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Are Epstein-Barr and Chronic Fatigue Syndrome Linked?

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Updated June 27, 2014

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Question: Are Epstein-Barr and Chronic Fatigue Syndrome Linked?

"My doctor says I test positive for the Epstein-Barr virus, but that I don't need to be treated for it. When I go online, though, I find sites that say Epstein-Barr is linked to chronic fatigue syndrome. Is the connection true? I'm concerned about going untreated, if so."

Answer:

Whether or not Epstein-Barr and chronic fatigue are linked is still a gray area.

The Epstein-Barr virus (EBV) is a member of the herpesvirus family, and it's extremely common. Typically, it causes either no symptoms or a mild and brief illness, but the virus remains in your body, dormant, for the rest of your life.

Some chronic fatigue syndrome doctors and researchers believe EBV or a reactivation of it can trigger chronic fatigue syndrome in people who are already predisposed to the condition. So far, however, research has not shown a conclusive connection in adults. In fact, the vast majority of people infected with EBV do not develop chronic fatigue syndrome.

These doctors frequently prescribe anti-viral medications, such as Valtrex (valacyclovir) or Valcyte (valganciclovir), for this reason. These doctors are a minority, though. (Most doctors don't use these drugs for chronic fatigue syndrome.)

EBV can cause mononucleosis (mono) in adolescents and young adults, and some research indicates that severe cases of mono may be more likely to result in juvenile chronic fatigue syndrome.

Sources:

Katz BZ, et al. Pediatrics. 2009 Jul;124(1):189-93. Chronic fatigue syndrome after infectious mononucleosis in adolescents.

Lerner AM, et al. In Vivo. 2007 Sep-Oct;21(5):707-13. Valacyclovir treatment in Epstein-Barr virus subset chronic fatigue syndrome: thirty-sixth month follow up.

Lerner AM, et al. In Vivo. 2004 Mar-Apr;18(2):101-6. IgM serum antibodies to Epstein-Barr virus are uniquely present in a subset of patients with the chronic fatigue syndrome.

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