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An update on the management of glandular fever (infectious mononucleosis) and its sequelae caused by Epstein-Barr virus (HHV-4): New and emerging treatment strategies – Source: Virus Adaptation and Treatment, Sep 2010

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Purpose: Beginning in 1993 at a single chronic fatigue syndrome (CFS) treatment center, we began studies that demonstrate Epstein-Barr virus (EBV) nonpermissive replication.

In the most recent study performed, EBV nonpermissive replication:

• Is the cause of 28.3% of 106 consecutive CFS cases,

• And is etiologic with human cytomegalovirus (HCMV) and/or human herpes virus 6 (HHV-6) as a coinfection in an additional 52.8% of CFS cases.

Therefore EBV is causally involved in 81% of cases of CFS.

Further, EBV CFS is effectively treated with long-term valacyclovir. Coinfection HCMV and HHV-6 CFS requires valganciclovir with valacyclovir.

Patients and Results:
The validated Energy Index Point Score(r) (EIPS(r)) monitors severity of CFS illness and its recovery.

A specific CFS diagnostic panel identifies EBV CFS subsets.

Four separate EBV CFS therapeutic studies of several hundred CFS patients describe valacyclovir administration and long-term patient recovery.

With valacyclovir, serum EBV titers (EBV, early antigen (diffuse); EBV, viral capsid antigen, immunoglobulin M); 24-hour electro- cardiography Holter monitors; and cardiac dynamic studies improve.

Conclusion:
Nonpermissive EBV infection is causal in a significant proportion of CFS cases. EBV CFS is safely and effectively treated with long-term valacyclovir.

Source: Virus Adaptation and Treatment, Sep 2010;#2, pp. 135-145. Lerner AM, Beqaj SH, Gill K, Edington J, Fitzgerald JT, Deeter RJ. Department of Medicine, William Beaumont Hospital, Royal Oak, MI; DCL Medical Laboratories, Indianapolis, IN; The Dr A Martin Lerner, Chronic Fatigue Syndrome Foundation, Beverly Hills, MI; Department of Medical Education, University of Michigan  Medical School, Ann Arbor, MI; Hematology-Oncology, Global Health Economics, Amgen Inc, Thousand Oaks, CA, USA. [Email: amartinlerner@yahoo.com]

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One thought on “An update on the management of glandular fever (infectious mononucleosis) and its sequelae caused by Epstein-Barr virus (HHV-4): New and emerging treatment strategies – Source: Virus Adaptation and Treatment, Sep 2010”

  1. saratbaker says:

    I had excellent results from Valtrex and Valcyte. I had to switch to Valcyte due to bruising. However,my insurance only paid for 4 months worth as it is off label. Now I am on immunovir for the second three month cycle. I don’t feel this drug is as effective, which is disappointing as it is very safe. I would like to be able to get back on the Valcyte–any ideas on how to get insurance to pay for it?

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