Volgens een recente studie van dr. José Montoya en collega's
leidt langdurig gebruik van valganciclovir tot
een substantiële verbetering van het fysieke en cognitieve functioneren
bij ca. 50% van de ME/CVS-patiënten met antilichamen tegen
EBV (Pfeiffer) en/of
HHV-6.
Als we alleen het cognitieve functioneren (concentreren, onthouden etc.) in beschouwing nemen,
gaf maar liefst 81% van de patiënten aan minstens 30% verbetering te ervaren.
De studie bouwt voort op een proefstudie uit 2006 die ook positieve resultaten te zien gaf.
Response to valganciclovir in chronic fatigue syndrome patients with human herpesvirus 6 and Epstein-Barr virus IgG antibody titers.
J Med Virol. 2012 Dec;84(12):1967-74. doi: 10.1002/jmv.23411.
Watt T, Oberfoell S, Balise R, Lunn MR, Kar AK, Merrihew L, Bhangoo MS, Montoya JG.
Abstract
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.
PMID: 23080504
http://onlinelibrary.wiley.com/doi/10.1002/jmv.23411/abstract
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