Reflections on viruses and diabetes mellitus

Abstract

While the much publicised, unconfirmed and unfounded association of viruses, for example with multiple sclerosis, with benign myalgic encephalomyelitis (chronic fatigue syndrome or the Royal Free disease as designated originally) among others, serves as an imperative for considerable caution particularly in the case of guilt by association, it is important to remember the propensity of viruses to surprise. Notable examples are persistent infection with hepatitis B virus and hepatitis C virus and chronic liver disease, cirrhosis and hepatocellular carcinoma; Epstein-Barr virus and Burkitt's lymphoma and various other lymphoid and epithelial tumours; high-risk papillomaviruses, particularly types 16 and 18 and cervical carcinoma; the human T lymphotropic virus 1 and adult T-cell leukaemia, human herpesvirus 8 and Kaposi's sarcoma, and other viruses and other syndromes. It would be unwise, therefore, to overlook or, worse still, to dismiss the role of virus infections directly or indirectly in the aetiology of diabetes mellitus.