Response to valganciclovir in chronic fatigue syndrome patients with human herpesvirus 6 and Epstein–Barr virus IgG antibody titersAn uncontrolled, unblinded retrospective chart review? With self-rated improvement? I am seriously underwhelmed.
Tessa Watt, Stephanie Oberfoell, Raymond Balise, Mitchell R. Lunn, Aroop K. Kar, Lindsey Merrihew, Munveer S. Bhangoo, José G. Montoya
Article first published online: 10 OCT 2012
J. Med. Virol., 84: 1967–1974. doi: 10.1002/jmv.23411
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.
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 900 mg valganciclovir daily (55 of whom took an induction dose of 1,800 mg daily for the first 3 weeks).
Antibody titers were considered high if HHV-6 IgG ≥1:320, EBV viral capsid antigen (VCA) IgG ≥1:640, and EBV early antigen (EA) IgG ≥1:160.
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.
Among these, 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.
If you have high titers, I won't blame you if you might want to give it a shot. If someone else pays for it, or if you have the money, that is.
And don't expect any miracles and don't bankrupt yourself on Valganciclovir.
Herpes viruses seem to be a contributing factor for some people with ME/CFS, but I would be seriously surprised if it turns out to cause ME/CFS in a larger sub-group of ME/CFS.