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THE WALL STREET JOURNAL
Linked to Chronic Fatigue
By AMY DOCKSER MARCUS
Researchers have linked an infectious virus known to
cause cancer in animals to chronic-fatigue syndrome,
a major discovery for sufferers of the condition and
one that concerned scientists for its potential
An estimated 17 million people world-wide suffer
from chronic-fatigue syndrome, and the Centers for
Disease Control and Prevention puts the U.S. figure
at between one million and four million.
CFS is characterized by debilitating fatigue and
chronic pain, but there are no specific treatments,
and the diagnosis is often made by ruling out other
Thus there is disagreement in the medical
community as to whether CFS is a distinct disease.
A study showing a strong viral association with CFS
could change that equation.
But the significance of the finding, published
Thursday in Science, extends far beyond the
community of people living with CFS.
Researchers are just as concerned about the finding
that nearly 4% of healthy people used as controls in
the study were also infected with the virus, called
If larger studies confirm these numbers, it could
mean that as many as 10 million people in the U.S.
and hundreds of millions of people around the world
are infected with a virus that is already strongly
associated with at least two diseases.
The study was done by researchers at the
Whittemore Peterson Institute for Neuro-Immune
Disease in Reno, Nev., the National Cancer Institute
and the Cleveland Clinic.
In September, researchers at the University of Utah
and Columbia University Medical Center found XMRV
in 27% of the prostate-cancer samples they
That study also showed that 6% of the benign
prostate samples had XMRV. The chronic-fatigue
study is the first to find live XMRV virus in humans.
Neither study conclusively shows that XMRV causes
chronic-fatigue syndrome or prostate cancer. But the
National Cancer Institute was sufficiently concerned
to convene a closed-door workshop in July to discuss
the public-health implications of XMRV infection.
"NCI is responding like it
did in the early days of HIV,"
says Stuart Le Grice, head of the Center of
Excellence in HIV/AIDS and cancer virology at NCI
and one of the organizers of the July workshop.
Like HIV, XMRV is a retrovirus, meaning once
someone is infected, the virus permanently remains
in the body; either a person's immune system keeps
it under control or drugs are needed to treat it.
The virus creates an underlying immune deficiency,
which might make people vulnerable to a range of
diseases, said Judy Mikovits of the Whittemore
Peterson Institute and one of the lead authors on
So far, XMRV, known fully as xenotropic murine
leukemia virus-related virus, doesn't appear to
replicate as quickly as HIV does. Scientists also don't
know how XMRV is transmitted, but the infection was
found in patients' blood samples, raising the
possibility that it could be transmitted through blood
or bodily fluids.
Dr. Le Grice of the NCI said the highest priority now
was to quickly develop a validated blood test or
other assay that could be used in doctors' offices to
determine who has XMRV.
At the workshop, participants also raised the issue of
protecting the nation's blood supply. Dr. Le Grice
said there isn't enough evidence yet to suggest that
people with XMRV shouldn't be blood donors but that
determining how XMRV is transmitted was a critical
"A large effort is under way to answer all these
questions," he said. "I do not want this to be
cause for panic."
Although Thursday's scientific paper doesn't
demonstrate conclusively that XMRV is a cause of
CFS, additional unpublished data make it a very
Dr. Mikovits said that using additional tests, the
scientists determined that more than 95% of the
patients in the study are either infected with live
virus or are making antibodies that show their
immune systems mounted an attack against XMRV
and now had the virus under control.
"Just like you cannot have AIDS without
HIV, I believe you won't be able to find a
case of chronic-fatigue syndrome without
Dr. Mikovits said.
At the July workshop, Dr. Mikovits also presented
preliminary data showing that 20 patients of the 101
in the study have lymphoma, a rare form of cancer.
The link between XMRV and lymphoma is still being
investigated, but it raised the possibility that XMRV
may be associated with other cancers in addition to
NCI's Dr. Le Grice said studies will be launched to
determine whether XMRV is associated with other
diseases. At the Whittemore Peterson Institute, Dr.
Mikovits said they also found XMRV in people with
autism, atypical multiple sclerosis and fibromyalgia.
The Science study was based on blood samples from
a national repository at the Whittemore Peterson
Institute collected from doctors in cities where
outbreaks of chronic-fatigue syndrome occurred
during the 1980s and '90s. One of the key questions
that the NCI's Dr. Le Grice says must now be
answered is whether XMRV shows up in large
numbers of CFS patients all over the country.
Robert Silverman, a professor at the Cleveland Clinic
Lerner Research Institute who is one of the
co-authors of the study and one of the discoverers of
the XMRV virus, said he believes the virus began in
mice and then spread to humans, and that:
"in most cases, people's immune systems are
probably able to control the virus."
Researchers are already starting to test antiretroviral
therapies developed for AIDS to see if they are
effective against XMRV.
The work on XMRV in chronic-fatigue patients initially
was funded by Annette and Harvey Whittemore and
the University of Nevada, Reno.
The Whittemores set up the institute in 2006 after
watching their daughter Andrea suffer from
chronic-fatigue syndrome for most of her life. They
spent millions of their own money to pay for
administrative services, office space, lab equipment
and research operations.
They were frustrated by the lack of government
funding for scientific research into the disease.
At their home in Reno, Andrea Whittemore-Goad, 31
years old, used oxygen before speaking about the
devastating toll CFS has taken on her.
Ms. Whittemore-Goad says she was a regular school
girl, playing sports and involved in school activities,
until the age of 10, when she became ill with a
monolike virus that she couldn't shake.
She said doctors first told her parents that the
illness was psychological, that she had school phobia
and was under stress from her parents. "We kept
searching for an answer," says Ms. Whittemore-
Goad, who says lymph nodes in her groin were so
painful that her brothers and sisters used to have to
carry her upstairs. She was diagnosed at age 12 with
Over the years, doctors have treated her symptoms,
like intense headaches and severe pain, but the
illness persists. She has had her gallbladder, spleen,
and appendix removed because they became
infected. She tried an experimental drug that she
says gave her relief for years, but she then started
experiencing side effects and had to stop taking it.
Recently the illness has become worse; she began
suffering seizures and can no longer drive.
Sitting on the couch next to her husband, whom she
married six months ago, Ms. Whittemore-Goad says
the news that she is infected with XMRV "made
everything that has happened to me make sense."
Brian Goad, her husband, said he felt relieved
knowing "now we can find a way to treat and
hopefully cure it."
For both of them, the discovery of the virus is
life-changing. There are more than 10 families in the
group where family members also tested positive for
XMRV. Members of the Whittemore family are now
Write to Amy Dockser Marcus at
Printed in The Wall Street Journal, page A4
Copyright 2009 Dow Jones & Company, Inc.
The Washington Post
Virus Associated With
Chronic Fatigue Syndrome
Scientists have found evidence that a virus may play
a role in chronic fatigue syndrome.
Vincent C. Lombardi of the Whittemore Peterson
Institute in Reno, Nev., and scientists elsewhere
studied 101 patients with chronic fatigue syndrome,
a baffling, debilitating and controversial condition
that affects an estimated 17 million people
They discovered that 68 of the patients -- 67 percent
-- had a virus in their blood known as the xenotropic
murine leukemia virus-related virus or XMRV.
Only eight of 218 similar subjects who did not have
chronic fatigue syndrome -- 3.7 percent -- had the
virus in their blood, the researchers report in a paper
published online Thursday by the journal Science.
Further studies showed that the virus is indeed
infectious, and can "provoke" the immune system to
The researchers cautioned that the findings far from
prove that the virus causes chronic fatigue. It may
be just part of the picture. But they suggest that the
virus may at least contribute to the development of
This isn't the first time a virus has been associated
with the condition. Previous research has suggested
that some herpes viruses and other viruses may also
play a role.
In an article accompanying the research, John Coffin
of Tufts University in Boston and Jonathan Stoye of
the National Institute for Medical Research in London
They noted that there are many unanswered
questions about the virus, including how it is
But if the findings are representative of what's going
on in the general public, perhaps 10 million
Americans and hundreds of millions of people
worldwide might be infected with the virus, which
could turn out to be playing a role in a variety of
diseases. The virus previously was found in some
patients with prostate cancer.
By Rob Stein
October 8, 2009;
© 2009 The Washington Post Company
Scientists link chronic
fatigue ailment to retrovirus
WASHINGTON - Chronic Fatigue Syndrome (CFS), a
mysterious and debilitating exhaustion that is not
relieved by sleep, appears to be linked to a
retrovirus, researchers announced Thursday in a
In the latest issue of Science, researchers said their
findings could lead to a treatment for an ailment
affecting millions of Americans and that in some
cases render them unable to work or engage in even
moderately robust activities.
The study was hailed as a breakthrough in
understanding the perplexing syndrome for which
there is no known treatment.
"We now have evidence that a retrovirus named
XMRV is frequently present in the blood of
patients with CFS,"
said Judy Mikovits, director of research for the
Whittemore Peterson Institute (WPI) located at the
University of Nevada, Reno, one of the organizations
which led the research.
"This discovery could be a major step in the
discovery of vital treatment options for millions of
Other health agencies which contributed to the study
were the National Cancer Institute (NCI), the
National Institutes of Health, and the Cleveland
Researchers cautioned that while there appears to be
a relationship between the retrovirus and Chronic
Fatigue Syndrome, they have not proven that the
illness is caused by XMRV.
They noted that earlier research has linked the
retrovirus with prostate cancer as well.
"The discovery of XMRV in two major diseases,
prostate cancer and now chronic fatigue
syndrome, is very exciting,"
said Robert Silverman, a professor in the Department
of Cancer Biology at the Cleveland Clinic Lerner
Research Institute, and co-author of the CFS study.
"If cause-and-effect is established, there would
be a new opportunity for prevention and
treatment of these diseases,"
In the study released Thursday, WPI scientists
identified XMRV in the blood of 68 of 101 (67
percent) CFS patients.
By contrast, the retrovirus was found in the blood of
only eight of 218 healthy people (3.7 percent).
"These compelling data allow the development of a
hypothesis concerning a cause of this complex and
misunderstood disease, since retroviruses are a
known cause of neurodegenerative diseases and
cancer in man,"
said Francis Ruscetti, of the Laboratory of
Experimental Immunology at NCI.
Retroviruses like XMRV have also been shown to
activate a number of other latent viruses. This could
explain why so many different viruses, such as
Epstein-Barr virus have been associated with CFS.
"The scientific evidence that a retrovirus is
implicated in CFS opens a new world of
possibilities for so many people,"
said Annette Whittemore, founder and president of
WPI and mother of a CFS patient.
"Scientists can now begin the important work of
translating this discovery into medical care for
individuals with XMRV related diseases."
© 2009 AFP.
Retrovirus May Be at Root
of Chronic Fatigue Syndrome
THURSDAY, Oct. 8 (HealthDay News) -- About
two-thirds of patients with chronic fatigue syndrome
sampled in a recent study were infected with a
retrovirus called XMRV.
The finding, albeit preliminary, has raised hopes that
there might be a concrete cause for the mysterious
malady and thus, down the line, treatments for the
"This study does not prove that XMRV is the cause
of chronic fatigue syndrome, however it does
suggest it is a viable candidate for a cause,"
said Robert H. Silverman, co-author of a report
appearing online Oct. 8 in Science.
"But if it can be proven that the virus causes the
disease, that would be a breakthrough in
diagnosing, combating and preventing the
added Silverman, a professor of cancer biology at the
Cleveland Clinic Lerner Research Institute. "There
could be an antiretroviral drug that could prevent this
virus from replicating."
Another expert was similarly hopeful.
"This article could give a spark of hope, one, that
chronic fatigue syndrome is caused by something,
and two, if that bears out, maybe we could do
something about it,"
said Dr. Tamara Kuittinen, an emergency physician
with Lenox Hill Hospital in New York City.
Chronic fatigue syndrome was first recognized in the
late 1980s and initially dubbed the "yuppie flu,"
resulting in an enduring credibility crisis.
Some segments of the medical community do not
believe it is a discrete illness because there is no
known cause, and diagnosis can only be made
through excluding other conditions, such as
"There's no test, no clear etiology, the symptoms
are vague, there's no treatment and no cure,"
said Kuittinen. "It's very frustrating."
Possible explanations for the disease have been
far-reaching, ranging from different viruses, including
Epstein-Barr, enteroviruses and herpes, to childhood
The illness affects an estimated 1 percent of people
worldwide and, as its name implies, involves
crippling fatigue as well as aching joints, headaches
and various other symptoms.
Recently, XMRV was detected in prostate cancer
patients and in prostate tumor biopsies. Like other
retroviruses, it can activate latent viruses in the
body, such as Epstein-Barr, which has been linked to
chronic fatigue syndrome.
For this study, researchers analyzed 101 blood
samples taken from patients with chronic fatigue
syndrome and found the virus in 68 of the samples,
as compared with only eight samples in 218 healthy
patients (67 percent versus 3.7 percent).
Although 3.7 percent seems a small proportion, the
authors do note that this could mean millions of
people are infected with a virus whose effects are as
Retroviruses, a group that includes both
XMRV and HIV, have genomes made of
RNA instead of DNA.
"When the virus infects cells, the RNA gets copied
into the DNA, then the DNA inserts itself or
integrates into the host DNA,"
"One of the many problems with infections with
retroviruses is that it's very difficult to actually
cure the patient because the virus DNA becomes
part of the infected person's DNA. Patients need
to continually take drugs to keep it from
XMRV is simpler than HIV, though, Silverman added,
which is a good thing.
"It's a kind of stripped down version of a
retrovirus. It has just the genes required for
infection and replication. We could probably stop it
with an antiretroviral drug."
There's also the possibility that a vaccine would
prevent people from being infected in the first place.
But, stressed Silverman, "there are lots of
qualifiers because it hasn't actually been proven
that it causes disease, although the evidence looks
pretty intriguing. This is an area that needs more
The U.S. Centers for Disease Control and Prevention
has more on chronic fatigue syndrome.
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