Wednesday, February 16, 2011

Documented involvement of Viruses in ME/CFS yet NO virological testing in Wessely and White's silly PACE Trial

by Margaret Williams:

For decades it has been known and shown that viruses play a role in ME/CFS. Now there is evidence of a direct association with a gamma retrovirus – XMRV -- that disables the immune system in ME/CFS, thus allowing numerous latent viruses to re-activate, which could result in the protean symptomatology.

As Professor Nancy Klimas said in her November 2009 lecture at the University of Miami:

“We’ve always thought something like that has to go on in (ME) CFS because you all have some neuro-inflammation. Your brain has a low grade level of inflammation. And you have some inflammation in the tissues that make hormones, particularly in the hypothalamic-pituitary-axis. And this is a virus that infects that type of tissue…” (see below).

Latent viruses that have been particularly studied in relation to ME/CFS include Coxsackie B virus (CBV), Epstein Barr virus (EBV) and human herpes virus-6 (HHV-6), and illustrations are provided below.

However, advised by psychiatrists of the Wessely School, in the UK the NICE Guideline of 2007 recommends limited serology testing for certain viruses only, which excludes testing for Coxsackie B virus, for which there is the most evidence (testing for Epstein Barr Virus, a particular interest of Professor Peter White is, however, permitted).

Given that a classified synonym for ME/CFS is “post-viral fatigue syndrome” (ICD-10 G93.3) and given that, like the MRC PACE Trial, the NICE Guideline purports to apply to people with “CFS/ME”, it is striking that the Guideline states on page 141:

“Serological testing should not be carried out unless the history is indicative of an infection”.

It is notable that the PACE Trial Investigators did not include virological testing of participants in their trial that is based on their theory that patients with “CFS/ME” are merely deconditioned, so it needs to be ascertained what, exactly, do the Wessely School psychiatrists understand the term “post-viral” to mean if not a history indicative of an infection? Read more>>

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