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No serological evidence for a role of HHV-6 infection in chronic fatigue syndrome ?!

Discussion in 'Latest ME/CFS Research' started by Omar88, Nov 13, 2012.

  1. Omar88

    Omar88 Senior Member

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    http://www.ncbi.nlm.nih.gov/pubmed/23145212

    Human herpesvirus 6A (HHV-6A) and human herpesvirus 6B (HHV-6B) are associated with a variety of conditions including rash, fever, and encephalitis and may play a role in several neurological diseases. Here luciferase immunoprecipitation systems (LIPS) was used to develop HHV-6 serologic diagnostic tests using antigens encoded by the U11 gene from HHV-6A (p100) and HHV-6B (p101). Analysis of the antibody responses against Renilla luciferase fusions with different HHV-6B p101 fragments identified an antigenic fragment (amino acids 389 to 858) that demonstrated ~86% seropositivity in serum samples from healthy US blood donors. Additional experiments detected a HHV-6A antigenic fragment (amino acids 751-870) that showed ~48% antibody seropositivity in samples from Mali, Africa, a known HHV-6A endemic region. In contrast to the high levels of HHV-6A immunoreactivity seen in the African samples, testing of US blood donors with the HHV-6A p100 antigenic fragment revealed little immunoreactivity. To potentially explore the role of HHV-6 infection in human disease, a blinded cohort of controls (n=59) and chronic fatigue syndrome (CFS) patients (n=72) from the US was examined for serum antibodies. While only a few of the controls and CFS patients showed high level immunoreactivity with HHV-6A, a majority of both the controls and CFS patients showed significant immunoreactivity with HHV-6B. However, no statistically significant differences in antibody levels or frequency of HHV-6A or HHV-6B infection were detected between the controls and CFS patients. These findings highlight the utility of LIPS for exploring the seroepidemiology of HHV-6A and HHV-6B infection, but suggest that these viruses are unlikely to play a role in the pathogenesis of CFS
    taniaaust1 and nanonug like this.
  2. Sparrow

    Sparrow Senior Member

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    Yeah. If you test healthy people, they often show elevated levels for EBV, HHV-6, etc. That's why "conventional" doctors tend to ignore those results.

    I'm not convinced viral reactivation isn't a factor at all, though.
    Little Bluestem and merylg like this.
  3. nanonug

    nanonug Senior Member

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    Why wouldn't they? It seems like a reasonable conclusion to think that the problem is not with the virus per se but maybe the way the body is handling it. What if the healthy people just have "healthy" immune systems and CFS people have the opposite? In this case, the problem would be immunologic, not viral.
    tyson oberle, Shell and justy like this.
  4. Omar88

    Omar88 Senior Member

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    Its really become annoying that we are in the end of 2012 and we are just getting those information , the only information we are getting is ruling out what we thought is causing our illness while we are not getting any new ideas of viral or immune disorders that could be the causes !!

    Am afraid that we will get to a point that they will treat as as physical illness patient and that what they are trying to do :(
  5. CBS

    CBS Senior Member

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    I would urge some caution in drawing conclusions from this study about what is and is not associated with ME. As nanonug wrote:

    This study does not claim that the HHV-6 virus is not involved in ME/CFS, but that elevated serologic levels of HHV-6 antibodies are no more prevalent in CFS patients than in healthy controls. There is nothing in this study about the possibility that an immunologic abnormality/deficiency could be resulting in a very atypical presentation of (and significant morbidity associated with) what is a relatively common viral infection. It is easy to read more into a headline/title than is actually there.
    SOC likes this.
  6. maryb

    maryb Senior Member

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    I have always tested negative for past or present infection of HHV-6, so for me it is not relevant in my illness, I agree its probably about how the body deals with the herpes viruses rather than which virus is causing the symptoms.
  7. SOC

    SOC Back to work (easy, part-time work)

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    My HHV-6 antibody titres were not sky high, but I had all the symptoms of herpesvirus infection(s). I got a huge improvement from Valcyte, which suggests that I did, indeed, have some infection that is significantly impacted by Valcyte. My antibody titres actually increased for a while before dropping again. My guess is that my body was not producing enough antibodies until my immune system was able to recover a bit during Valcyte treatment.

    I doubt antibody titres are necessarily a reliable indicator of herpesvirus infections in PWME unless it can be confirmed that the patient's body is actually capable of producing those antibodies when needed. IMO, that's where the vast majority of the medical world is falling down with ME/CFS. They assume we have fully functioning immune systems and judge test results according to their (often incorrect) assumption.
    NK17, taniaaust1, Shell and 4 others like this.
  8. Sparrow

    Sparrow Senior Member

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    I'm totally fine with thinking the problem is in the way the body is handling it. That's my theory as well. But that seems not to be the direction many people are going with it. Many doctors don't stop to consider that the body may not be handling it normally or coping well or producing a proportionate number of antibodies as what a healthy person would. They just see same levels = not a factor, while viruses may still be involved in perpetuating an autoimmune response or in some of the symptoms we experience (either directly or indirectly).

    I'm not trying to get down on doctors either. It just seems to be one of those areas where I feel like many write off potential connections too fast. Like SOC mentioned, even the test itself is only valid if you assume the person's immune system is producing a healthy number of antibodies. And it's odd to me that a subgroup of patients shows significant improvement on anti-virals if there were no connection at all.
  9. soxfan

    soxfan Senior Member

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    I have always had high HHV6 titers in every test I have had...even from different labs. I was seeing Dr. Komaroff and even though my titer was extremely high he told me there just wasn't enough evidence to prove whether it was an reactivated infection or past.
    I don't believe my symptoms have anything to do with this as I fully believe whatever infected me is long gone and I am left with permanent damage. I have been dealing with the same symptoms for 8 years (the same ones I started off with) and no matter what I have taken whether it is anti virals or abx (except for rocephin) they still remain.
  10. wastwater

    wastwater

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    I followed the link and on the same page there seems to be a complete contradiction.The paper from 2000 suggests there is a link.It made me laugh in the end because that's the typical state of play in this.There might be something in the idea of mishandling simple infections.Might be something in it being a metabolic pathways disorder and essential fatty acids and antioxidants are meant to help
  11. kaffiend

    kaffiend Senior Member

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    There was a case study published last year reporting HHV-6 infection as the cause of fatal myocarditis (found on tissue biopsy). The paper states that only low levels of IgG were found both pre- and postmortem in serum. So, it's possible to have a reactivated infection without serological evidence.
  12. nanonug

    nanonug Senior Member

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    Which pretty much confirms the uselessness of serological tests!
    alex3619 and Shell like this.
  13. ukxmrv

    ukxmrv Senior Member

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    I wonder if they would have said that same thing about HHV8 or as it was known in the early AIDS days Kaposi's Sarcoma?

    <quote>

    KS was thought to be an uncommon tumor of Jewish and Mediterranean populations until it was realized that it is actually quite common throughout sub-Saharan Africa. This led to the first suggestions in the 1950s that this tumor might be caused by a virus. With the onset of the AIDS epidemic in the early 1980s, there was a sudden epidemic resurgence of KS affecting primarily gay and bisexual AIDS patients with up to 50% of reported AIDS patients having this tumor—an extraordinary rate of cancer predisposition. Careful analysis of epidemiologic data by Valerie Beral, Thomas Peterman and Harold Jaffe,[2] led these investigators to propose that KS is caused by an unknown sexually transmitted virus that rarely causes tumors unless the host becomes immunosuppressed

    http://en.wikipedia.org/wiki/Kaposi's_sarcoma-associated_herpesvirus
    NK17 likes this.
  14. CBS

    CBS Senior Member

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    SOC,

    Your response to Valcyte, your titer levels (actually increasing after being on Valcyte before eventually decreasing), and your impression of the utility of basic anti-body levels could not be more similar to my own experiences and conclusions. Medicine is looking right past a core problem with ME because of the simple assumption that test results which are founded upon a functioning immune system are valid in this population (treating antibodies as thought they were a direct measure of an infection rather than a indirect measure and instead are a measure of the body's response to an infection, a critical distinction).

    Shane
    NK17, vli and SOC like this.
  15. satoshikasumi

    satoshikasumi Senior Member

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    There is nothing wrong with replication studies, but this has been studied before, ad nauseum. The authors don't review the literature on this topic- Dr. Knox and Dr. Ablashi have reviewed it before. See www.hhv-6foundation.org.

    In short, the overwhelming majority of studies that use methods capable of distinguishing active and latent infections show a significant association between active HHV-6 and ME/CFS. Studies that do not use methods that distinguish active and latent infections, including serological studies, have failed to show an association.

    The conclusion: ME/CFS patients are no more likely than healthy people to have been infected with HHV-6 at some point. Antibody titers alone, without showing recent 4-fold rise in titer, are not reliable indicators of active infection. But, ME/CFS patients are more likely to have this virus actively replicating in their blood and spinal fluid.
  16. satoshikasumi

    satoshikasumi Senior Member

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    "Efforts to establish an association between HHV-6 infection and CFS have been complicated by the fact that several studies have been published using tests that don’t differentiate between active and latent HHV-6 infection. Studies that utilized such assays showed no association between HHV-6 and CFS, contradicting the positive studies and creating confusion. However, when assays able to distinguish active and latent infection have been employed (by surveying for specific agents such as IgG “early antigen” antibodies, which are present only during active viral infection), strong disease associations have been observed, suggesting an important role for HHV-6 in CFS.
    For example, Ablashi et al found that 57% of CFS patients were positive for IgM early antigen antibodies, compared to only 8% of controls; this group also found that CFS patients had a greater lymphocyte response (Ablashi 2000). Buchwald et al found that 70% of 114 CFS patients were positive for HHV-6 by primary cell culture, as compared to 20% of controls (Buchwald 1992). However, when assays such as qualitative PCR testing on whole blood were used, there was often no significant difference found between patients and controls (Reeves 2000, Wallace 1999). This is because most healthy adults have a small amount of latent HHV-6 DNA in the whole blood."
  17. MishMash

    MishMash *****

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    I had reactivated HHV-6, then a year later it went away. So I'm pretty sure it is not associated with the basis of CFS. Several other viruses reactivated, like Q-virus and EBV, which I guess we all have. The Q virus, I was told, was associated with living around cattle or some such thing, and it very prevalent in Australia. I guess because they have a lot of sheep there (?)

    The MS people went down that path about HHV-6 being responsible for their illness in the late 90s. I went to an MS support group meeting with a friend, and the MS neurologist specialist who was speaking was basically shouted down by a room full of mostly-female MS patients. It got pretty rowdy. At the time, I thought, Wow, that guy's really insensitive, doesn't he realize this is the key to MS? As it turns out, he was right.

    Why is it so damned hard to be right in science?
    nanonug likes this.
  18. August59

    August59 Daughters High School Graduation

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    I thibk something is happening that allows them to reactivate. I had posted an article on here somewhere that sshowed that Astronauts started having higher and higher levels of EBV up until lauch time and it stayed elevated for their entire trip I believe and during return to earth. There was some thoughts that was the reason astronayts felt really weak and tired when they returned home, Within 5 times they felt fine and their EBV values back well with normal values

    The actual same teast was done on college students riight be fore their final exams withe the exact same results. EBV went up pre-exam and by a week after the exam all were normal.

    Mine went up and has been up for 4 years as well HHV-6. These viruses may not be causing peopl with ME/CFS patients to become sick, but I bet the continued elevevated anitbodies over multiple years may us feel like shit!!

    Why don't they try to find out why our bodies will not put these diseases back in to remission. Another damn waste of money. Do a damn study and actualy finsh one for a change
    jimells likes this.
  19. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    I dont think its an indiviual infection we have but more an immune defiency that allows certain infections to cause us issues.
    I would like to know why we have low nk function and cd8 t cell dysfunction, i think this is what they should be going for. But by all means go after infections that are causing us problems. Im not sure on it being an autoimmune problem, i think b-cells are a resevoir of infections but i dont know??
    taniaaust1, merylg and ukxmrv like this.
  20. nanonug

    nanonug Senior Member

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    alwayshopeful and heapsreal like this.

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