Regarding Prof Robert Naviaux's statement quoted earlier
Third, latent and reactivated viral and bacterial infections can occur, but in the case of ME/CFS that has lasted for more than 6 months, this may be the exception rather than the rule.
Some doctors and scientists have not done a good job at educating patients and other scientists about the difference between serological evidence of infection in the form of antibodies like IgM and IgG, and physical evidence of viral replication like PCR amplification of viral RNA or DNA, or bacterial DNA.
There are more classifications of viral infection other than the latent and reactivated viral infections Prof Naviaux mentions above: there are also
non-cytolytic infections, and
abortive infections. These two types of infection exist purely inside human cells, and do not produce any new viral particles.
Numerous studies have found non-cytolytic enterovirus in the muscles, guts and brains of ME/CFS patients. So clearly long term chronic viral infections are found in ME/CFS.
In the case of these chronic enterovirus infections, you don't find much virus in the blood; it's mostly located in the tissues. So this is why blood PCR for enterovirus is often negative in ME/CFS.
However, if you look for enterovirus in the muscle or intestinal tissues, that's where you will find the infection.
And likely because of these enterovirus infections in the tissues of ME/CFS patients, that's why you find high IgG titers in ME/CFS.
I'm curious about the value of pcr because i'm trying to test multiple pathogens. curious about any evidence that shows it doesn't have value, so please feel free to post some
I would not say blood PCR has no value in ME/CFS, but Dr Chia says that in the case of enterovirus, even under the best conditions blood PCR will only detect chronic enterovirus around 30% of the time (see the paragraph on PCR at the
Enterovirus Foundation).
So if you were using blood PCR to detect enterovirus infections, you would miss these infections in 2 out of every 3 enterovirus ME/CFS patients you tested, and these patients who then potentially miss out on what is sometimes an effective treatment for enterovirus ME/CFS: oxymatrine.
In the case of enterovirus, we know that non-cytolytic enteroviruses are present as chronic intracellular infections in the muscles, gut and brains of ME/CFS patients. But you don't find much enterovirus in the blood in such chronic infections, so that's why blood PCR often comes out negative.
I am not aware of any similar statistics for the reliability of blood PCR for detecting chronic herpesvirus infections in ME/CFS, but I know that Dr Lerner and Dr Montoya used antibody testing in their research studies and clinical work, not PCR. And Dr Dantini says that PCR is not much use in ME/CFS.
However, Dr Peterson uses antibody, PCR, antigenemia and culture tests for herpesviruses (I am guessing he prefers a belts and braces approach to testing). See page 10 of
this pdf. But he only uses antibody testing for enterovirus.