The Role of Antiviral Therapy in Chronic Fatigue Treatment


The MFSI and Fatigue Severity Scale are also useful tools, as well as the DePaul Symptom Questionnaire.1 Laboratory data which I consistently find to be abnormal include: Decreased NK cell numbers, decreased NK cell function, elevated EBV antibody titers, elevated HHV6 antibody titers, and, to a lesser extent, elevated cytomegalovirus antibody titers. Some patients have obtained perfusion Single Photon Emission Computed Tomography (SPECT) scans which show diffuse hypoperfusion consistent with findings in the literature.13,14

Response to valacyclovir is slow, as often an interval of 3 months or more is necessary. Duration of treatment is variable, ranging from 8 months to years. Cessation of antiviral treatment can sometimes precipitate a relapse of symptoms.

These data are also consistent with prior studies of antiviral treatment of SEID. Lerner and colleagues found significant and persistent improvement in symptoms and in cardiovascular function in SEID patients who were treated with the valacyclovir.15,16 Montoya and colleagues reported a 75% response rate to another antiviral, valganciclovir, in SEID patients with high IgG titers to EBV and HHV-6.17 Antiviral therapy may be a powerful tool in the fight against SEID.

Theodore Henderson, MD., PhD, is a psychiatrist in Denver, Colo., who specializes in the diagnosis of complex adult, child, and adolescent psychiatric cases. His website is


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