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Subset-directed antiviral treatment of 142 herpesvirus patients with chronic fatigue syndrome - Source: Virus Adaptation and Treatment, May 2010

  [ 71 votes ]   [ 2 Comments ]
By A Martin Lerner, et al. • • May 24, 2010

[Note: To read the free full text of this important article on the results of long-term antiviral treatment of ME/CFS patients, click here.

Purpose: We hypothesized that chronic fatigue syndrome (CFS) may be caused by single or multiple Epstein–Barr virus (EBV), cytomegalovirus (HCMV), or human herpesvirus 6 (HHV6) infection.

To determine if CFS life-altering fatigue and associated findings including muscle aches, tachycardia at rest, chest aches, left ventricular dysfunction, syncope, and elevated herpesvirus serum antibody titers are reversed by long-term subset-directed valacyclovir and/or valganciclovir.

Patients and methods:
Data were collected at physician visits every 4–6 weeks from 142 CFS patients at one clinic from 2001 to 2007. To be included in this study, patients had to be followed for at least six months. The data captured included over 7,000 patient visits and over 35,000 fields of information. Severity of fatigue was monitored by a validated Energy Index Point Score® (EIPS®).

Baseline and follow-up serum antibody titers to EBV, HCMV, and HHV6, as well as coinfections with Borrelia burgdorferi, Anaplasma phagocytophila, Babesia microti, and antistreptolysin O [a marker of Group A streptococcus infection], 24-hour ECG Holter monitors, 2D echocardiograms, cardiac dynamic studies, symptoms, and toxicity were captured and monitored.

International criteria for CFS plus a specifically designed CFS diagnostic panel were used.

Results and conclusions:

• The Group A herpesvirus CFS patients (no coinfections) returned to a near-normal to normal life (P = 0.0001). [Probability of result occuring by chance 1 in 10,000.]
-  The long-term EIPS value increased (primary endpoint, P < 0.0001) with subset-directed long-term valacyclovir and/or valganciclovir therapy.
-  Secondary endpoints (cardiac, immunologic, and neurocognitive abnormalities) improved or disappeared.

• Group B CFS patients (herpesvirus plus coinfections) continued to have CFS.

Source: Virus Adaptation and Treatment, May 2010;2010(2). Lerner AM, Begaj S, Fitzgerald JT, Gill K, Gill C, Edington J. Department of Medicine, William Beaumont Hospital, Royal Oak; Wayne State University School of Medicine, Detroit; Department of Medical Education, University of Michigan Medical School, Ann Arbor; Dr A Martin Lerner Chronic Fatigue Syndrome Foundation, Beverly Hills, Michigan, USA. [Email:]

[To read ME/CFS science reporter Cort Johnson's very informative article on this research and his interview with Dr. Lerner, click here.]

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Article Comments Post a Comment

Antiviral treatment
Posted by: KerryK
May 24, 2010
This should be huge news! It seems to also confirm the notion of multiple causes.
Reply Reply

More evidence of an immunological dysfunction - multipathogen
Posted by: IanH
May 26, 2010
These results are a bit of surprise in a way because previous studies looking at the herpes viruses were unclear. It does lend more weight to the theory that CFS is caused by an altered immune state by the existence of one or more pathogens which keep the immune system "activated". That is, it is not the pathogens themselves which is causing CFS but the immunological state as suggested in the recent paper by Broderick, Klimas et al showing how different "cytokine networks" are imbalanced. This theory also leaves open the possibility that some forms of CFS may be caused by toxins either alone or in conjunction with viral pathogens.


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