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They also present with similar symptoms such as asthenia, exercise intolerance, sleep disorders, cognitive dysfunction, and neurological and gastrointestinal complaints. In addition, both pathologies present Epstein\u2013Barr virus (EBV) reactivation, indicating the possibility of this virus being the link between both pathologies. Therefore, we propose that latency and recurrent EBV reactivation could generate an acquired immunodeficiency syndrome in three steps: first, an acquired EBV immunodeficiency develops in individuals with \u201cweak\u201d EBV HLA-II haplotypes, which prevents the control of latency I cells. Second, ectopic lymphoid structures with EBV latency form in different tissues (including the CNS), promoting inflammatory responses and further impairment of cell-mediated immunity. Finally, immune exhaustion occurs due to chronic exposure to viral antigens, with consolidation of the disease. In the case of LC, prior to the first step, there is the possibility of previous SARS-CoV-2 infection in individuals with \u201cweak\u201d HLA-II haplotypes against this virus and\/or EBV.<\/jats:p>","DOI":"10.1186\/s12967-023-04515-7","type":"journal-article","created":{"date-parts":[[2023,9,17]],"date-time":"2023-09-17T15:01:22Z","timestamp":1694962882000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Epstein\u2013Barr virus-acquired immunodeficiency in myalgic encephalomyelitis\u2014Is it present in long COVID?"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6605-6611","authenticated-orcid":false,"given":"Manuel","family":"Ruiz-Pablos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Paiva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aintzane","family":"Zabaleta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,9,17]]},"reference":[{"issue":"4","key":"4515_CR1","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1016\/j.autrev.2008.08.003","volume":"8","author":"L Lorusso","year":"2009","unstructured":"Lorusso L, Mikhaylova SV, Capelli E, Ferrari D, Ngonga GK, Ricevuti G. 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