Changing status of XMRV / HGRV research

I expect that Next Generation Sequencing or NGS, which does not have the flaws of PCR technology in evaluating a poorly understood human virus(es), will be the best way forward to a consensus as to the question of association of CFS with XMRV/HGRV.

The Nuts and Bolts of New XMRV Testing

There are now two tests for XMRV known as the XAND PCR/culture and XNDS serology tests from VIP Dx (www.vipdx.com) in Reno, NV. You can do both tests together for about $550 or about $700 for both separately. CFS patients need to do both initially but exposure controls or family members might want to only do serology for $250. For CFS cases, there is a non-overlapping chance of being negative on PCR/culture at about 25% or greater and about a 50% chance of being negative on serology but perhaps close to a 80-90% chance in our clinic of being positive if you do both (one or the other positive).

Common Overlap Diagnoses in CFS Cases

I have recently evaluated the overlapping illnesses often associated with CFS including chronic lyme, mold related illness, FM, MCS, IBS and allergies (both food and inhalants). To do this I used patient report questionnaires to help dissect out the important question of the frequency of these overlapping diagnoses in a CFS-only practice. Questionnaires lack some of the diagnostic precision of more detailed case definitions but the inherent biases already built into a CFS-only specialty practice would exist despite any improvement gained by using more accurate case definition discriminators such as exam and laboratory data, if they exist at all.

Detection of XMRV in well described and consecutive CFS cases

I have reviewed the recently returned serology data from VIP Dx. Of the 22 CFS patients returned with serology results to date, 2 out of 3 or 67% were reported positive who previously had been negative by PCR/culture. 8 were from the 12 reported as negative by PCR/culture using the LNCaP permissive cell line in the 47 consecutive Cheney Clinic case study done in late 2009. Of the eight, four were seropositive and four were seronegative. An additional four are either not returned as yet or a request for repeat was made (indeterminate). On the four reported as seronegative, one is part of a multi-member family in which all except this patient who is also the sickest are XMRV PCR/culture positive. One of the indeterminantes is also in this multi-member XMRV positive family category.

Can the naturally occurring glycoprotein known as GcMAF be the best available treatment for XMRV/MLV infection?

GcMAF is a naturally occurring yet potent activator of the immune system antigen processing cells known as Macrophages. This post discusses the nature of GcMAF including how it is derived and its potential utility in treating both cancer and retroviral infections. Studies in Europe are being completed which demonstrate the effectiveness of GcMAF in CFS patients and soon to be published.

Monkey study sheds light on the lifecycle and potential reservoirs of XMRV

Presented at the 1st International XMRV conference held at the NIH in early September 2010 was an extraordinary study by a group connected to Abbott Labs that infected male and female macaques which are monkeys closely related to man with human XMRV to see what happens over time and where the virus ends up or concentrates itself.

Dr. Cheney’s poster presentation at an XMRV conference held at the NIH is reviewed by YouTube – are there misrepresentations?

A poster presentation by Dr. Cheney made at the 1st International XMRV meetings held at the NIH in early September, 2010 was partially summarized by a U-tube video (see http://www.youtube.com/watch?v=S3UwkdzBaro). While the video was in many respects very well done and brings needed attention to CFS and its link to XMRV, there are key misrepresentations made about the poster and what it actually said or implied. This post discusses in detail the good points and bad points of this U-tube presentation which Dr. Cheney knew nothing about and had no hand in it.

Interpretation of XMRV Testing

Current testing, primarily by VIP Dx in Reno, gives three results. 1) Serum RT-PCR for viral RNA 2) Whole blood PCR for viral DNA and 3) Culture of human blood white cells which amplifies the infection to see it better and the most sensitive of the three tests, the most labor intensive and the most costly. Coming soon will be antibody testing including 4) IgG against common viral proteins and 5) Western blot (WB) which looks at the entire pattern of viral protein antibody expression which are present and considered the gold standard for confirming any direct detection of virus by PCR or RT-PCR testing which is subject to false positives. When IgG ELISA testing is available, there will likely be a contraction of standard testing to just serum RT-PCR and whole blood PCR and IgG if positive to confirm and perhaps IgG if negative to confirm any past infection which, of course in a retrovirus, is permanent infection of your DNA. There are other issues involving infectiousness and viral latency that are peculiar to retroviruses. Below is a fuller explanation.

Oxygen toxicity in CFS, links to XMRV and Autism

I have observed ventilatory and echocardiographic responses to 4 lpm NC oxygen every day in this practice for over three years now, admittedly in a rarified group of long time ill (ave 15 years) and very disabled (ave KPS of 50-60) cases of well characterized CFS cases. They have large ventilatory reactions (hyperventilatory and hypoventilatory) and some express immediate dislike of oxygen and get very anxious and agitated. A few have stopped breathing and had to be noxiously stimulated to revive them off oxygen. The echo shows an average of 10-20% loss of free energy by IVRT criteria on 4 lpm NC oxygen which means decreased ability to pump calcium out of the myocardium and relax and fill properly the LV. This cannot be a good thing if sustained and has potentially deeper threats related to poor oxygen handling such as DNA damage from accelerated ROS.

Failure to find XMRV in German prostate cancer patients

A recent publication out of Germany (Hohn O. et al, Retrovirology, 2009 Oct 16;6(1):92. [Epub ahead of print] – PMID: 19835577) reports that prostate cancer patients with a known RNAse-L mutation, linked in the US to XMRV, had no evidence of XMRV infection. The same type of patient was shown to be associated with a high incidence of XMRV infection reported by the Cleveland Clinic in 2007.