Published online ahead of print on 9 December 2009 as
doi:10.1099/vir.0.017590-0
J Gen Virol (2009), DOI 10.1099/vir.0.017590-0
C 2009 Society for General Microbiology
Antibody to parvovirus B19 nonstructural protein is associated with chronic
arthralgia in patients with Chronic Fatigue Syndrome / Myalgic
Encephalomyelitis (CFS/ME)
Jonathan R. Kerr1,7, John Gough1, Selwyn C. M. Richards2, Janice Main3,
Derek Enlander4, Michelle McCreary5, Anthony L. Komaroff5 and John K. Chia6
1 St George's University of London;
2 Poole Hospital NHS Trust;
3 Imperial College London;
4 New York ME/CFS Service;
5 Brigham & Women's Hospital, Harvard Medical School;
6 ID Med, Torrance, CA
7 E-mail: jkerr@sgul.ac.uk
(Tom: This was one long paragraph but I've given every line a paragraph)
Chronic Fatigue Syndrome / Myalgic Encephalomyelitis (CFS/ME) is a
neuro-immune disease of uncertain pathogenesis.
Human parvovirus B19 infection has been shown to occur just prior to
development of the onset of CFS/ME in several cases, although B19
seroprevalence studies do not shown any significant differences between
CFS/ME and controls.
In this study, we analysed parvovirus B19 markers in CFS/ME patients
(n=200), diagnosed according to Fukuda CDC criteria, and normal blood donors
(n=200).
Serum from each subject was tested for anti-B19 VP2 IgM and IgG (by Biotrin
ELISA), anti-B19 NS1 IgM and IgG (by immunoflourescence), and B19 DNA by
real-time PCR.
CFS/ME patients and normal blood donors had a similar B19 seroprevalence
(75% versus 78%, respectively).
Eighty-three CFS patients (41.5%) as compared with fourteen (7%) of normal
blood donors tested positive for anti-B19 NS1 IgG (2= 64.8; P<0.0001; Odds
ratio = 9.42, CI 5.11 - 17.38).
Of these 83 patients, 61 complained of chronic joint pain, while 22 did not.
Parvovirus B19 DNA was detected in serum of 11 CFS patients and none of the
controls by Taqman real-time PCR (2 = 9.35, P<0.002.
Positivity for anti-B19 NS1 IgG was associated with higher expression levels
of the human CFS-associated genes NHLH1 and GABPA.
As NS1 antibodies are thought to indicate chronic or severe courses of B19
infection, these findings suggest that although the seroprevalence of B19 in
CFS patients is similar to controls, the immune control of the virus may not
be efficient.
Received 13 October 2009; accepted 4 December 2009.
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