Predictors of chronic fatigue in adolescents six months after acute Epstein-Barr virus infection: A prospective cohort study

• Published in: Brain, behavior, and immunity Vol. 75; pp. 94 - 100
• Main Authors: Pedersen, Maria, Asprusten, Tarjei Tørre, Godang, Kristin, Leegaard, Truls Michael, Osnes, Liv Toril, Skovlund, Eva, Tjade, Trygve, Øie, Merete Glenne, Wyller, Vegard Bruun Bratholm
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.01.2019
• Subjects: Adolescent; Adolescents; Antibodies, Viral - blood; Antigens, Viral - immunology; Child; Chronic fatigue; Chronic Fatigue Syndrome; Cohort Studies; Cross-Sectional Studies; Disease Progression; Epstein-Barr virus infection; Epstein-Barr Virus Infections - complications; Epstein-Barr Virus Infections - immunology; Fatigue; Fatigue Syndrome, Chronic - blood; Fatigue Syndrome, Chronic - etiology; Fatigue Syndrome, Chronic - physiopathology; Female; Forecasting - methods; Herpesvirus 4, Human - pathogenicity; Humans; Infectious Mononucleosis; Linear Models; Male; Prospective Studies; Young Adult; Epstein-Barr virus infection; IM; KSQ; HADS; FDI; LEC; Infectious mononucleosis; Chronic Fatigue Syndrome; CFQ; Chronic fatigue; TAS-20; BIPQ; EBV; PSWQ; BPI; Adolescents; PedsQL; CAPS
• ISSN: 0889-1591; 1090-2139; 1090-2139
• DOI: 10.1016/j.bbi.2018.09.023

•Post-infectious fatigue is common, but little is known on predicting factors.•We studied a prospective cohort of 200 EBV-infected adolescents.•Baseline symptoms and functional impairments predicted fatigue at 6 months.•Baseline markers of infection and immunity were poor predictors of fatigue.•Prediction models were similar across different definitions of chronic fatigue. Acute Epstein-Barr virus (EBV) infection is a trigger of chronic fatigue and Chronic Fatigue Syndrome (CFS). This study investigated baseline predictors of chronic fatigue six months after an acute EBV infection. A total of 200 adolescents (12–20 years old) with acute EBV infection were assessed for 149 possible baseline predictors and followed prospectively. We performed linear regression to assess possible associations between baseline predictors and fatigue (Chalder Fatigue Questionnaire total score) six months after the acute EBV infection. A total of 70 healthy controls were included for cross-sectional reference. This study is part of the CEBA-project (Chronic fatigue following acute Epstein-Barr virus infection in adolescents). In the final multiple linear regression model, fatigue six months after acute EBV infection was significantly and independently predicted by the following baseline variables (regression coefficient B[95% CI]): Sensory sensitivity (0.8[0.09–1.6]), pain severity (0.2[0.02–0.3]), functional impairment (1000 steps/day) (−0.3[−0.5 to −0.08]), negative emotions (anxiety) (0.4[0.2–0.6]), verbal memory (correct word recognition) (1.7[0.1–3.3]), plasma C-reactive protein (2.8[1.1–4.4] for CRP values >0.86) and plasma Vitamin B12 (−0.005[−0.01 to −0.001]). Development of fatigue after acute EBV infection is to a larger extent predicted by baseline variables related to symptoms and functions than to baseline variables reflecting infectious and immune processes. ClinicalTrials, ID: NCT02335437, https://clinicaltrials.gov/ct2/show/NCT02335437.