Natelson, B H, Ye, N, Moul, D E et al. · Journal of medical virology · 1994 · DOI
This study looked for specific antibodies (proteins the immune system makes) against Epstein-Barr virus (EBV) in people with ME/CFS compared to healthy people. Researchers found that abnormal levels of these antibodies were twice as common in ME/CFS patients, and the effect was even stronger in sicker patients. This suggests these antibodies might help doctors identify which ME/CFS patients have more severe illness.
This study suggests a potential biological marker—anti-EBV DNA polymerase antibodies—that might help identify ME/CFS patients with severe illness. Such a marker could improve patient stratification for treatment trials and enable objective monitoring of disease progression, addressing a major clinical need in ME/CFS where objective diagnostic tests are lacking.
This study does not prove that EBV antibodies cause ME/CFS or that EBV reactivation is the primary mechanism of the illness. It is cross-sectional, so it cannot establish temporal relationships or whether antibody levels change with treatment. The correlation between antibodies and severity does not indicate causation.
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
Natelson, B H, Ye, N, Moul, D E, Jenkins, F J, Oren, D A, Tapp, W N, et al. (1994). High titers of anti-Epstein-Barr virus DNA polymerase are found in patients with severe fatiguing illness.. Journal of medical virology. https://doi.org/10.1002/jmv.1890420109
BibTeX
@article{mecfsatlas-natelson-1994-high-titers,
author = {Natelson, B H and Ye, N and Moul, D E and Jenkins, F J and Oren, D A and Tapp, W N and Cheng, Y C},
title = {High titers of anti-Epstein-Barr virus DNA polymerase are found in patients with severe fatiguing illness.},
journal = {Journal of medical virology},
year = {1994},
doi = {10.1002/jmv.1890420109},
note = {PubMed: 8308519},
url = {https://www.mecfsatlas.com/evidence/natelson-1994-high-titers},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/natelson-1994-high-titers
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