Valacyclovir treatment in Epstein-Barr virus subset chronic fatigue syndrome: thirty-six months follow-up.
We hypothesized that subset classification of Epstein-Barr virus (EBV) in chronic fatigue syndrome (CFS) is required. At first, a blinded-random placebo-controlled trial of valacyclovir in EBV CFS subset was performed (Group 1), and this EBV subset was followed for thirty-six months (Group 2). Patients were given valacyclovir at 14.3 mg/kg every 6 hours. The validated Energy Index (EI) point score assessing physical functional capacity, Holter monitor, multigated (radionuclide) MUGA rest/stress ventriculographic examination, EBV serum IgM viral capsid antibodies (VCA), and EBV early antigen diffuse (EA) were followed. After six-months, Group 1 CFS patients receiving valacyclovir experienced an increased mean least square EI point score +1.12 units (122 kcal/day), while the placebo cohort increased +0.42 EI units (65 kcal/day). EI point scores at Group 2 increased progressively. Sinus tachycardias decreased and abnormal cardiac wall motion improved. Serum antibody titers to EBV VCA IgM decreased. Patients resumed normal activities.
Lerner
A Martin
AM
Department of Medicine, William Beaumont Hospital, Royal Oak, MI, USA. amartinlerner@yahoo.com
Beqaj
Safedin H
SH
Deeter
Robert G
RG
Fitzgerald
James T
JT
D000212:Acyclovir / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood / Q000276:immunology; D000998:Antiviral Agents / Q000627:therapeutic use*; D004562:Electrocardiography; D015673:Fatigue Syndrome, Chronic / Q000134:cerebrospinal fluid / Q000188:drug therapy* / Q000276:immunology / Q000821:virology*; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000187:drug effects / Q000502:physiology; D004854:Herpesvirus 4, Human / Q000187:drug effects* / Q000276:immunology; D006801:Humans; D007244:Infectious Mononucleosis / Q000134:cerebrospinal fluid / Q000188:drug therapy* / Q000276:immunology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000187:drug effects; D013997:Time Factors; D000077483:Valacyclovir; D014633:Valine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000914:Antibodies, Viral; D000998:Antiviral Agents; D014633:Valine; D000077483:Valacyclovir; D000212:Acyclovir