Response to valganciclovir in chronic fatigue syndrome patients with human herpesvirus 6 and Epstein-Barr virus IgG antibody titers
– Source: Journal of Medical Virology, Oct 10, 2012
By Tessa Watt, Jose G Montoya, et al.
[Note: Dr. Montoya has studied the impact of the antiviral valganciclovir (Valcyte®) on ME/CFS patients affected by these viruses for years. This report suggests longer term treatment may be linked to better response.]
Valganciclovir has been reported to improve physical and cognitive symptoms in patients with chronic fatigue syndrome (CFS) with elevated human herpesvirus 6 (HHV-6) and Epstein–Barr virus (EBV) IgG antibody titers [concentrations].
This study investigated whether antibody titers against HHV-6 and EBV were associated with clinical response to valganciclovir in a subset of CFS patients.
An uncontrolled, unblinded retrospective chart review was performed on 61 CFS patients treated with 900mg valganciclovir daily (55 of whom took an induction dose of 1,800mg daily for the first 3 weeks).
Antibody titers were considered high if:
• HHV-6 IgG was 1:320 or greater,
• EBV viral capsid antigen (VCA) IgG was 1:640 or greater,
• And EBV early antigen (EA) IgG was 1:160 or greater.
Patients self-rated physical and cognitive functioning as a percentage of their functioning prior to illness.
Patients were categorized as responders if they experienced at least 30% improvement in physical and/or cognitive functioning.
Thirty-two patients (52%) were categorized as responders.
• 19 patients (59%) responded physically
• And 26 patients (81%) responded cognitively.
Baseline antibody titers showed no significant association with response.
After treatment, the average change in physical and cognitive functioning levels for all patients was +19% and +23%, respectively (P<0.0001). Longer treatment was associated with improved response (P=0.0002).
No significant difference was found between responders and non-responders among other variables analyzed.
Valganciclovir treatment, independent of the baseline antibody titers, was associated with self-rated improvement in physical and cognitive functioning for CFS patients who had positive HHV-6 and/or EBV serologies.
Longer valganciclovir treatment correlated with an improved response.
Source: Journal of Medical Virology, Oct 10, 2012;84(12), pp 1967-1974. DOI: 10.1002/jmv.23411, by Watt T, Oberfoell S, Balise R, Lunn MR, Kar AK, Merrihew L, Bhangoo MS, Montoya JG. Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University Medical Center, Palo Alto, California; University of Michigan Medical School, Ann Arbor; David Geffen School of Medicine, UCLA, Los Angeles, California; Brigham and Women’s Hospital, Boston, Massachusetts; San Diego School of Medicine, University of California, USA. [Email: Jose G Montoya Gilberto@stanford.edu]