Friday, 27 November 2009

Antiviral treatment

Whilst researching current available ME/CFS treatments I came across an antiviral clinical study.  It was formed by a Dr Lerner at the Treatment Center for Chronic Fatigue Syndrome located in Michigan in the United States.  Dr Lerner has devoted his entire working life to analysing the correlation between viruses and ME/CFS.  His latest study revealed catagorising antiviral treatment into three subsets.  Those whose ME/CFS commenced from Epstein-Barr Virus (EBV), those from Cytomegalovirus (HCMV), or those from both. As my ME/CFS commenced from EBV and I have been tested negative for HCMV, I was keen to discover the approach that was taken.  The paper revealed the antiviral drug used for an onset by EBV was Valacyclovir, for HCMV was Valganciclovir, and went on to state that both should be used if both viruses were present at onset.  My EBNA IgG antibody for EBV is up at 200.  This is unusually high and although this result only shows a latent infection, every medical professional I have asked to why the value is so high has not been able to provide me with an explanation, just saying this titre remains up for life.  Just maybe this is the reason for such prolonged EBV symptoms, and a link to ME/CFS.  I will be interested to retake this blood test after a year or so on antiviral treatment, as this value has now remained constant for 18 months. 

Dr Lerner presented these results in the UK in 2008 and a link to the video presentation from his website is below.

An interesting question was raised by a member of the public at the end of the presentation, asking whether this will become available in the UK.  A representative replied, ‘it will take time for the ground rules to be put in place’.  This suggested over time this will become available.  I have recently read that the NICE guideline for ME/CFS will be reviewed in late 2010.  As of yet this antiviral treatment is still not offered so these procedures mentioned have not developed over the last two years.  It is common practice in the US to offer antiviral's, so in my view it must be down to funding in the UK.  I understand this treatment is inevitably not the complete answer.  However, if it has helped so many people with the same condition to even reduce symptoms, in my eyes is it worth a trial, especially as they reported no serious side effects.

Reading into the ‘Breakspear’ literature, it highlights they offer antiviral treatment.  This was the only place I have found in the UK to do so, but do they use the same drug?  Well yes, nearly.  After I undergo allergy testing on the product, I am to start on Aciclovir.  Dr Lerner recommends Valacyclovir for my condition but I then discovered something interesting.  Valacyclovir is a pro-drug and once inside the body is broken down into the active ingredient Aciclovir.  The reason I can see to use Valacyclovir over Aciclovir is that it is more absorbable and hence more effective with the final compound used by the body being the same.  I am to double check with the ‘Breakspear’ that Valacyclovir is not available, but am happy to have found and share a route for this treatment which many do not think is available here in the UK.

3 comments:

  1. Oliver,

    Where have you taken the tests to show your viral titre levels? I was with the breakspear for a year and the viruses they tested for came back negative, although my on-set of illness seems to be linked to a bout of shingles, I was not tested for varicella zoster (shingles). I emailed Dr Lerner and his comment was that (determined from my email) my shingles was a major contributory factor to my illness. I would like to see what my viral load is for this virus

    regards
    Clive

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  2. Clive, I did the full viral screens at a spire hospital before I ever went to the breakspear. The consultant thought perhaps my EBV had come back (which it hadn't) but wanted to check before they diagnosed me with ME/CFS. I am still very confused to why my EBNA for EBV is so high so will retest this titre after a year on antivirals.

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  3. Hi guys
    Interesting discussion.
    Here's my 2 cents: I'm really excited about the whole XMRV thing, because I think it fits my case.
    But I think whatever the trigger is, it's only the lede-in to a syndrome which is characterised by a broken immune system, a broken detox system and ultimately a broken methylation cycle.
    I clearly have chronic EBV, and respond well to Valtrex, but I've held off on the antivirals because I wanted to work on my immune system first so that if/when I get around to using the drugs, I can do more than just prevent viral replication. I want my immune system to be strong enough to actually kill off any virus I am flushing out.
    It's a gamble of course, what with the virus-cancer connection, and maybe I should have been using OLE or Lauricidin all this time.
    But I was reading the forum at www.aboutmecfs.org and I was interested to hear one of Nancy Klimas patients say that Klimas is concerned about viral resistance.
    I've heard of people in the states who are on Valtrex or counterparts for years.
    Seems like Klimas is starting off with immune modulators.
    I've spent my time working on my methylation cycle per Amy Yasko and Rich Van Konynenburg.
    Theoretically this approach made sense to me. Fix the methylation cycle, the biochemistry,allow the immune system to function normally, Then go after the pathogens.
    Sorry.. this was a bit of a ramble..hope it's of some interest.
    I'm aquariusgirl on the phoenix rising ..or aboutmecfs.org forums.
    Good Luck.

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