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Assessment of a retroviral sequence and other possible risk factors for the chronic fatigue syndrome in adults.
Khan AS, Heneine WM, Chapman LE, Gary HE, Woods TC, Folks TM, Schonberger LB.Assessment of a retroviral sequence and other possible risk factors for the chronic fatigue syndrome in adults.
Annals of Internal Medicine, vol. 118, pages 241-245, 1993.
Summary
This study of the reported HTLV-II-like marker for CFS was conducted on 21 metropolitan Atlanta cases, 21 controls from among CDC employees, and 42 neighborhood controls matched with patients by age, race, and sex. No association was found between the retroviral marker (HTLV-II gag sequence) and CFS cases. This report indicated that the retrovirus marker test was not valuable for the diagnosis of CFS.
Abstract
Objective: To assess whether the human T-lymphotropic virus type II (HTLV-II) gag gene sequence, a purportedly new laboratory marker of the chronic fatigue syndrome (CFS), and other possible risk factors for CFS, particularly those associated with retroviral transmission, are associated with well-characterized CFS.
Design: 2 matched case-control studies.
Setting: The metropolitan Atlanta area.
Patients: 21 patients with CFS who were identified by the Centers for Disease Control and Prevention CFS surveillance system; 21
CDC employee controls (laboratory study) and 42 neighborhood controls (risk-factor study) who were matched to patients by age, race, and gender.
Measurements: Peripheral blood lymphocytes and leukocytes were assayed for the HTLV-II gag sequence by polymerase chain reaction and specific Southern blot hybridization. Questionnaires elicited demographic and clinical information and a history of exposures associated with retroviral transmission (for example, blood transfusions, sexual practices, intravenous drug use).
Results: All patients were white and 86% were female. The median age at illness onset was 34 years (range, 16 to 51 years). The HTLV-II gag sequence was not identified in the blood of any patient or control under conditions in which the appropriate assay controls were positive. No statistical differences were observed between patients and controls in frequency or blood transfusions (10% compared with 7%), median number of sex partners before illness (3 compared with 3), bisexual or homosexual behavior (14% compared with 7%), intravenous drug use (0% compared with 0%), and other factors associated with retroviral infection.
Conclusions: TheHTLV-II gag sequence was not a marker for CFS in this small study of well-defined patients, nor did other characteristics of the patients and controls support the hypothesis that a retrovirus, transmitted by the usual modes, was a cause of CFS.
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