Lee, Ji-Sook, Lacerda, Eliana M, Nacul, Luis et al. · Frontiers in medicine · 2021 · DOI
This study tested saliva samples from people with ME/CFS and healthy people to measure levels of common viruses that stay dormant in the body. Researchers found that two viruses (HHV-6B and HHV-7) were present at higher levels in people with ME/CFS, especially in those whose viral levels went up and down over time. Importantly, when these viral levels were higher, patients reported worse symptoms like pain, brain fog, and heart/blood pressure problems.
For years, researchers have suspected that dormant viruses might play a role in ME/CFS, but couldn't detect them reliably. This study provides the first sensitive molecular evidence linking measurable viral reactivation patterns to specific ME/CFS symptoms, potentially opening new avenues for diagnosis and treatment. The methodology developed here could enable larger studies to clarify whether controlling viral reactivation might improve patient outcomes.
This study demonstrates correlation, not causation—elevated viral loads may be a cause of ME/CFS symptoms, a consequence of weakened immune control, or both. The small sample size and observational design cannot establish whether antiviral treatments would help patients. The study also does not explain why some ME/CFS patients show stable viral patterns while others show fluctuating patterns.
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
Lee, Ji-Sook, Lacerda, Eliana M, Nacul, Luis, Kingdon, Caroline C, Norris, Jasmin, O'Boyle, Shennae, et al. (2021). Salivary DNA Loads for Human Herpesviruses 6 and 7 Are Correlated With Disease Phenotype in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.. Frontiers in medicine. https://doi.org/10.3389/fmed.2021.656692
BibTeX
@article{mecfsatlas-lee-2021-salivary-dna,
author = {Lee, Ji-Sook and Lacerda, Eliana M and Nacul, Luis and Kingdon, Caroline C and Norris, Jasmin and O'Boyle, Shennae and Roberts, Chrissy H and Palla, Luigi and Riley, Eleanor M and Cliff, Jacqueline M},
title = {Salivary DNA Loads for Human Herpesviruses 6 and 7 Are Correlated With Disease Phenotype in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.},
journal = {Frontiers in medicine},
year = {2021},
doi = {10.3389/fmed.2021.656692},
note = {PubMed: 34422848},
url = {https://www.mecfsatlas.com/evidence/lee-2021-salivary-dna},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/lee-2021-salivary-dna
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