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Although EBV proteins may play a role in the progression of ME/CFS (52), researchers have hypothesised that the virus has a third state termed the abortive/leaky/lytic replication, as has been suggested upon analysis of the EBV genome in T and NK cells of patients with chronic EBV infection (134136)

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For example, from the patient perspective, inadequate health literacy, financial constraints, phobias, fear of hypoglycaemia, and social, cultural or personal pressures can adversely impact lifestyle and treatment adherence

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