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* Objective.. To assess whether the human T-lymphotropic tropic virus type II (HTLV-II) gag gene sequence, a purportedly new laboratory marker of the chronic fatigue syndrome (CFS), and other possible risk factors for CFS, particularly those associated with retroviral transmission, are associated with well-characterized CFS. * Design., Two matched case-control studies. * Setting., The metropolitan Atlanta area. * Patients.. Twenty-one Patients with CFS who were identified by the Centers for Disease Control and Prevention CFS surveillance system; 21 CDC employee controls (laboratory study) and 42 neighborhood controls (risk-factor study) who were matched to patients by age, race, and gender. * Measurements.. Peripheral blood lymphocytes and leukocytes were assayed for the HTLV-II gag gene sequence by polymerase chain reaction and specific Southern blot hybridization. Questionnaires elicited demographic and clinical information and a history of exposures associated with retrovirus transmission (for example, blood transfusions, sexual practices, intravenous drug use). * Results., All patients were white and 86% were female. The median age at illness onset was n years (range, 16 to 51 years). The HTLV-II gag gene sequence was not identified in the blood of any patient or control under conditions in which the appropriate assay controls were positive. No statistical differences were observed between patients and controls in frequency of blood transfusions (10% compared with 7%), median number of sex partners before illness (3 compared with 3), bisexual or homosexual behavior (14% compared with 7%), intravenous drug use (0% compared with 0%), and other factors associated with retroviral infection. * Conclusions.. The HTLV-II gag gene sequence was not a marker for CFS in this small study of well-defined patients, nor did other characteristics of the patients and controls support the hypothesis that a retrovirus, transmitted by usual modes, was a cause of CFS., Human T-lymphotropic virus type II (HTLV-II), a type of retrovirus, may not cause chronic fatigue syndrome (CFS). CFS is a disorder characterized by chronic lethargy and fatigue. A study compared the occurrence of the HTLV-II gag gene sequence, an alleged laboratory marker for HTLV-II infection, in the blood of 21 patients with CFS to that among 63 healthy individuals. The HTLV-II gag gene sequence was not detected in the blood of the patients with CFS or any of the healthy individuals. The prevalence of risk factors for retrovirus infection was not higher among patients with CFS than among individuals without CFS. Risk factors for retrovirus infection include blood transfusions, an increased number of sexual partners, bisexual or homosexual behavior and intravenous drug use. Patients were more likely to have a family member or roommate suffering from CFS or to have a history of allergies than individuals without CFS.

* Objective: To conduct neurologic, immunologic, and virologic studies in patients with a chronic debilitating illness of acute onset. * Design: Cohort study with comparison to matched, healthy control subjects. * Patients: We studied 259 patients who sought care in one medical practice; 29% of the patients were regularly bedridded or shut-in. * Main Outcome Measures: Detailed medical history, physical examination, conventional hematologic and chemistry testing, magnetic resonance imaging MRI) studies, lymphocyte phenotyping studies, and assays for active infection of patients' lymphocytes with human herpesvirus type 6 (HHV-6). * Main Results: Patients had a higher mean (+ - SD) CD4/CD8 T-cell ratio than matched healthy controls (3.16 + - 1.5 compared with 2.3 [+ or -] 1.0 respectively; P < 0.003). Magnetic resonance scans of the brain showed punctate, subcortical areas of high signal intensity consistent with edema or demyelination in 78% of patients (95% Cl, 72% to 86%) and in 21% of controls (Cl, 11% to 36%) P < [10.sub.-9]). Primary cell culture of lymphocytes showed active replication of HHV-6 in 79 of 113 patients (70%; Cl, 61% to 78%) and in 8 of 40 controls (20%; Cl, 9% to 36%) (P < [10.sub.-8]), a finding confirmed by assays using monoclonal antibodies specific for HHV-6 proteins and by polymerase chain reaction assays specific for HHV-6 DNA. * Conclusions: Neurologic symptoms, MRI findings, and lympocyte phenotyping studies suggest that the patients may have been experiencing a chronic, immunologically mediated inflammatory process of the central nervous system. The active replication of HHV-6 most likely represents reactivation of latent infection, perhaps due to immunologic dysfunction. Our study did not directly address whether HHV-6, a lymphotropic and gliotropic virus, plays a role in procuding the symptoms or the immunologic and neurologic dysfunction seen in this illness. Whether the findings in our patients, who came from a relatively small geographic area, will be generalizable to other patients with a similar syndrome remains to be seen.