Linde, A, Andersson, B, Svenson, S B et al. · The Journal of infectious diseases · 1992 · DOI
This study compared immune system markers in the blood of people with acute EBV infection (infectious mononucleosis), people recovering from EBV, and people with ME/CFS who had evidence of EBV reactivation. The researchers found that while acute EBV infection caused strong immune activation markers, people with ME/CFS did not show these same activation patterns, suggesting that active EBV reactivation may not be the primary cause of ME/CFS symptoms.
This study directly addresses a prevalent hypothesis that ME/CFS is caused by chronic EBV reactivation. By showing that ME/CFS patients lack the immune activation patterns seen in documented active EBV infection, it challenges a common attribution and suggests researchers should investigate other mechanisms, potentially redirecting clinical and research efforts.
This study does not prove that EBV never plays any role in ME/CFS pathogenesis—it only suggests active viral reactivation is unlikely the primary cause. The cross-sectional design cannot establish causation. Additionally, absence of typical acute immune markers does not rule out other forms of EBV-related pathology (e.g., latent viral effects, defective immune control) or other triggering infections.
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
Linde, A, Andersson, B, Svenson, S B, Ahrne, H, Carlsson, M, Forsberg, P, et al. (1992). Serum levels of lymphokines and soluble cellular receptors in primary Epstein-Barr virus infection and in patients with chronic fatigue syndrome.. The Journal of infectious diseases. https://doi.org/10.1093/infdis/165.6.994
BibTeX
@article{mecfsatlas-linde-1992-serum-levels,
author = {Linde, A and Andersson, B and Svenson, S B and Ahrne, H and Carlsson, M and Forsberg, P and Hugo, H and Karstorp, A and Lenkei, R and Lindwall, A},
title = {Serum levels of lymphokines and soluble cellular receptors in primary Epstein-Barr virus infection and in patients with chronic fatigue syndrome.},
journal = {The Journal of infectious diseases},
year = {1992},
doi = {10.1093/infdis/165.6.994},
note = {PubMed: 1316417},
url = {https://www.mecfsatlas.com/evidence/linde-1992-serum-levels},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/linde-1992-serum-levels
Contribute
Private, reviewed by a human. Not a public comment thread.