{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T22:22:59Z","timestamp":1791238979040,"version":"4.1.0"},"reference-count":28,"publisher":"BMJ","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"published-print":{"date-parts":[[2010,2]]},"abstract":"<jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Enteroviruses are well-known causes of acute respiratory and\/or gastrointestinal infections and non-specific flu-like illness. Although enterovirus protein, RNA and non-cytopathic viruses have been demonstrated in the stomach biopsies of patients with myalgia encephalomyelitis\/chronic fatigue syndrome (ME\/CFS), causality for chronic diseases is difficult to establish without having well-documented cases of acute enterovirus infections. The aim of this study was to link acute enteroviral infection to viral persistence in patients with ME\/CFS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Method<\/jats:title>\n                  <jats:p>Patients admitted to the hospital with acute febrile illnesses were screened for enteroviral infections. Acutely infected patients were followed longitudinally, and those who developed symptoms of ME\/CFS underwent oesophagogastroduodenoscopy and biopsies of the antrum to document viral persistence by immunoperoxidase staining for viral protein and viral RNA assay.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Three representative patients with different manifestations of acute enterovirus infections progressed to have chronic symptoms of ME\/CFS. Persistent viral infection was demonstrated in the antrum years later.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>After acute infections, enteroviruses can persist in patients resulting in manifestation of ME\/CFS. Chronic enterovirus infection in an immunocompetent host may be an example of a stalemate between attenuated, intracellular viruses and an ineffective immune response.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jcp.2009.070466","type":"journal-article","created":{"date-parts":[[2009,10,14]],"date-time":"2009-10-14T22:34:47Z","timestamp":1255559687000},"page":"165-168","source":"Crossref","is-referenced-by-count":64,"title":["Acute enterovirus infection followed by myalgic encephalomyelitis\/chronic fatigue syndrome (ME\/CFS) and viral persistence: Figure 1"],"prefix":"10.1136","volume":"63","author":[{"given":"J","family":"Chia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Chia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Voeller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2009,10,14]]},"reference":[{"key":"2025092504454584000_63.2.165.1","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1288.004"},{"key":"2025092504454584000_63.2.165.2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/157.1.183"},{"key":"2025092504454584000_63.2.165.3","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(90)90501-4"},{"key":"2025092504454584000_63.2.165.4","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.79.11.7024-7041.2005"},{"key":"2025092504454584000_63.2.165.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.virol.2008.02.030"},{"key":"2025092504454584000_63.2.165.6","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-009-1410-z"},{"key":"2025092504454584000_63.2.165.7","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-3-25"},{"key":"2025092504454584000_63.2.165.8","doi-asserted-by":"publisher","DOI":"10.1086\/367666"},{"key":"2025092504454584000_63.2.165.9","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38933.585764.AE"},{"key":"2025092504454584000_63.2.165.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2006.08.013"},{"key":"2025092504454584000_63.2.165.11","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2004.020255"},{"key":"2025092504454584000_63.2.165.12","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2007.050054"},{"key":"2025092504454584000_63.2.165.13","first-page":"286","article-title":"Ribavirin and interferon \u03b1 for the treatment of patients with chronic fatigue syndrome associated with chronic Coxsackievirus B infection: a preliminary observation","volume":"4","author":"Chia","year":"2004","journal-title":"J Appl Res"},{"key":"2025092504454584000_63.2.165.14","doi-asserted-by":"crossref","unstructured":"Chia J Chia A . 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