Long term EBV treatment usefull for ME/CFS

The 2007 study investigated the long-term use of valacyclovir in a specific subgroup of patients with chronic fatigue syndrome (CFS) associated with active Epstein-Barr virus (EBV) infection.

Here is a summary:

Study design and patient groups:

double-blind, randomized, placebo-controlled

• Group 1: CFS patients suffering from active EBV infection received valacyclovir. After six months, the Valacyclovir group showed a significant increase in the Energy Index (EI) by an average of +1.12 units (equivalent to approximately 122 kcal/day) compared to the placebo group, which only improved by +0.42 units (approximately 65 kcal/day).
• Group 2: In an open long-term study arm (36 months), similar EBV-associated CFS patients were treated. Here, the EI increased continuously over the course of treatment, indicating a sustained improvement in physical performance.
  • • Open: There is no blinding – so both the patients and the treating doctors know which treatment is being administered (in contrast to a double-blind design).
    • Long-term study arm: The patients are observed and treated over a longer period of time, in this case 36 months, in order to evaluate the long-term effects and sustainability of the therapy.
    • The term “open long-term study arm (36 months)” refers to a study group in which:
    • In this study group, the effects of the treatment (here: Valacyclovir or Famciclovir for EBV-associated CFS) on the patients were documented over three years, without a placebo comparison in this phase. took place.

     

Treatment protocol:

• Patients received valacyclovir at a dose of 14.3 mg/kg every 6 hours (i.e. approx. 3 x 1000mg) in case of undesirable gastrointestinal side effects, Famciclovir was switched to –> we see effects in the Ordi already with 2 x 500
• Additional measures included the control of tachycardias (using atenolol) and the adjustment of physical activity based on the EI to avoid overexertion.

Result parameters:

• Improvement in physical performance: The energy index (EI) as the primary endpoint increased significantly in both the short-term (6 months) and long-term observation (36 months).
• Cardiac improvements: In addition to the increase in EI, abnormal cardiac parameters (such as tachycardias and T-wave changes in ECG and MUGA studies).
• EBV antibody titers: There was a significant decrease in IgM antibody titers against the EBV virus capsid antigen, indicating a decrease in viral activity.

Conclusion:
Results show that targeted antiviral therapy with valacyclovir leads to a noticeable (“significant”) and long-lasting improvement in physical performance and a reduction in cardiac abnormalities in EBV-associated CFS patients.

In addition, the study supports the hypothesis that persistent herpes virus activity – in this case EBV – could play an essential role in the pathogenesis of CFS.

For successful treatment, therapy of 6-12 months in combination with a coordinated plan of action to gradually increase physical activity seems to be necessary.

Photo: Grok(c)