List of herpesvirus infection studies

From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history

Herpesvirus family viruses including Epstein-Barr virus, human herpesvirus 6 (HHV-6) and cytomegalovirus are associated with myalgic encephalomyelitis. This article lists herpesvirus studies examining the role and prevalence of herpesviruses in ME/CFS patients. Positive studies (finding herpesvirus more prevalent in ME/CFS patients than healthy controls) are indicated by a + symbol, whereas negative studies (finding no significant difference in prevalence between patients and healthy controls) are indicated by the symbol.

Epstein-Barr virus studies[edit | edit source]

Epstein-Barr virus (EBV) is found in 95% of the adult population (usually in a latent state),[1] and is the most common cause of mononucleosis.

Study Title Date Details
+ Chronic fatigue syndrome: clinical condition associated with immune activation

A L Landay, C Jessop, E T Lennette, J A Levy[2]

1991 This study found CFS patients had a significantly higher prevalence of antibodies to EBV-EA (Early Antigen) than did controls; 32 of 63 (51%) patients compared to 6 of 40 (15%) controls.
+ Persistent virus infection of muscle in postviral fatigue syndrome

L Cunningham, N E Bowles, L C Archard[3]

1991 Postviral Fatigue Syndrome (PVFS) patients suffering from chronic muscle fatiguability were studied to test their association with viral infection versus healthy controls. EBV DNA was found in muscle biopsies in 8 of 86 (9%) PVFS patients and in 0 of 36 (0%) controls.
+ Simultaneous measurement of antibodies to Epstein-Barr virus, human herpesvirus 6, herpes simplex virus types 1 and 2, and 14 enteroviruses in chronic fatigue syndrome: is there evidence of activation of a nonspecific polyclonal immune response?

F A Manian[4]

1994 20 patients with CFS and 20 age- and gender-matched controls were compared to test for potential differences in viral antibody titers. EBV viral capsid antigen (VCA) IgG was present at titers ≥ 1:320 in 11 of 20 (55%) CFS patients vs. 3 of 20 (15%) Controls.
Viral serologies in patients with chronic fatigue and chronic fatigue syndrome

Dedra Buchwald, Rhoda L. Ashley, Tsilke Pearlman, Phalla Kith, and Anthony L. Komaroff[5]

1996 Large study was performed on CFS patients and healthy control subjects to compare antibodies to various viruses. Epstein-Barr virus antibody results shown in table below.
VCA IgG >1:640 VCA IgM Positive Early Antigen (EA) Positive
CFS Patients 24 of 308 (8%) 2 of 310 (1%) 56 of 306 (18%)
Healthy Controls 1 of 30 (3%) 1 of 30 (3%) 7 of 30 (23%)
+ Diagnostic evaluation of 2′, 5′-oligoadenylate synthetase activities and antibodies against Epstein–Barr virus and Coxiella burnetii in patients with chronic fatigue syndrome in Japan

Kazufumi Ikuta, Takeshi Yamada, Tokio Shimomura, Hirohiko Kuratsune, Ryuzo Kawahara, Shiro Ikawa, Eiko Ohnishi, Yoshihiro Sokawa, Hideto Fukushi, Katsuya Hirai, Yasuyoshi Watanabe, Takeshi Kurata, Teruo Kitani, Takeshi Sairenji[6]

2003 A total of 44 ME/CFS patients from two Japanese hospitals located in different areas of the country were tested for EBV Early Antigen (EA) antibodies, and were compared to healthy controls. EA IgG was found positive in 9 of 44 (20%) CFS patients and 0 of 9 (0%) controls.
+ IgM serum antibodies to Epstein-Barr virus are uniquely present in a subset of patients with the chronic fatigue syndrome

A Martin Lerner, Safedin H Beqaj, Robert G Deeter, James T Fitzgerald[7]

2004 58 ME/CFS patients and 68 non-CFS matched controls were studied for possible active EBV infection through serum antibodies. VCA IgM was positive in 33 of 58 (57%) CFS patients and 5 of 68 (7%) controls. Early Antigen (EA) IgG was positive in 51 of 58 (88%) CFS patients and 24 of 68 (35%) controls.
+ Chronic fatigue syndrome after infectious mononucleosis in adolescents

Ben Z Katz, Yukiko Shiraishi, Cynthia J Mears, Helen J Binns, Renee Taylor [8]

2009 This study of 301 adolescents with infectious mononucleosis found that at 6, 12, and 24 months after mononucleosis, 13%, 7%, and 4% of these adolescents respectively met the criteria for ME/CFS.
Detection of herpesviruses and parvovirus B19 in gastric and intestinal mucosa of chronic fatigue syndrome patients

Marc Frémont, Kristine Metzger, Hamada Rady, Jan Hulstaert, Kenny De Meirleir[9]

2009 Stomach and duodenum biopsies using DNA PCR found only a slight increase in CFS patients that were positive for EBV compared to controls.
CFS Patients Healthy Controls
DNA Stomach Biopsy 10 of 48 (21%) 6 of 35 (17%)
DNA Duodenum Biopsy 15 of 48 (31%) 5 of 35 (15%)
+ Antibody to Epstein-Barr virus deoxyuridine triphosphate nucleotidohydrolase and deoxyribonucleotide polymerase in a chronic fatigue syndrome subset

A Martin Lerner, Maria E Ariza, Marshall Williams, Leonard Jason, Safedin Beqaj, James T Fitzgerald, Stanley Lemeshow, Ronald Glaser [10]

2012 This study of 20 ME/CFS patients and 20 healthy controls found 94% of patients were positive for EBV early antigen diffuse, versus 32% of the healthy controls; 44% of patients were positive for EBV dUTPase, versus 0% of the controls; 79% of patients were positive for EBV DNA polymerase, versus 0% of the controls.
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Gulf War Illness patients exhibit increased humoral responses to the Herpesviruses-encoded dUTPase: Implications in disease pathophysiology

Peter Halpin, Marshall Vance Williams, Nancy G. Klimas, Mary Ann Fletcher, Zachary Barnes, Maria Eugenia Ariza[11]

2017 Antibodies against multiple human herpesviruses-encoded dUTPases were shown as being simultaneously produced in (30.91–52.7%) ME/CFS patients and (17.21%) of controls. EBV dUTPase antibodies were present in 16 of 55 (29%) CFS patients and 39 of 151 (26%) controls.
+ Cytomegalovirus, Epstein‐Barr virus, and human herpesvirus‐6 infections in patients with myalgic еncephalomyelitis/chronic fatigue syndrome

Evelina Shikova, Valentina Reshkova, Аntoniya Kumanova, Sevdalina Raleva, Dora Alexandrova, Natasa Capo, Modra Murovska[12]

2020 Study of 58 Bulgarian ME/CFS patients and 50 healthy controls found EBV DNA in the plasma of 14 of 58 (24%) patients vs. 2 of 50 (4%) controls.

HHV-6 studies[edit | edit source]

HHV-6 is found in nearly 100% of adults (usually in a latent state).[13]

Study Title Date Details
+ A chronic illness characterized by fatigue, neurologic and immunologic disorders, and active human herpesvirus type 6 infection

Dedra Buchwald, Paul R Cheney, Daniel L Peterson, Berch Henry, Susan B Wormsley, Ann Geiger, Dharam V Ablashi, S Zaki Salahuddin, Carl Saxinger, Royce Biddle, Ron Kikinis, Ferenc A Jolesz, Thomas Folks, N Balachandran, James B Peter, Robert C Gallo, Anthony L Komaroff[14]

1992 This study reviewed patients in the Lake Tahoe area with a chronic debilitating illness of acute onset, a portion of which were regularly bedridden or shut-in. Using lymphocyte cell culture, DNA PCR, and monoclonal antibody assay, active HHV-6 replication was found in 79 of 113 (70%) patients and 8 of 40 (20%) controls.

Despite limitations of this study involving a small geographic area and relatively moderate study size, the results may be seen as significant due to the extensive analysis, and investigative measures conducted. Measurements used in the study include Magnetic Resonance Imaging (MRI), cerebrospinal fluid (CFS) analysis, standard lab testing, lymphocyte phenotyping, cell culture bioassay, and serologic testing.

+ Prevalence of human herpesvirus 6 variants A and B in patients with chronic fatigue syndrome

S Yalcin, H Kuratsune, K Yamaguchi, T Kitani, K Yamanishi [15]

1994 This study examined 13 cases of ME/CFS and 13 healthy controls. In the peripheral blood mononuclear cells, HHV-6 DNA was detected in 53% of the patients, but no HHV-6 DNA was detected in the controls. Higher antibody levels to the HHV-6 late antigen were found in patients, and antibodies to HHV-6 early antigen were more prevalent in patients.
+ Human herpesvirus 6 and human herpesvirus 7 in chronic fatigue syndrome

D Di Luca, M Zorzenon, P Mirandola, R Colle, G A Botta, E Cassai[16]

1995 This study of CFS patients and healthy controls found the presence of either HHV-6A or HHV-6B DNA by PCR in 26 of 36 (44%) CFS patients and 7 of 24 (29%) controls; and found HHV-6A DNA in 8 of 36 (22%) patients and 1 of 24 (4%) controls.
+ Prevalence of IgM antibodies to human herpesvirus 6 early antigen (p41/38) in patients with chronic fatigue syndrome

M Patnaik, A L Komaroff, E Conley, E A Ojo-Amaize, J B Peter[17]

1995 Fairly large study using 2 geographically separate groups of patients to evaluate the possible association of HHV-6 infection with chronic fatigue syndrome (CFS). Methods involved prevalence of IgG and IgM antibodies against HHV-6 early antigen (EA), perhaps indicating active replication.

Elevated HHV-6 EA-specific IgG or IgM antibody titers were found in 119 of 154 (77%) CFS patients and 20 of 165 (12%) controls.

+ Viral serologies in patients with chronic fatigue and chronic fatigue syndrome

Dedra Buchwald, Rhoda L. Ashley, Tsilke Pearlman, Phalla Kith, and Anthony L. Komaroff[14]

1996 Large study was performed on CFS patients and healthy control subjects to compare antibodies to various viruses. HHV-6 virus antibody IgG were ≥12,800 in 39 of 295 (13%) CFS patients and 2 of 30 (7%) controls.
Human Herpesviruses in Chronic Fatigue Syndrome

Howard L. Wallace, II, Benjamin Natelson, William Gause, John Hay[18]

1999 This study of civilian and Persian Gulf War veterans found HHV-6 DNA in the peripheral blood of 26 of 74 (35%) CFS patients and 19 of 71 (27%) controls.
Human herpesviruses 6 and 7 in chronic fatigue syndrome: a case-control study

W C Reeves, F R Stamey, J B Black, A C Mawle, J A Stewart, P E Pellett[19]

2000 Study on infection association of human herpesvirus (HHV) 6A, HHV-6B, or HHV-7 between ME/CFS patients and healthy controls. HHV-6 DNA was found in 3 of 26 (12%) patients and 15 of 50 (28%) controls.
+ Frequent HHV-6 reactivation in multiple sclerosis (MS) and chronic fatigue syndrome (CFS) patients

D V Ablashi, H B Eastman, C B Owen, M M Roman, J Friedman, J B Zabriskie, D L Peterson, G R Pearson, J E Whitman[20]

2000 This study of 35 ME/CFS patients and 25 healthy controls found higher levels of HHV-6 Early Antigen (EA) IgM antibody in 54% of patients versus 8% of controls; and found EA IgG in 66% of patients versus 20% of controls.
+ Multiple co-infections (Mycoplasma, Chlamydia, human herpes virus-6) in blood of chronic fatigue syndrome patients: association with signs and symptoms

G L Nicolson, R Gan, J Haier[21]

2003 This fairly large study used polymerase chain reaction (PCR) in an attempt to show evidence of active human herpes virus-6 (HHV-6) infections, as well as Mycoplasma and Chlamydia Pneumoniae infections in CFS patients. HHV-6 DNA was detected in 61 of 200 (31%) CFS patients and 9 of 100 (9%) healthy controls.

While none of the controls had co-infections, multiple co-infections found in CFS patients included multiple Mycoplasmal infections (22%), HHV-6 + Mycoplasma (16%), C. pneumoniae + Mycoplasma (4%), and C. pneumoniae + HHV-6 (2.5%).

Detection of Herpesviruses and Parvovirus B19 in Gastric and Intestinal Mucosa of Chronic Fatigue Syndrome Patients

Marc Frémont, Kristine Metzger, Hamada Rady, Jan Hulstaert, Kenny De Meirleir[22]

2009 A study to investigate the presence of HHV-6, HHV-7, EBV and parvovirus B19 in the gastro-intestinal tract of CFS patients found HHV-6 stomach biopsy DNA in 15 of 48 (31%) CFS patients and 10 of 35 (29%) controls.
+ Association of Active Human Herpesvirus-6, -7 and Parvovirus B19 Infection with Clinical Outcomes in Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Svetlana Chapenko, Angelika Krumina, Inara Logina, Santa Rasa, Maksims Chistjakovs, Alina Sultanova, Ludmila Viksna, Modra Murovska[23]

2012 This study of 108 ME/CFS patients and 90 healthy controls found HHV-6 DNA in plasma samples of 16 of 108 (15%) ME/CFS patients and 0 of 90 (0%) healthy controls.

Of the 16 HHV-6 positive CFS patients, 14 of 16 were co-infections with HHV-7 and/or Parvovirus B19, where only 2 of 16 were single HHV-6 infections.[24]

+ Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Gulf War Illness patients exhibit increased humoral responses to the Herpesviruses-encoded dUTPase: Implications in disease pathophysiology

Peter Halpin, Marshall Vance Williams, Nancy G. Klimas, Mary Ann Fletcher, Zachary Barnes, Maria Eugenia Ariza[11]

2017 A study surrounding the involvement of herpesvirus as a possible trigger for ME/CFS as well as the involvement of herpesvirus in the pathophysiology of Gulf War Illness (GWI) patients. A separate set of healthy controls were used for comparison and matched to ME/CFS and GWI cases by age, gender, and race/ethnicity.

Antibodies against multiple human herpesviruses-encoded dUTPases were shown as being simultaneously produced in (30.91–52.7%) ME/CFS patients and (17.21%) of controls. HHV-6 dUTPase antibodies were present in 29 of 55 (53%) CFS patients and 45 of 151 (30%) controls.

+ Cytomegalovirus, Epstein‐Barr virus, and human herpesvirus‐6 infections in patients with myalgic еncephalomyelitis/chronic fatigue syndrome

Evelina Shikova, Valentina Reshkova, Аntoniya Kumanova, Sevdalina Raleva, Dora Alexandrova, Natasa Capo, Modra Murovska[12]

2020 Study of 58 Bulgarian ME/CFS patients and 50 healthy controls found HHV-6 DNA in the plasma of 1 of 58 (1.7%) patients vs. 0 of 50 (0%) controls.

Cytomegalovirus studies[edit | edit source]

Cytomegalovirus is found in 58% of adults (usually in a latent state).[25] Cytomegalovirus is a rarer cause of mononucleosis.

Study Title Date Details
Viral serologies in patients with chronic fatigue and chronic fatigue syndrome

Dedra Buchwald, Rhoda L. Ashley, Tsilke Pearlman, Phalla Kith, and Anthony L. Komaroff[5]

1996 Large study was performed on CFS patients and healthy control subjects to compare antibodies to various viruses. Cytomegalovirus (CMV) antibody IgG were > 2,048 in 9 of 285 (3%) CFS patients and 1 of 30 (3%) controls.
+ Cytomegalovirus, Epstein‐Barr virus, and human herpesvirus‐6 infections in patients with myalgic еncephalomyelitis/chronic fatigue syndrome

Evelina Shikova, Valentina Reshkova, Аntoniya Kumanova, Sevdalina Raleva, Dora Alexandrova, Natasa Capo, Modra Murovska[12]

2020 Study of 58 Bulgarian ME/CFS patients and 50 healthy controls found CMV DNA in the plasma of 2 of 58 (3.4%) patients vs. 0 of 50 (0%) controls.

Varicella zoster virus studies[edit | edit source]

Varicella zoster virus (VZV) is found in 88% of the adult population (usually in a latent state).[26] It causes chickenpox and shingles.

Study Title Date Details
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Gulf War Illness patients exhibit increased humoral responses to the Herpesviruses-encoded dUTPase: Implications in disease pathophysiology

Peter Halpin, Marshall Vance Williams, Nancy G. Klimas, Mary Ann Fletcher, Zachary Barnes, Maria Eugenia Ariza[11]

2017 A study surrounding the involvement of herpesvirus as a possible trigger for ME/CFS as well as the involvement of herpesvirus in the pathophysiology of Gulf War Illness (GWI) patients. A separate set of healthy controls were used for comparison and matched to ME/CFS and GWI cases by age, gender, and race/ethnicity.

Varicella-zoster virus (VZV) dUTPase antibodies were present in 2 of 55 (4%) CFS patients and 13 of 151 (9%) controls.

Herpes simplex virus studies[edit | edit source]

Herpes simplex virus I is found in 54% of adults, and herpes simplex virus II in 16% of adults (usually in a latent state).[27] HSV causes oral mouth sores.

Study Title Date Details
+ Antibodies to Herpes Simplex Types 1 and 2 in Chronic Fatigue Syndrome

PA Bond & TG Dinan[28]

2011 This study of 27 ME/CFS patients and 26 healthy controls found HSV I antibodies in 74% of patients versus 42% of controls; and found HSV II antibodies in 70% of patients versus 31% of controls.
Antibodies to Human Herpesviruses in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients

Blomberg et al.[29]

2019 This study of patients meeting the Canadian Consensus Criteria for ME/CFS and/or the ACR 1990 criteria for fibromyalgia found that levels of antibodies to HSV-1 and HSV-2 were similar or slightly lower in ME/CFS patients and fibromyalgia patients compared to healthy blood donors.

HHV-7 studies[edit | edit source]

HHV-7 is found in more than 95% of the adult population (usually in a latent state).[30]

Study Title Date Details
Human herpesvirus 6 and human herpesvirus 7 in chronic fatigue syndrome

D Di Luca, M Zorzenon, P Mirandola, R Colle, G A Botta, E Cassai[16]

1995 This study of CFS patients and healthy controls found the presence of HHV-7 DNA by PCR in 23 of 28 (82%) CFS patients and 20 of 24 (83%) controls.
Human Herpesviruses in Chronic Fatigue Syndrome

Howard L. Wallace, II, Benjamin Natelson, William Gause, John Hay[18]

1999 This study of civilian and Persian Gulf War veterans found HHV-7 DNA in the peripheral blood of 58 of 75 (77%) CFS patients and 51 of 73 (70%) controls.
Human herpesviruses 6 and 7 in chronic fatigue syndrome: a case-control study

W C Reeves, F R Stamey, J B Black, A C Mawle, J A Stewart, P E Pellett[19]

2000 Study on infection association of human herpesvirus (HHV) 6A, HHV-6B, or HHV-7 between ME/CFS patients and healthy controls. HHV-7 DNA was found in 2 of 26 (8%) patients and 12 of 50 (25%) controls.
Detection of Herpesviruses and Parvovirus B19 in Gastric and Intestinal Mucosa of Chronic Fatigue Syndrome Patients

Marc Frémont, Kristine Metzger, Hamada Rady, Jan Hulstaert, Kenny De Meirleir[22]

2009 A study to investigate the presence of HHV-6, HHV-7, EBV and parvovirus B19 in the gastro-intestinal tract of CFS patients found HHV-7 stomach biopsy DNA in 44 of 48 (92%) CFS patients and 29 of 35 (83%) controls.
+ Association of Active Human Herpesvirus-6, -7 and Parvovirus B19 Infection with Clinical Outcomes in Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Svetlana Chapenko, Angelika Krumina, Inara Logina, Santa Rasa, Maksims Chistjakovs, Alina Sultanova, Ludmila Viksna, Modra Murovska[23]

2012 This study of 108 ME/CFS patients and 90 healthy controls found HHV-7 DNA in plasma samples of 57 of 108 (53%) ME/CFS patients and 10 of 90 (11%) healthy controls.

Of the 57 HHV-7 positive CFS patients, 29 of 57 were co-infections with HHV-6 and/or Parvovirus B19, where only 28 of 57 were single HHV-7 infections.[24]

See also[edit | edit source]

Learn more[edit | edit source]

References[edit | edit source]

  1. "Epstein-barr | Mononucleosis | About Virus | Mono | CDC". Centers for Disease Control and Prevention. January 28, 2019. Retrieved August 19, 2020.
  2. Landay, A.L.; Jessop, C.; Lennette, E.T.; Levy, J.A. (September 21, 1991). "Chronic fatigue syndrome: clinical condition associated with immune activation". Lancet (London, England). 338 (8769): 707–712. doi:10.1016/0140-6736(91)91440-6. ISSN 0140-6736. PMID 1679864.
  3. Cunningham, L.; Bowles, N.E.; Archard, L.C. (October 1991). "Persistent virus infection of muscle in postviral fatigue syndrome". British Medical Bulletin. 47 (4): 852–871. doi:10.1093/oxfordjournals.bmb.a072516. ISSN 0007-1420. PMID 1665379.
  4. Manian, F.A. (September 1994). "Simultaneous measurement of antibodies to Epstein-Barr virus, human herpesvirus 6, herpes simplex virus types 1 and 2, and 14 enteroviruses in chronic fatigue syndrome: is there evidence of activation of a nonspecific polyclonal immune response?". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 19 (3): 448–453. doi:10.1093/clinids/19.3.448. ISSN 1058-4838. PMID 7811864.
  5. 5.0 5.1 Buchwald, D.; Ashley, R.L.; Pearlman, T.; Kith, P.; Komaroff, A.L. (September 1996). "Viral serologies in patients with chronic fatigue and chronic fatigue syndrome". Journal of Medical Virology. 50 (1): 25–30. doi:10.1002/(SICI)1096-9071(199609)50:13.0.CO;2-V. ISSN 0146-6615. PMID 8890037.
  6. Ikuta, Kazufumi; Yamada, Takeshi; Shimomura, Tokio; Kuratsune, Hirohiko; Kawahara, Ryuzo; Ikawa, Shiro; Ohnishi, Eiko; Sokawa, Yoshihiro; Fukushi, Hideto (October 2003). "Diagnostic evaluation of 2′, 5′-oligoadenylate synthetase activities and antibodies against Epstein–Barr virus and Coxiella burnetii in patients with chronic fatigue syndrome in Japan". Microbes and Infection. 5 (12): 1096–1102. doi:10.1016/j.micinf.2003.07.002. ISSN 1286-4579.
  7. Lerner, A. Martin; Beqaj, Safedin H.; Deeter, Robert G.; Fitzgerald, James T. (March 2004). "IgM serum antibodies to Epstein-Barr virus are uniquely present in a subset of patients with the chronic fatigue syndrome". In Vivo (Athens, Greece). 18 (2): 101–106. ISSN 0258-851X. PMID 15113035.
  8. Katz, Ben Z.; Shiraishi, Yukiko; Mears, Cynthia J.; Binns, Helen J.; Taylor, Renee (July 2009). "Chronic fatigue syndrome after infectious mononucleosis in adolescents". Pediatrics. 124 (1): 189–193. doi:10.1542/peds.2008-1879. ISSN 1098-4275. PMC 2756827. PMID 19564299.
  9. Frémont, Marc; Metzger, Kristine; Rady, Hamada; Hulstaert, Jan; De Meirleir, Kenny (March 2009). "Detection of herpesviruses and parvovirus B19 in gastric and intestinal mucosa of chronic fatigue syndrome patients". In Vivo (Athens, Greece). 23 (2): 209–213. ISSN 0258-851X. PMID 19414405.
  10. Lerner, A. Martin; Ariza, Maria E.; Williams, Marshall; Jason, Leonard; Beqaj, Safedin; Fitzgerald, James T.; Lemeshow, Stanley; Glaser, Ronald (2012). "Antibody to Epstein-Barr virus deoxyuridine triphosphate nucleotidohydrolase and deoxyribonucleotide polymerase in a chronic fatigue syndrome subset". PloS One. 7 (11): e47891. doi:10.1371/journal.pone.0047891. ISSN 1932-6203. PMC 3498272. PMID 23155374.
  11. 11.0 11.1 11.2 Halpin, Peter; Williams, Marshall Vance; Klimas, Nancy G.; Fletcher, Mary Ann; Barnes, Zachary; Ariza, Maria Eugenia (September 2017). "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Gulf War Illness patients exhibit increased humoral responses to the Herpesviruses-encoded dUTPase: Implications in disease pathophysiology". Journal of medical virology. 89 (9): 1636–1645. doi:10.1002/jmv.24810. ISSN 0146-6615. PMC 5513753. PMID 28303641.
  12. 12.0 12.1 12.2 Shikova, Evelina; Reshkova, Valentina; Kumanova, Аntoniya; Raleva, Sevdalina; Alexandrova, Dora; Capo, Natasa; Murovska, Modra. "Cytomegalovirus, Epstein-Barr virus, and human herpesvirus-6 infections in patients with myalgic еncephalomyelitis/chronic fatigue syndrome". Journal of Medical Virology. n/a (n/a). doi:10.1002/jmv.25744. ISSN 1096-9071.
  13. Ansari, Asad; Li, Shaobing; Abzug, Mark J.; Weinberg, Adriana (August 2004). "Human Herpesviruses 6 and 7 and Central Nervous System Infection in Children1". Emerging Infectious Diseases. 10 (8): 1450–1454. doi:10.3201/eid1008.030788. ISSN 1080-6040. PMC 3320425. PMID 15496247.
  14. 14.0 14.1 Buchwald, Dedra; Cheney, Paul R.; Peterson, Daniel L.; Henry, Berch; Wormsley, Susan B.; Geiger, Ann; Ablashi, Dharam V.; Salahuddin, S. Zaki; Saxinger, CArl (January 15, 1992). "A chronic illness characterized by fatigue, neurologic and immunologic disorders, and active human herpesvirus type 6 infection". Annals of Internal Medicine. 116 (2): 103–113. doi:10.7326/0003-4819-116-2-103. ISSN 0003-4819. PMID 1309285.
  15. Yalcin, S.; Kuratsune, H.; Yamaguchi, K.; Kitani, T.; Yamanishi, K. (1994). "Prevalence of human herpesvirus 6 variants A and B in patients with chronic fatigue syndrome". Microbiology and Immunology. 38 (7): 587–590. doi:10.1111/j.1348-0421.1994.tb01827.x. ISSN 0385-5600. PMID 7968694.
  16. 16.0 16.1 Luca, D. Di; Zorzenon, M.; Mirandola, P.; Colle, R.; Botta, G.A.; Cassai, E. (June 1, 1995). "Human herpesvirus 6 and human herpesvirus 7 in chronic fatigue syndrome". Journal of Clinical Microbiology. 33 (6): 1660–1661. ISSN 0095-1137. PMID 7650209.
  17. Patnaik, M.; Komaroff, A.L.; Conley, E.; Ojo-Amaize, E.A.; Peter, J.B. (November 1995). "Prevalence of IgM antibodies to human herpesvirus 6 early antigen (p41/38) in patients with chronic fatigue syndrome". The Journal of Infectious Diseases. 172 (5): 1364–1367. doi:10.1093/infdis/172.5.1364. ISSN 0022-1899. PMID 7594679.
  18. 18.0 18.1 Wallace, Howard L.; Natelson, Benjamin; Gause, William; Hay, John (March 1999). "Human Herpesviruses in Chronic Fatigue Syndrome". Clinical and Diagnostic Laboratory Immunology. 6 (2): 216–223. ISSN 1071-412X. PMID 10066657.
  19. 19.0 19.1 Reeves, W.C.; Stamey, F.R.; Black, J.B.; Mawle, A.C.; Stewart, J.A.; Pellett, P.E. (July 2000). "Human herpesviruses 6 and 7 in chronic fatigue syndrome: a case-control study". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 31 (1): 48–52. doi:10.1086/313908. ISSN 1058-4838. PMID 10913395.
  20. Ablashi, D.V.; Eastman, H.B.; Owen, C.B.; Roman, M.M.; Friedman, J.; Zabriskie, J.B.; Peterson, D.L.; Pearson, G.R.; Whitman, J.E. (May 2000). "Frequent HHV-6 reactivation in multiple sclerosis (MS) and chronic fatigue syndrome (CFS) patients". Journal of Clinical Virology: The Official Publication of the Pan American Society for Clinical Virology. 16 (3): 179–191. doi:10.1016/s1386-6532(99)00079-7. ISSN 1386-6532. PMID 10738137.
  21. Nicolson, G.L.; Gan, R.; Haier, J. (May 2003). "Multiple co-infections (Mycoplasma, Chlamydia, human herpes virus-6) in blood of chronic fatigue syndrome patients: association with signs and symptoms". APMIS: acta pathologica, microbiologica, et immunologica Scandinavica. 111 (5): 557–566. doi:10.1034/j.1600-0463.2003.1110504.x. ISSN 0903-4641. PMID 12887507.
  22. 22.0 22.1 Frémont, Marc; Metzger, Kristine; Rady, Hamada; Hulstaert, Jan; De Meirleir, Kenny (March 2009). "Detection of herpesviruses and parvovirus B19 in gastric and intestinal mucosa of chronic fatigue syndrome patients". In Vivo (Athens, Greece). 23 (2): 209–213. ISSN 0258-851X. PMID 19414405.
  23. 23.0 23.1 Chapenko, Svetlana; Krumina, Angelika; Logina, Inara; Rasa, Santa; Chistjakovs, Maksims; Sultanova, Alina; Viksna, Ludmila; Murovska, Modra (August 13, 2012). "Association of Active Human Herpesvirus-6, -7 and Parvovirus B19 Infection with Clinical Outcomes in Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome". Advances in Virology. Retrieved August 20, 2020.
  24. 24.0 24.1 "Table 1 | Association of Active Human Herpesvirus-6, -7 and Parvovirus B19 Infection with Clinical Outcomes in Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome". hindawi.com. Retrieved August 20, 2020.
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