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xmrz versus hiv?? follow up to what you thought I had..
Dec 28, 2009

Hi Dr. Bob Hope you had a good holiday.. This is P btw I told you I would follow up with you after my doctors appoitment. Well the doctor did run tests for the iga deficincy and it wasn't that so he ran a group of tests including yet another hiv test to look for what could be causing all these problems. They sent me in for a spinal tap which tested positive for a certain type of virus xmrz I guess it doesn't even have an offical name... or it is other wise known as cfids.. He said there hasn't been a whole lot of research on this and as far as they know it is linked to ebv and cmv which I tested positive for as well. My question to you is which is worse? from what I am understanding this cfids is a bitch and very debillitating it also mimics hiv in many ways.. thats why I was tested 10 times for it which all tests and I had a garden variety of different hiv tests came back completly negative not even a maybe or might be but flat out negative! I am scared because there is no known treatment for cfids from what I have gathered and I feel like shit everyday and just want my life back.. Is this virus the new aids? From what I am hearing from these doctors which really don't know all that much about it say it is very similar. So to all those people out there that insist they have hiv because of all the symptoms etc.. they may want to get tested for this new virus apparently it affects more people than hiv. They also told me they are not sure about its method of transmission or if it's like a form of cancer.. they also told me they are not sure if it is transmitted sexually or not.. I had a full std panel done 6 times over a 10 month period and I am negative for everyone except hpv which is dormant. I see alot of people on this forum that insist they have hiv and I thought for damn sure I did too... because the symptoms came after an unprotected incident and very coincidental however it was not hiv... I am not trying to scare anyone either or the people out there that truly are mentally making themselves sick I don't want them thinking they have this either I am just saying that there are other viruses out there that can mimic hiv. And if you ever had a bad case of chicken pox or mono as a kid and get really ill out of the blue and just know something is very wrong this virus might be something to consider. I guess I am just looking for your opinion on this virus dr. Bob because you are very educated on these topics and I just would like some advice from you as to what step I should take next? The docs I have out here are very limited and don't know very much about it. I know this is an hiv forum I apologize but I trust your opionions and I know your a damn good doctor and I just want to hear your opionion on this virus. I think it is going to get major attention in the next year or two because so many people are coming to doctors with the same thing I have been going through so I am just wondering about your thoughts on this..

Thanks, P...

Response from Dr. Frascino

Hello,

You are correct: We don't know much about xmrz (xenotropic murine leukemia virus). However, I would expect, now that we have a possible link to chronic fatigue syndrome, there will be intensive research gearing up. We should expect to hear much more about xmrz in the near future. I'll post below some preliminary information. As for what steps you should take next, I would continue to work closely with an infectious disease doctor or clinical immunologist who is well versed or doing active research in this area.

Good luck. Keep us posted on your progress. (I do expect progress in treating this condition soon.)

Dr. Bob

Virus Is Found in Many With Chronic Fatigue Syndrome, New York Times, October 9, 2009

By DENISE GRADY

Many people with chronic fatigue syndrome are infected with a little known virus that may cause or at least contribute to their illness, researchers are reporting.

The syndrome, which causes prolonged and severe fatigue, body aches and other symptoms, has long been a mystery ailment, and patients have sometimes been suspected of malingering or having psychiatric problems rather than genuine physical ones. Worldwide, 17 million people have the syndrome, including at least one million Americans.

An article published online Thursday in the journal Science reports that 68 of 101 patients with the syndrome, or 67 percent, were infected with an infectious virus, xenotropic murine leukemia virus-related virus, or XMRV. By contrast, only 3.7 percent of 218 healthy people were infected. Continuing work after the paper was published has found the virus in nearly 98 percent of about 300 patients with the syndrome, said Dr. Judy A. Mikovits, the lead author of the paper.

XMRV is a retrovirus, a member of the same family of viruses as the AIDS virus. These viruses carry their genetic information in RNA rather than DNA, and they insert themselves into their hosts' genetic material and stay for life.

Dr. Mikovits and other scientists cautioned that they had not yet proved that the virus causes the syndrome. In theory, people with the syndrome may have some other, underlying health problem that makes them prone to being infected by the virus, which could be just a bystander. More studies are needed to explain the connection.

But Dr. Mikovits said she thought the virus would turn out to be the cause, not just of chronic fatigue, but of other illnesses as well. Previous studies have found it in cells taken from prostate cancers.

"I think this establishes what had always been considered a psychiatric disease as an infectious disease," said Dr. Mikovits, who is research director at the Whittemore Peterson Institute in Reno, a nonprofit center created by the parents of a woman who has a severe case of the syndrome. Her co-authors include scientists from the National Cancer Institute and the Cleveland Clinic.

Dr. Mikovits said she and her colleagues were drawing up plans to test antiretroviral drugs some of the same ones used to treat HIV infection to see whether they could help patients with chronic fatigue. If the drugs work, that will help prove that the virus is causing the illness. She said patients and doctors should wait for the studies to be finished before trying the drugs.

Dr. William Schaffner, an infectious disease expert at Vanderbilt University, said the discovery was exciting and made sense.

"My first reaction is, 'At last,' " Dr. Schaffner said. "In interacting with patients with chronic fatigue syndrome, you get the distinct impression that there's got to be something there."

He said the illness is intensely frustrating to doctors because it is not understood, there is no effective treatment and many patients are sick for a long time.

He added, "This is going to create an avalanche of subsequent studies."

Xenotropic murine leukemia virus-related virus (XMRV) is a gammaretrovirus that was first described in 2006.[1] XMRV has been isolated from human biological samples, and several reports associate the virus with familial and sporadic prostate cancer.[2][3] A 2009 publication reports a possible association with chronic fatigue syndrome.[4]

XMRV belongs to the virus family Retroviridae and the genus gammaretrovirus. It has a single-stranded RNA genome that replicates through a DNA intermediate. Its name refers to its similarity to murine leukemia viruses ("MuLVs"). The genome, 8135 nucleotides in length, is 95% identical with several endogenous retroviruses of mice, and is 93-94% identical with several exogenous mouse viruses.[1] [edit]History

XMRV was discovered by laboratories led by Joseph DeRisi at the University of California, San Francisco, and Robert Silverman and Eric Klein of the Cleveland Clinic. Silverman had previously cloned and investigated the enzyme ribonuclease L (RNase L), part of the cell's natural defense against viruses. When activated, RNase L degrades cellular and viral RNA to halt viral replication. In 2002, the "hereditary prostate cancer 1" locus (HPC1) was mapped to the RNase L gene, implicating it in the development of prostate cancer.[5] The cancer-associated "R462Q" mutation results in a glutamine instead of an arginine at position 462 of the RNase L enzyme, reducing its catalytic activity. A man with two copies of this mutation has twice the risk of prostate cancer; one copy raises the risk by 50%.[2] Silverman and Klein hypothesised that "the putative linkage of RNase L alterations to HPC might reflect enhanced susceptibility to a viral agent",[2] leading to the discovery of XMRV. [edit]Reported disease associations and transmission

[edit]Prostate cancer A link between prostate cancer and XMRV has been hypothesised. Current reports in the scientific literature offer evidence both for and against such a link. In the initial report on XMRV, the virus was detected in cancerous prostate tissues using a microarray containing samples of genetic material from about 950 viruses. The screen indicated the presence of a gammaretrovirus-like sequence in seven of eleven tumours homozygous for the R462Q mutation, but only in one of five tumours without the mutation. After isolation and cloning of the virus, an expanded screen found it present in 40% of tumours homozygous for R462Q and in only 1.5% of those not.[1] XMRV protein was found in the cells of the tumors but not in the actual prostate cancer cells, raising the possibility the virus may indirectly support tumorigenesis.[6] Additionally, a 2009 study reported XMRV infection in 23% of subjects independent of the RNase L gene variation.[7] However, researchers in Germany failed to find any XMRV-specific sequences in the DNA or RNA of samples from prostate cancer patients, and no XMRV-specific antibodies were detected in blood serum samples.[8] Another German study had previously found no XMRV association with non-familial (sporadic) prostate cancer,[9] and no XMRV link was found in Irish prostate cancer patients with the R462Q mutation.[10] [edit]Chronic fatigue syndrome A study published in Science in 2009 reported that DNA from XMRV was detected in the blood of 67% of CFS patients but in only 4% of healthy controls. The authors, including Robert Silverman, the co-discoverer of XMRV, suggested the virus could cause CFS or be a passenger co-infection.[4] The study was greeted with cautious optimism by some scientists,[11][12] whilst others, including the co-discoverer of XMRV, Joseph DeRisi, pointed out potential flaws in the research, including the fact that murine leukemia viruses are common contaminants of lab cultures and the need for a third-party lab to validate the results of the study in double blind experiments before claims should be made.[12][13] Previous reports that other types of retroviruses were associated with CFS were not replicated in follow-up studies.[14] [edit]Transmission XMRV is closely related to several known xenotropic mouse viruses. These viruses recognize and enter cells of non-rodent species by means of the cell-surface receptor XPR1 or SYG1. It has been suggested that XMRV could be sexually transmitted.[15][16][17] [edit]References

^ a b c Urisman A, Molinaro RJ, Fischer N, et al. (March 2006). "Identification of a novel Gammaretrovirus in prostate tumors of patients homozygous for R462Q RNASEL variant". PLoS Pathog. 2 (3): e25. doi:10.1371/journal.ppat.0020025. PMID 16609730. ^ a b c Silverman, RH. (Oct-Dec 2007). "A scientific journey through the 2-5A/RNase L system.". Cytokine Growth Factor Rev 18 (5-6): 381-8. PMID 17681844. ^ Schlaberg R, Choe DJ, Brown KR, Thaker HM, Singh IR (2009). "XMRV is present in malignant prostatic epithelium and is associated with prostate cancer, especially high-grade tumors.". Proc Natl Acad Sci U S A 106 (38): 16351-6. doi:10.1073/pnas.0906922106. PMID 19805305. PMC PMC2739868. ^ a b Lombardi VC, Ruscetti FW, Das Gupta J, et al. (October 2009). "Detection of an Infectious Retrovirus, XMRV, in Blood Cells of Patients with Chronic Fatigue Syndrome". Science 326 (5952): 585-9. doi:10.1126/science.1179052. PMID 19815723. ^ Carpten J, Nupponen N, Isaacs S, et al. (2002). "Germline mutations in the ribonuclease L gene in families showing linkage with HPC1". Nat Genet. 30 (2): 181-4. PMID 11799394. ^ McLaughlin-Drubin ME, Munger K (March 2008). "Viruses associated with human cancer". Biochim. Biophys. Acta 1782 (3): 12750. doi:10.1016/j.bbadis.2007.12.005. PMID 18201576. PMC 2267909. ^ Schlaberg, Robert; Daniel J Choe, Kristy R Brown, Harshwardhan M Thaker, Ila R Singh (2009-09-22). "XMRV is present in malignant prostatic epithelium and is associated with prostate cancer, especially high-grade tumors". Proceedings of the National Academy of Sciences of the United States of America 106 (38): 16351-16356. doi:10.1073/pnas.0906922106. ISSN 1091-6490. Retrieved 2009-11-15. ^ Hohn O, Krause H, Barbarotto P, Niederstadt L, Beimforde N, Denner J, Miller K, Kurth R Bannert N (2009). "Lack of evidence for xenotropic murine leukemia virus-related virus (XMRV) in German prostate cancer patients". Retrovirology. doi:10.1371/. ^ Fischer N, Hellwinkel O, Schulz C, Chun FK, Huland H, Aepfelbacher M, Schlomm T. (November 2008). "Prevalence of human gammaretrovirus XMRV in sporadic prostate cancer.". Clin Virol. 43 (3): 277-83. doi:10.1016/j.jcv.2008.04.016. PMID 18823818. ^ D'Arcy F, Foley R, Perry A, et al. (2008). "No evidence of XMRV in Irish prostate cancer patients with the R462Q mutation.". European Urology Supplements 7: 271. ^ Coffin JM, Stoye JP (October 2009). "Virology. A new virus for old diseases?". Science 326 (5952): 5301. doi:10.1126/science.1181349. PMID 19815721. ^ a b Kean, Sam (09 October 2009). "Chronic fatigue and prostate cancer: A retroviral connection?". Science 326 (5950): 215. doi:10.1126/science.326_215a. ^ http://www.nytimes.com/2009/10/13/health/13fatigue.html?_r=1&ref=health ^ Ablashi DV (January 1994). "Viral studies of chronic fatigue syndrome". Clin. Infect. Dis. 18 Suppl 1: S1303. PMID 8148440. ^ Hong, S.; Klein, E.; Das Gupta, J.; Hanke, K.; Weight, C.; Nguyen, C.; Gaughan, C.; Kim, K. et al. (Jul 2009). "Fibrils of prostatic acid phosphatase fragments boost infections with XMRV (xenotropic murine leukemia virus-related virus), a human retrovirus associated with prostate cancer". Journal of virology 83 (14): 69957003. doi:10.1128/JVI.00268-09. ISSN 0022-538X. PMID 19403677. edit ^ Brower, V. (May 2009). "Is a retrovirus implicated in familial prostate cancer?". Journal of the National Cancer Institute 101 (10): 700701. doi:10.1093/jnci/djp137. ISSN 0027-8874. PMID 19436028. edit ^ Eastman, Peggy (2009). "Prostate Cancer: New Data Help Refine Risk Stratification". Oncology Times 31 (2): 32-33. Retrieved 2009-10-09. edit [edit]



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