Predictors of chronic fatigue in adolescents six months after acute Epstein-Barr virus infection: A prospective cohort study.

Comment; Numerous “routinely done” parameters were evaluated–none really showed any significant deviation from normal range. Why not look at other markers of biotoxin illness such as C4a, TGF- β1, MSH, MMP9?

Pedersen M¹, Asprusten TT¹, Godang K², Leegaard TM³, Osnes LT⁴, Skovlund E⁵, Tjade T⁶, Øie MG⁷, Wyller VBB⁸.

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Abstract

INTRODUCTION:

Acute Epstein-Barr virus (EBV) infection is a trigger of chronic fatigue and Chronic Fatigue Syndrome (CFS). This study investigated baseline predictors of chronic fatigue six months after an acute EBV infection.

MATERIALS AND METHODS:

A total of 200 adolescents (12-20 years old) with acute EBV infection were assessed for 149 possible baseline predictors and followed prospectively. We performed linear regression to assess possible associations between baseline predictors and fatigue (Chalder Fatigue Questionnaire total score) six months after the acute EBV infection. A total of 70 healthy controls were included for cross-sectional reference. This study is part of the CEBA-project (Chronic fatigue following acute Epstein-Barr virus infection in adolescents).

RESULTS:

In the final multiple linear regression model, fatigue six months after acute EBV infection was significantly and independently predicted by the following baseline variables (regression coefficient B[95% CI]): Sensory sensitivity (0.8[0.09-1.6]), pain severity (0.2[0.02-0.3]), functional impairment (1000 steps/day) (-0.3[-0.5 to -0.08]), negative emotions (anxiety) (0.4[0.2-0.6]), verbal memory (correct word recognition) (1.7[0.1-3.3]), plasma C-reactive protein (2.8[1.1-4.4] for CRP values >0.86) and plasma Vitamin B₁₂ (-0.005[-0.01 to -0.001]).

CONCLUSIONS:

Development of fatigue after acute EBV infection is to a larger extent predicted by baseline variables related to symptoms and functions than to baseline variables reflecting infectious and immune processes.

TRIAL REGISTRATION:

ClinicalTrials, ID: NCT02335437, https://clinicaltrials.gov/ct2/show/NCT02335437.

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Dr. Raymond Oenbrink

Dr. Raymond Oenbrink DO is board certified by the American Osteopathic Board of Family Physicians (AOBFP) and the American Board of Addiction Medicine (ABAM). He specializes in complex and chronic illnesses such as Chronic Inflammatory Response Syndrome (CIRS).

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