Chia, J K S, Chia, A Y · Journal of clinical pathology · 2008 · DOI
This study examined stomach biopsies from 165 ME/CFS patients to look for enterovirus (a type of virus) because many patients report stomach problems. Researchers found that 82% of ME/CFS patients had signs of enterovirus in their stomach cells, compared to only 20% of healthy control patients. Some patients tested positive for the virus years apart, suggesting a persistent infection rather than a one-time illness.
This research addresses a longstanding question about whether viral infections could cause or perpetuate ME/CFS, particularly in patients with gastrointestinal symptoms. The high prevalence of enterovirus detection in stomach tissue provides a potential diagnostic target and could justify investigation into antiviral or other targeted treatments for a subset of ME/CFS patients.
This study does not prove that enterovirus causes ME/CFS, only that it is more frequently detected in CFS patients' stomach tissue than in controls. The cross-sectional design means we cannot determine whether the virus preceded symptom onset or is a consequence of immunological dysfunction. The clinical significance of non-cytopathic (non-cell-damaging) enterovirus infection remains unclear.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Chia, J K S & Chia, A Y (2008). Chronic fatigue syndrome is associated with chronic enterovirus infection of the stomach.. Journal of clinical pathology. https://doi.org/10.1136/jcp.2007.050054
BibTeX
@article{mecfsatlas-chia-2008-chronic-fatigue,
author = {Chia, J K S and Chia, A Y},
title = {Chronic fatigue syndrome is associated with chronic enterovirus infection of the stomach.},
journal = {Journal of clinical pathology},
year = {2008},
doi = {10.1136/jcp.2007.050054},
note = {PubMed: 17872383},
url = {https://www.mecfsatlas.com/evidence/chia-2008-chronic-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/chia-2008-chronic-fatigue
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