Most of the studies in this long list look at antibodies, which are not evidence of persistent infection in any way.
That's true, but it's interesting that in ME/CFS patients with enterovirus infection in their muscles — as demonstrated by PCR — you find these chronically high antibody levels. So the high antibody levels correlate to these non-cytolytic enterovirus infections, suggesting the ongoing non-cytolytic infection may be the cause of these elevated antibodies.
But I agree, elevated antibodies are not themselves direct proof of an ongoing infection.
Note also that some healthy controls have these non-cytolytic infections in their muscles; thus the the presence of these infection in the muscles cannot be the sole cause of ME/CFS.
I don't have an explanation for why the nucleic acid is there 20 years later, but I'm not an expert.
These chronic non-cytolytic enterovirus infections were a mystery for many decades. They were mainly observed and studied in chronic enterovirus myocarditis (in the heart muscle tissues), and these enigmatic infections left virologists scratching their heads for years.
The big mystery was that in chronic enterovirus heart muscle infections, you would find enterovirus RNA, but researchers were almost never able to culture lytic enterovirus infections from these heart tissue biopsies. That really made no sense: if there is an infection producing viral RNA, it should also produce viral particles which you should be able to culture in vitro.
It's only in recently years that this anomaly has been understood: we now know that non-cytolytic infections produce almost no lytic viral particles, as they are primarily an intracellular infection, comprising naked, self-replicating enteroviral RNA that lives inside human cells.
Are there any textbook-like resources you can provide that discuss non-cytolytic infection as a concept?
Sadly there's little in the way of good textbook introductions to non-cytolytic enterovirus. But I did write this MEpedia article
on the subject a while back (it took me about a month of solid work to do write it, not to mention many years prior to that trying to understand non-cytolytic infections).
The bottom of the MEpedia article has links to further tutorial info; in particular, the videos by Prof Nora M. Chapman are where I got much of my info from (Prof Chapman is the discoverer of the mechanism of non-cytolytic infection).
And also I posted this easier-to-understand thread on non-cytolytic infection
, which you might like to read, just to give an overview.
If you find any errors, please let me know; it is a very difficult subject to work with under brain fog conditions.