Woodward, C G, Cox, R A · The Journal of infection · 1992 · DOI
Researchers tested blood samples from 136 ME/CFS patients to look for signs of past or ongoing Epstein-Barr virus (EBV) infection, comparing them to healthy blood donors. They found that CFS patients had higher levels of certain EBV antibodies than the control group, but these differences weren't consistent enough to be useful for diagnosing individual patients. The study also found that some patients had signs of other viral infections alongside the EBV markers.
This study investigates whether EBV reactivation or persistent infection plays a role in ME/CFS pathogenesis, which remains an important question given anecdotal patient reports of symptom onset following EBV infection. The finding of elevated EBV antibodies in the group suggests viral immune dysregulation may be relevant to ME/CFS, though the lack of individual diagnostic utility indicates EBV serology alone cannot define the condition.
This study does not prove that EBV causes ME/CFS or that EBV reactivation is necessary for disease development. The elevated group-level antibody titres do not establish active viral replication, and the lack of clinical differentiation between patients with high versus normal titres suggests EBV antibody levels alone do not determine symptom severity or disease course. Cross-sectional design prevents determination of whether elevated antibodies precede or follow symptom onset.
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
Woodward, C G & Cox, R A (1992). Epstein-Barr virus serology in the chronic fatigue syndrome.. The Journal of infection. https://doi.org/10.1016/0163-4453(92)92772-b
BibTeX
@article{mecfsatlas-woodward-1992-epstein-barr,
author = {Woodward, C G and Cox, R A},
title = {Epstein-Barr virus serology in the chronic fatigue syndrome.},
journal = {The Journal of infection},
year = {1992},
doi = {10.1016/0163-4453(92)92772-b},
note = {PubMed: 1314860},
url = {https://www.mecfsatlas.com/evidence/woodward-1992-epstein-barr},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/woodward-1992-epstein-barr
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