymphocytes and leukocytes were assayed for the HTLV-II gag gene sequence by polymerase chain reaction and specific Southern blot hybridization. Questionnaires elicited demographic and clinical information and a history of exposures associated with retrovirus transmission (for example, blood transfusions, sexual practices, intravenous drug use).

Results: All patients were white and 86% were female. The median age at illness onset was 34 years (range, 16 to 51 years). The HTLV-II gag gene sequence was not identified in the blood of any patient or control under conditions in which the appropriate assay controls were positive. No statistical differences were observed between patients and controls in frequency of blood transfusions (10% compared with 7%), median number of sex partners before illness (3 compared with 3), bisexual or homosexual behavior (14% compared with 7%), intravenous drug use (0% compared with 0%), and other factors associated with retroviral infection.

Conclusions: The HTLV-II gag gene sequence was not a marker for CFS in this small study of well-defined patients, nor did other characteristics of the patients and controls support the hypothesis that a retrovirus, transmitted by usual modes, was a cause of CFS.


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Figure 1.
A representative polymerase chain reaction analysis of the human T-lymphotropic virus type 2 (HTLV-II) gag gene sequence.

Blot is shown for eight patients with the chronic fatigue syndrome (lanes 1, 2, 4, 5, 7, 8, 10, and 11); four healthy controls (lanes 3, 6, 9, and 12); 2 µg of carrier DNA containing 20, 2, 0.2, and 0.02 ng of DNA from an HTLV-II-infected cell line (Mo-T) (lanes, 15, 16, 17, and 18, respectively); noninfected Hut-78 (lane 13); molecular size marker (lane 14); and reagent cocktail control (lane 19).

Grahic Jump Location




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