Valacyclovir treatment in Epstein-Barr virus subset chronic fatigue syndrome: thirty-six months follow-up

In Vivo. Sep-Oct 2007;21(5):707-13.

Abstract

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.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acyclovir / adverse effects
  • Acyclovir / analogs & derivatives*
  • Acyclovir / therapeutic use
  • Adolescent
  • Adult
  • Antibodies, Viral / blood
  • Antibodies, Viral / immunology
  • Antiviral Agents / therapeutic use*
  • Electrocardiography
  • Fatigue Syndrome, Chronic / cerebrospinal fluid
  • Fatigue Syndrome, Chronic / drug therapy*
  • Fatigue Syndrome, Chronic / immunology
  • Fatigue Syndrome, Chronic / virology*
  • Female
  • Follow-Up Studies
  • Heart / drug effects
  • Heart / physiology
  • Herpesvirus 4, Human / drug effects*
  • Herpesvirus 4, Human / immunology
  • Humans
  • Infectious Mononucleosis / cerebrospinal fluid
  • Infectious Mononucleosis / drug therapy*
  • Infectious Mononucleosis / immunology
  • Infectious Mononucleosis / virology*
  • Male
  • Middle Aged
  • Motor Activity / drug effects
  • Time Factors
  • Valacyclovir
  • Valine / adverse effects
  • Valine / analogs & derivatives*
  • Valine / therapeutic use

Substances

  • Antibodies, Viral
  • Antiviral Agents
  • Valine
  • Valacyclovir
  • Acyclovir