XMRV- Proving XMVR -The Next Steps
“We need much more research from the CDC, from the NIH, from the National Cancer Institute – from everybody… (everyone) needs to take this retrovirus as seriously as they did the last most famous retrovirus – HIV” Dr. Donnica Moore on Good Morning America
FIRST UP! – Probably A Commercially Available Blood Test – The only blood test currently available can only be used by researchers but a commercial blood test your doctor can order appears to be proceeding rapidly first we heard it would be a year – now (Oct 15th) we’re hearing mere weeks. Stay tuned!
THE CRITICAL STEPS – Does XMRV Cause Chronic Fatigue Syndrome (ME/CFS)? – Below are hurdles the virus must overcome to be considered the cause of this disease
- Replication – Studies by independent laboratories are where the rubber meets the road in science. It was the inability to replicate the original studies results where the last retroviral discovery in ME/CFS foundered. What do we know now? The fact that t the NIH convened at least one private conference in August to discuss XMRV suggests that replication efforts by other laboratories were probably already been underway. There is a report of an upcoming National Cancer Institute study and we know of at least three other efforts; the CDC, Dr. Kerr in the U.K., Dr. LLoyd in Australia and there are reports of others. When they’re done expect quick publication; because this is a hot topic these papers will likely jump to the front of the queue at medical journals.
- More Different types of Patients in Future Studies – one of the big questions regarding the original finding is if they will translate from the severely ill patients in the original study to the more moderately ill patients that probably make up the bulk of the chronic fatigue syndrome community. Quickly expect studies that determine if the virus is found in a range of chronic fatigue syndrome patients.
- Studies That Examine if XMRV is the Cause Of Chronic Fatigue Syndrome Expect studies that attempt to correlate how much virus is present (viral load) with how ill patient is (their symptoms). Correlation is not causation but it helps. The study below is the clincher in this regard.
- Treatment Studies – the Whittemore Peterson Institute is reportedly already beginning to engage in treatment studies using antiretrovirals and other drugs. The best test of causation is to remove the virus and determine if the patient recovers or gets better. If as viral loads drop the patient recovers or gets better we can assume the virus is causing or significantly contributing to an illness. (Note, though, that the typical course of my anti-retrovirals in AIDS rapidly results in reduced viral loads and increased immune functioning but that symptom remission usually takes far longer to achieve. Interestingly, the same is often true with the current antiviral regimes in ME/CFS; improved laboratory results can often be seen quite rapidly but it takes a quite sustained course of antivirals (>1 year) for symptoms to improved markedly.)
- Studies That Attempt to Determine How Infectious the Virus Is – the Science paper was the first time researchers looked to see if this virus was found in the general population. They were rather aghast to find it in almost 4% of their control samples. Because the virus is found in the blood this finding brought into question the safety of the blood supply. Expect studies to come whizzing out of the NIH how often this virus is found in the general population and if it can be transmitted via the blood, the saliva, the semen, etc.
- Studies of Close Contacts and Relatives – Expect studies to quickly come out assessing how many family members and close contacts of the positive ME/CFS patients test positive for the virus.
- Finding the Trigger – Not everyone with this virus is ill. Look for studies trying to determine what triggers the virus to either become activated or to somehow cause its ill effects.
- Studies That Look for This Virus In Other Parts of the Body – thus far the virus has been found in white blood cells which are easy to test. Expect studies that look for it in more cells and that more clearly elucidate which types of white blood cells the virus has targeted.
- Studies That Expand the Focus Beyond Chronic Fatigue Syndrome (ME/CFS) -The Whittemore Peterson Institute has also found the virus in autism, fibromyalgia and ‘atypical MS’ patients hence the preliminary name “X Associated Neuro- Immune Disorder.” Expect the WPI try to uncover what other diseases XMRV is associated with.
- Studies That Examine XMRV’s Effects in Healthy People – Expect researchers to follow XMRV infected healthy people to see if they either.develop chronic fatigue syndrome or display increasing immune abnormalities over time.