Article Index

Virology

Chronic pelvic pain and enterovirus infection of ovarian tubes

This session started with a presentation by John Chia (Lomita, USA). His study was looking to see if chronic pelvic pain in ME/CFS patients was associated with chronic enterovirus infection of the ovarian tubes. Chronic pelvic pain has to have been present for at least 6 months and not necessarily associated with menstruation before a diagnosis is made. Enterovirus VP-1 (enteroviral protein) was found in the tubes of most patients with ME/CFS, but not in controls. Furthermore, injection of the lysate into SCID mice caused infection. Enterovirus was also detected in the vaginal secretions of 2 women. It should be noted that as the egg travels down the tube, there is a possibility of vertical transmission.

Human parvo-virus B-19

Human parvo-virus B-19 was discussed by Santa Rasa (Riga, Latvia) in relation to typical symptoms and markers in ME/CFS. Patients who have suffered infection with this virus can end up with the characteristic symptoms for a diagnosis of ME/CFS. A large study of 190 patients compared to controls was reviewed, and B-19 genomic sequence was detected more frequently (41/190) in the patients’ DNA isolated from plasma (a marker for active infection) than from whole blood (15/190) (a marker for latent infection), and this was more frequent than in controls. Most symptoms were slightly less frequent in the patients in the latent phase of their illness, apart from muscle and joint pain, which was worse in the latent group. Activation and reactivation of this virus may be a risk factor for ME/CFS. It should be noted, too, that there was increased incidence of infertility.

Chronic enterovirus infection of the stomach tissues

John Chia (Lomita, USA) then spoke again about the pathogenesis of chronic enterovirus infection in ME/CFS looking at stomach tissues. Patients with enterovirus in the gastro-intestinal tract usually have functional dyspepsia, and irritable bowel symptoms in the lower G.I. tract. 82% and 63% of the stomach biopsies stained positive for VP-1 and dsRNA respectively (significantly higher than controls). 24 mice were injected with the VP-1+,RNA+ stomach biopsies , and 66% of their spleen biopsies tested positive for VP-1. Other organs were also involved. Only one control specimen tested positive.Enteroviral dsRNA was frequently demonstrated in the stomach biopsies, and as it may play a central role in pathogenesis, it should be targeted for anti-viral therapy. (It was noted that there are over 150 enteroviruses and the Chia lab can only test for 11.)