New Studies Show Evidence of Borna Disease Virus Infection in Psychiatric Patients Borna disease virus (BDV) infects a wide array of species, including: humans, horses, foxes, cats, dogs, cows, sheep and birds. It can cause Borna disease, a neurological syndrome involving viral infection of the limbic system and the brain stem. 1 Borna disease virus (BDV) has been associated with a range of human diseases, including ME/CFS, major depressive disorder, bipolar disorder, schizophrenia, anxiety disorder, multiple sclerosis, amyotrophic lateral sclerosis, dementia and glioblastoma multiforme. 1 But in 2012, Ian Lipkin, Mady Hornig et al published a major study examining the prevalence of BDV antibodies and BDV RNA in the blood (although they did not check the cerebrospinal fluid) of 198 schizophrenia, bipolar disorder and major depressive disorder patients, and found no association with Borna disease virus infection. They concluded that: "our results argue strongly against a role for BDV in the pathogenesis of these psychiatric disorders". And back in 1999, a study by Lipkin et al found no evidence of Borna disease virus infection in Swedish patients with ME/CFS (although this 1997 Japanese study found BDV in 34% of ME/CFS patients). So does that put paid to the idea that Borna disease virus could be involved in psychiatric disorders, or involved in diseases with psychiatric and physical symptoms such as ME/CFS? Borna Disease Virus Circulating Immune Complexes (BDV CICs) Not quite, it seems, because in the last few years, a couple of new studies have provided fresh evidence of Borna disease virus infection in psychiatric patients using a novel means of BDV detection, namely by looking for Borna disease virus circulating immune complexes (BDV CICs) in the blood of these psychiatric patients. I'll get to these two new studies in a moment, but first we need to understand a bit about the nature of these BDV CICs. In Borna disease virus research, there was an apparent problem of erratic and inconsistent BDV detection, with various epidemiological studies showing contradictory results. But in 2001, a German study (full paper here) claimed that BDV CICs are responsible for this problem of erratic and inconsistent detectability of the virus. They found that BDV CICs interact with free BDV antibodies and BDV plasma antigens, making detection by normal viral antibodies haphazard. So this German study seemed to explain the inconsistent results in BDV detection. Furthermore, the German study found that high levels of BDV CICs in the blood correspond to a high presence of BDV antigens in the blood (antigenemia). So the authors suggest that finding Borna disease virus CICs is an easy and reliable way to detect BDV infection, more reliable than BDV antibody detection. Additionally, the study authors demonstrated an association between BDV CICs and some psychiatric disorders: they found that 28 patients with major depressive disorder or bipolar disorder hospitalized due to severe depressive crisis nearly all had high BDV CIC levels, as did a further 28 patients with the same disorders who were just moderately depressed. Whereas in healthy controls, only 32% had high BDV CICs. So BDV CICs are potentially a more reliable means of detecting BDV infection. Two New Studies on Borna Disease Virus and Psychiatric Disorders Two new studies used Borna disease virus CICs as a means to detect BDV, and discovered that BDV infections are more frequently found in psychiatric patients: Primary psychosis and Borna disease virus infection in Lithuania: a case control study (2016) This Lithuanian study looked at 106 patients with acute primary psychosis admitted to a mental hospital (these patients had no physical illnesses). They found BDV CICs in 40% of the psychosis patients (indicating a BDV infection), but only in 22% of the healthy controls. Interestingly, this finding of BDV CICs in 22% of healthy controls is one of the lowest figures reported in Europe (the authors point out that in the Czech Republic, the figure is 37%). This study also details how BDV CICs are formed: Borna disease virus (BDV) infection in psychiatric patients and healthy controls in Iran (2014) This Iranian study focused on a total of 114 psychiatric patients admitted to psychiatric departments: 64 bipolar disorder patients, 12 major depressive disorder patients, 18 schizophrenia patients, 15 schizoaffective patients and 5 obsessive compulsive disorder patients. They found that in total, 40% of these psychiatric patients had BDV CICs, compared to 30% of healthy controls. In particular, in the bipolar, major depression and OCD patients, the BDV infection rates were high: 45%, 50% and 40% respectively. Borna Disease Virus and ME/CFS What all this means for ME/CFS is not clear. Although the1999 study by Lipkin et al found no evidence of Borna disease virus infection in ME/CFS, the study did not detect BDV infection by means of BDV CICs. So might BDV CICs exist in ME/CFS patients, indicating a BDV infection? I am not aware of any studies that have looked at this. Borna Disease Virus Testing Laboratory The following German laboratory tests for Borna disease virus infection by means of BDV CICs: MVZ Diamedis Diagnostische Medizin Sennestadt Dunlopstraße 50 33689 Bielefeld www.diamedis.eu/Bornavirus.html (English translation here). Info sheet in English here. Note though that BDV CICs are found in around 30% of the general population, so it probably does not make much sense for individual ME/CFS patients to get tested. It would be more interesting to see if ME/CFS patients as a whole have a higher prevalence of BDV CICs, but that would require a study. Borna Disease Virus Antiviral Treatments The following drugs have efficacy against Borna disease virus: Amantadine 200 mg daily. 1 (Though others claim amantadine does not work for BDV). Ribavirin. 1 Ribavirin + interferon alpha synergistic for avian bornavirus in parrots. 1 Interferon gamma. 1 2'-fluoro-2'-deoxycytidine. 1 Favipiravir (Avigan) may have a strong antiviral activity against a broad range of bornaviruses. 1 Favipiravir has been approved in Japan for the treatment of influenza virus infections. Bornavirus Taxonomy Note that there are seven species of bornavirus identified, which each infect different animals, including humans. It is the mammalian 1 bornavirus species (which comprises two viruses: Borna disease virus 1 and Borna disease virus 2), that infects humans and other mammals and can cause Borna disease. And it is specifically Borna disease virus 1 (BoDV-1) that has been associated with psychiatric disorders in humans.