Retrovirus May Be at Root of Chronic Fatigue Syndrome

ByABC News
October 8, 2009, 5:23 PM

Oct. 9 -- THURSDAY, Oct. 8 (HealthDay News) -- About two-thirds of patients with chronic fatigue syndrome sampled in a recent study were infected with a retrovirus called XMRV.

The finding, albeit preliminary, has raised hopes that there might be a concrete cause for the mysterious malady and thus, down the line, treatments for the disease.

"This study does not prove that XMRV is the cause of chronic fatigue syndrome, however it does suggest it is a viable candidate for a cause," said Robert H. Silverman, co-author of a report appearing online Oct. 8 in Science.

"But if it can be proven that the virus causes the disease, that would be a breakthrough in diagnosing, combating and preventing the disease," added Silverman, a professor of cancer biology at the Cleveland Clinic Lerner Research Institute. "There could be an antiretroviral drug that could prevent this virus from replicating."

Another expert was similarly hopeful.

"This article could give a spark of hope, one, that chronic fatigue syndrome is caused by something, and two, if that bears out, maybe we could do something about it," said Dr. Tamara Kuittinen, an emergency physician with Lenox Hill Hospital in New York City.

Chronic fatigue syndrome was first recognized in the late 1980s and initially dubbed the "yuppie flu," resulting in an enduring credibility crisis.

Some segments of the medical community do not believe it is a discrete illness because there is no known cause, and diagnosis can only be made through excluding other conditions, such as depression.

"There's no test, no clear etiology, the symptoms are vague, there's no treatment and no cure," said Kuittinen. "It's very frustrating."

Possible explanations for the disease have been far-reaching, ranging from different viruses, including Epstein-Barr, enteroviruses and herpes, to childhood trauma.

The illness affects an estimated 1 percent of people worldwide and, as its name implies, involves crippling fatigue as well as aching joints, headaches and various other symptoms.

Recently, XMRV was detected in prostate cancer patients and in prostate tumor biopsies. Like other retroviruses, it can activate latent viruses in the body, such as Epstein-Barr, which has been linked to chronic fatigue syndrome.

For this study, researchers analyzed 101 blood samples taken from patients with chronic fatigue syndrome and found the virus in 68 of the samples, as compared with only eight samples in 218 healthy patients (67 percent versus 3.7 percent).

Although 3.7 percent seems a small proportion, the authors do note that this could mean millions of people are infected with a virus whose effects are as yet unknown.

Retroviruses, a group that includes both XMRV and HIV, have genomes made of RNA instead of DNA.

"When the virus infects cells, the RNA gets copied into the DNA, then the DNA inserts itself or integrates into the host DNA," explained Silverman. "One of the many problems with infections with retroviruses is that it's very difficult to actually cure the patient because the virus DNA becomes part of the infected person's DNA. Patients need to continually take drugs to keep it from replicating."

XMRV is simpler than HIV, though, Silverman added, which is a good thing. "It's a kind of stripped down version of a retrovirus. It has just the genes required for infection and replication. We could probably stop it with an antiretroviral drug."

There's also the possibility that a vaccine would prevent people from being infected in the first place.

But, stressed Silverman, "there are lots of qualifiers because it hasn't actually been proven that it causes disease, although the evidence looks pretty intriguing. This is an area that needs more research."

More information

The U.S. Centers for Disease Control and Prevention has more on chronic fatigue syndrome.

SOURCES: Tamara R. Kuittinen, M.D., emergency physician, Lenox Hill Hospital, New York City; Robert H. Silverman, Ph.D., professor, cancer biology, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio; Oct. 8, 2009, Science, online

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