Signs and Symptoms Suggestive of Inflammatory Latent Herpesvirus Abortive Lytic Replication in U.S. Veterans with Chronic Multi-Symptom Illnesses

Background: Chronic multi-symptom illness (CMI) is an idiopathic condition that can cause severe disability in U.S. Veterans. Objective: The collection of data to better characterize and assist in the development of a hypothesis that describes the pathophysiology of CMI. Design: This is an observational VA pilot study of a cohort of 40 U.S. Veterans with CMI. Methods: U.S. Veterans were initially referred to the Rehabilitation Medicine Service (RMS). From this pool of RMS patients, 36 males and four females diagnosed with CMI were selected. Data collected during this study included demographic data, medical history, psychological/cognitive information, and physical exam results. Lab tests were performed twice on the study subjects. Lab tests included serum 25(OH)D3 levels, calcium levels, and human serum IgM and IgG antibody levels to three herpetic virus dUTPase. Serum 25(OH)D3 levels were examined because active vitamin D has a role in immune system function, including the suppression of latent viruses and the modulation (attenuation) of the immune system’s inflammatory response. Herpesvirus dUTPases are proteins that are produced during viral DNA replication but are not structural components of virions. Human antibodies to dUTPase proteins were used as biomarkers for abortive lytic viral replication, a process that can stimulate an inflammatory immune process. Results: In our study subjects, the most common symptom was chronic pain (95%), the most common sign was hyperalgesia to pin prick (95%) and the most serious diagnoses were quadriparesis and neurocognitive decline in two study subjects. Conclusions: The clinical findings together with previous vitD and dUTPase serology studies suggest a possible association with low vitD levels, inflammatory elevated herpesvirus abortive lytic replication and CMI.