Norwegian ME/CFS studies: Can chronic virus infections cause Chronic Fatigue syndrome?

Can chronic virus infections cause Chronic Fatigue syndrome?

This study is performed by CFS Department at Oslo University Hospital HF Ullevaal. A govermental clinic for patiens above 18 years suspected for ME/CFS. Head of the clinic is  MD Barbara Baumgarten.

STUDY PROTOCOL

Introduction and background

Chronic Fatigue Syndrome (CFS) is a debilitating condition with no known cause or cure. It ischaracterised by chronic disabling fatigue and physiological, cognitional, neurological and emotional symptoms. CFS often starts after an infection (70-75%), vaccinations, physical orpsychological traumas. There are no specific tests for diagnosing CFS. The diagnosis is therefore based on a description of functional level and additional symptoms and by ruling out alternative diagnoses. Some patients fully recover, while others get worse over time. Most patients will be able to function at a stable, but reduced functional level most of the time.

There are about 9000-18000 people with CFS in Norway (1). CFS is found at all ages, social classes and ethnical groups, but with a much higher prevalence among women (2).

The steering committee is composed of:

• Project leader and main supervisor: Professor emeritus Dr. med Stig Jeansson,

Division of Microbiology, Oslo University Hospital, Ullevaal.

Supervisor:

• MD Barbara Baumgarten, Head of CFS Department at Oslo University Hospital HF Ullevaal.

• MD Oddbjøm Brubakk, consultant of CFS Department at Oslo University Hospital HF – Ullevaal.

Collaboration

• Division of Psychiatry at UUS, We will have to find a specialist in SCID.

• Assistant professor Eirik Frengen, Institute of Medical Genetics, University of Oslo.

• FoU, Mikrobiologisk avdeling, Oslo Universitetssykehus – Ullevaal

• Professor Jonas Blomberg Section of Clinical Virology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.

• Professor Jonathan R. Kerr, Department of Cellular & Molecular Medicine, St Georges University of London, UK

• Dr. Yenan T. Bryceson, Center for Infectious Medicine, Department of Medicine, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden.

Timeframe: Study start 1 Mars 2010 – 29 December 2034.

Publishing

The project is a doctoral project for Barbara Baumgarten. The results will be published ininternational and national scientific journals with referee-service, regardless of the outcome ofthe interventions.

Ethical considerations

Participation is based on informed consent. If the SCID discloses psychiatric diseases, which makes the individual not eligible for the study, alternate treatment options will be discussed. “Personvernombud” at UUS and Regional Committee for Medical Ethics will be contacted for assessment and approval of this study.

Aims:

1. We will determine the prevalence of XMRV in CFS patients and matched controls. A possible relationship between XMRV infection and the presence of other viruses that are often associated with CFS (e.g. herpesviruses and enteroviruses) will be looked into.

2. a) Determine the prevalence of CIHHV-6 in CFS patients and matched controls. If CIHHV-6 is found we will subtype virus as HHV-6A or HHV-6B. The presence of free HHV-6 virus particles in plasma (viremia) will be determined in CFS patients and matched controls.

2. b) Verify that HHV-7 activation is higher in CFS patients than in controls and that a simultaneous activation of HHV-7 and HHV-6 is found in CFS patients only. Hopefully be able to show that in a subgroup of CFS patients a simultaneous active infection with these viruses is a causal factor. Do CFS patients have an increased shedding of HHV-7 in saliva?

3. We will determine the prevalence of chronic enterovirus infection in CFS patients and a control group. If a reliable diagnosis of a chronic enterovirus infection can be established in a subgroup of CFS patients the possibility of antiviral treatment will be considered.

4. Immunological parameters will be evaluated in CFS patients and healthy controls:

a. Various mediators of cytotoxic cell function.

b. Cytokine analyses

c. Gene-expression markers for immunological dysfunction

Project study protocol, CFS Department at Oslo University Hospital HF Ullevaal, Norway. Read here: Can-chronic-virus-infections-cause-Chronic-Fatigue-syndrome-STUDY-PROTOCOL-by-Oslo-University-Hospital-HF-UlIevaal-Norway

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