Dale, J K, Di Bisceglie, A M, Hoofnagle, J H et al. · Journal of medical virology · 1991 · DOI
Researchers tested whether hepatitis C virus (HCV), a virus that affects the liver, might be a cause of ME/CFS. They compared blood tests from 36 ME/CFS patients and 14 healthy controls. They found that only one ME/CFS patient showed signs of past HCV infection, while none of the healthy people did. This suggests that hepatitis C is not a common cause of ME/CFS.
Since ME/CFS patients and clinicians have explored various viral causes for the condition, this study provides evidence that routine screening for hepatitis C is not warranted in typical CFS cases. This helps refocus diagnostic efforts and resources on more promising investigative pathways.
This study does not prove that HCV never plays a role in any ME/CFS cases, only that it is not common. The small sample size and single-center design limit generalizability. Absence of HCV in typical cases does not exclude other viral infections as potential contributors to CFS.
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
Dale, J K, Di Bisceglie, A M, Hoofnagle, J H, & Straus, S E (1991). Chronic fatigue syndrome: lack of association with hepatitis C virus infection.. Journal of medical virology. https://doi.org/10.1002/jmv.1890340209
BibTeX
@article{mecfsatlas-dale-1991-chronic-fatigue,
author = {Dale, J K and Di Bisceglie, A M and Hoofnagle, J H and Straus, S E},
title = {Chronic fatigue syndrome: lack of association with hepatitis C virus infection.},
journal = {Journal of medical virology},
year = {1991},
doi = {10.1002/jmv.1890340209},
note = {PubMed: 1653818},
url = {https://www.mecfsatlas.com/evidence/dale-1991-chronic-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/dale-1991-chronic-fatigue
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