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Association of Active Human Herpesvirus -6, -7 and Parvavirus B19

Firestormm

Senior Member
Messages
5,055
Location
Cornwall England
Advances in Virology

Volume 2012 (2012), Article ID 205085, 7 pages
doi:10.1155/2012/205085Research Article

Association of Active Human Herpesvirus-6, -7 and Parvovirus B19 Infection with Clinical Outcomes in Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Svetlana Chapenko,1 Angelika Krumina,2 Inara Logina,3 Santa Rasa,1 Maksims Chistjakovs,1 Alina Sultanova,1 Ludmila Viksna,2 and Modra Murovska1

1August Kirchenstein Institute of Microbiology and Virology, Riga Stradins University, Ratsupites Street 5, LV-1067 Riga, Latvia
2Department of Infectology and Dermatology, Riga Stradins University, Linezera Street 3, LV-1006 Riga, Latvia
3Department of Neurology and Neurosurgery, Riga Stradins University, Pilsonu Street 13, LV-1002 Riga, LatviaReceived 2 March 2012; Revised 21 June 2012; Accepted 28 June 2012Academic Editor: Julia G. Prado

Copyright © 2012 Svetlana Chapenko et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received 2 March 2012; Revised 21 June 2012; Accepted 28 June 2012

Full paper: http://downloads.hindawi.com/journals/av/2012/205085.pdf

Abstract: http://www.hindawi.com/journals/av/2012/205085/

Abstract
Frequency of active human herpesvirus-6, -7 (HHV-6, HHV-7) and parvovirus B19 (B19) infection/coinfection and its association with clinical course of ME/CFS was evaluated.

108 ME/CFS patients and 90 practically healthy persons were enrolled in the study. Viral genomic sequences were detected by PCR, virus-specific antibodies and cytokine levels—by ELISA, HHV-6 variants—by restriction analysis.

Active viral infection including concurrent infection was found in 64.8% (70/108) of patients and in 13.3% (12/90) of practically healthy persons. Increase in peripheral blood leukocyte DNA HHV-6 load as well as in proinflammatory cytokines' levels was detected in patients during active viral infection.

Definite relationship was observed between active betaherpesvirus infection and subfebrility, lymphadenopathy and malaise after exertion, and between active B19 infection and multijoint pain.

Neuropsychological disturbances were detected in all patients. The manifestation of symptoms was of more frequent occurrence in patients with concurrent infection.

The high rate of active HHV-6, HHV-7 and B19 infection/coinfection with the simultaneous increase in plasma proinflammatory cytokines' level as well as the association between active viral infection and distinctive types of clinical symptoms shows necessity of simultaneous study of these viral infections for identification of possible subsets of ME/CFS.
 

Enid

Senior Member
Messages
3,309
Location
UK
Thanks Firestormm - a very interesting paper indeed. Trouble is testing for these viruses (targeted) does not form part of the simple UK one off blood test.
 

Firestormm

Senior Member
Messages
5,055
Location
Cornwall England
Not sure they would know what to do if they did Enid. Parvovirus was determined to be my original infection that I suspected triggered at least my initial descent into this madness.

What effect these viruses might or might not have should they remain in a person's system has never to my knowledge been determined. So far as I know even Post Viral Fatigue Syndrome has never received the kind of study that perhaps as a patient I would have liked to see.

We seem to get plenty of studies similar to the one above but very little comes of it. I don't know - a trigger? Yes. That's always been my conclusion but quite how or why something like Parvovirus could continue to cause the fluctuations and debilitation that I have experienced over 15 years now I don't know so other factors are probably at play.

Too many theories and not enough evidence if you ask me. Last thing I need is more opinion or enticing research for that matter. Still I suppose it's a revealing study to some extent - don't know if they define the time these patients have experienced ME symptoms since original infection - I'd have to check.
 

Sasha

Fine, thank you
Messages
17,863
Location
UK
Wasn't it the parvovirus that Dr Jonathon Kerr did a treatment study with antivirals and found it to be very, very effective? I've always been surprised at the lack of follow-up.
 

Firestormm

Senior Member
Messages
5,055
Location
Cornwall England
Rings a bell Sasha. I was just saying elsewhere I've never been offered anti-virals because of my ME and from what I have read over the years it remains a 'hit and miss' treatment. Not that I wouldn't expect it to be given the way in which we are all cobbled together.
 
Messages
646
Advances in Virology

Volume 2012 (2012), Article ID 205085, 7 pages
doi:10.1155/2012/205085Research Article

Association of Active Human Herpesvirus-6, -7 and Parvovirus B19 Infection with Clinical Outcomes in Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.....................................................

The high rate of active HHV-6, HHV-7 and B19 infection/coinfection with the simultaneous increase in plasma proinflammatory cytokines' level as well as the association between active viral infection and distinctive types of clinical symptoms shows necessity of simultaneous study of these viral infections for identification of possible subsets of ME/CFS.

This is the kind of 'small step' science that IMO should command a lot of confidence - both from patients, and the medical profession. What further study would hopefully elucidate is whether the association with M.E/CFS is a result of opportunistic infection because of immocompromise (CFIDS !?), whether there is actual chronic active infection, or whether there is a process of reactivation of an otherwise dormant virus - or indeed some combination of all these, either in individuals, or across the patient population as whole. I'm sure much of this has been visited before, but perhaps not directly connected to M.E/CFS in a medium sized cohort study - in any event I thought the reactivation issue referred to here http://emedicine.medscape.com/article/1134049-overview has relevance.

IVI
 
Messages
646
Rings a bell Sasha. I was just saying elsewhere I've never been offered anti-virals because of my ME and from what I have read over the years it remains a 'hit and miss' treatment. Not that I wouldn't expect it to be given the way in which we are all cobbled together.

The problem is that antiviral treatment needs to be delivered as part of well monitored process. Under normal circumstances a viral infection the body fights of the worst of infection and one is left with a low level of clinically insignificant virus for the rest of ones life, medically making an intervention in the face of viral infection is usually not justified - so testing needs to happen on a number of occasions to see whether there is a persistent or repeatedly reactived infection, that might be amenable to treatment. There then needs to be re-testing during the course of the treatment to see if it has any effect. Even if all that is carried out, there is no certainty that the antiviral treatment has caused a reduction in viral load, or whether remission is in play that would have happened anyway, further there is no guarantee that reduction in viral load is only temporary and that resurrgence will arise in due course. There is a great deal of concern regarding the development of anti viral resistance, given the limited range of treatments available, the development of resistance could be catastrophic in an individual. Anti viral treatment in M.E might turn out to be valuable, but simply throwing anti virals at the problem is likely not to have a happy ending.

IVI
 

floydguy

Senior Member
Messages
650
The problem is that antiviral treatment needs to be delivered as part of well monitored process. Under normal circumstances a viral infection the body fights of the worst of infection and one is left with a low level of clinically insignificant virus for the rest of ones life, medically making an intervention in the face of viral infection is usually not justified - so testing needs to happen on a number of occasions to see whether there is a persistent or repeatedly reactived infection, that might be amenable to treatment. There then needs to be re-testing during the course of the treatment to see if it has any effect. Even if all that is carried out, there is no certainty that the antiviral treatment has caused a reduction in viral load, or whether remission is in play that would have happened anyway, further there is no guarantee that reduction in viral load is only temporary and that resurrgence will arise in due course. There is a great deal of concern regarding the development of anti viral resistance, given the limited range of treatments available, the development of resistance could be catastrophic in an individual. Anti viral treatment in M.E might turn out to be valuable, but simply throwing anti virals at the problem is likely not to have a happy ending.

IVI

One must compare anti-viral treatments (or anything else for that matter) to doing nothing. Sure there are consequences of any treatment but in long term ME there are also consequences to doing nothing such as inability to support oneself and in the US that means being on Medicaid which can essentially mean no treatment and no hope at all. For some people with ME anti-virals could mean the difference between functioning and not functioning. Perhaps there will be consequences to that but many don't have the luxury of waiting for the NEJM to come out with a rock solid treatment plan while hanging out at the Ritz getting massages while being supported by spouses or trust funds.
 

Firestormm

Senior Member
Messages
5,055
Location
Cornwall England
What then are you suggesting Floydguy? I'm not incidentally being disrespectful, I would genuinely like to know.

I don't think anyone here was suggesting that people diagnosed with our condition should not be prescribed anti-virals should a doctor determine there to be just cause on an individual basis. Just that the evidence for their effectiveness across a cohort or even broader than that has been sketchy at best.

Speaking personally, and to build on what I have said above, I am rather pissed off that studies such as this one have not led anywhere. There is not enough evidence to move to clinical trials if that's what you would suggest. What I would like to see is for studies using well structured cohorts move to the stage beyond the one this paper reports, you know? To build on this finding and the seeming associations - finally.

Why is it so hard (well I suspect I know why but anyway) for scientists to not take a cohort of patients with ME who were triggered by parvovirus, who still have traces of parvovirus to study the effect of parovirus within the human body?

Surely somebody somewhere has looked at the long term effects of parvovirus even in mice. Even to the extent of studying mice infected with parvovirus and treated with anti-virals then observing the effects over the longer term. I mean is there no evidence of long term residual effects of viral infection?

We seem sometimes to be stuck on 'Go'. Bloody Groundhog Day.​

Instead of clumping us all together (even those with a known or suspected 'viral trigger') narrow it down. Focus in on it. But then I guess they have been doing that for years with Herpes viruses and EBV for that matter and haven't got very far. It's all rather depressing really.

Still. I must read that paper when I get more time. It does sound rather interesting. But I'm rather fed-up of that word too :(
 

ukxmrv

Senior Member
Messages
4,413
Location
London
It's having a "happy ending" for me, IVI. A dose of Valtrex reduced the severe burning at night I had experienced for over a decade and also reduced the sore throats and glands. In the absence of proof and the research we need, patients are experimenting on themselves. It is a personal choice and the right one for me.

We only get one life. Over 25 years of this disease and still treatment options are limited.

I'm very glad that antivirals and immune modulators have helped me so far. Then again I'm an acute onset patient. I'm not saying that antivirals will help everyone or even all the acute onset patients.

Yes, we do need clinical trails but what to do in the mean time while we campaign for them? I've happy that I took the risk. Other meds prescribed by UK NHS doctors (like antidepressants) have harmed my health.
 

Firestormm

Senior Member
Messages
5,055
Location
Cornwall England
I think there have indeed been sporadic reported successes with anti-virals as there has with anything else. Nobody has declared though that research points to 'antivirals being effective for the disease' or even a portion of those with the disease. Hence their sporadic prescription. And nobody has said how those antivirals are effective or why, even in those for whom they are prescribed - not in a scientific way. Perhaps those who have been so prescribe and feel they have benefitted there has been some proven improvement directly associated with the drugs taken. But if so I can't recall hearing about it in relation to a decrease in their ME symptoms for example.
 

Guido den Broeder

Senior Member
Messages
278
Location
Rotterdam, The Netherlands
Effectiveness of the right antivirals

Lerner M, Beqaj S, Fitzgerald JT, Gill K, Gill C, Edington J (2010), "Subset-directed antiviral treatment of 142 herpesvirus patients with chronic fatigue syndrome", Virus Adaptation and Treatment, May, Volume 2010:2, p.47-57

What latent EBV does

Tzartos JS, Khan G, Vossenkamper A, Cruz-Sadaba M, Lonardi S, Sefia E, Meager A, Elia A, Middeldorp JM, Clemens M, Farrell PJ, Giovannoni G, Meier UC (2012), "Association of innate immune activation with latent Epstein-Barr virus in active MS lesions", Neurology. 2012 Jan 3;78(1):15-23. Epub 2011 Dec 7, PMID: 22156987

Xu S, Gaskin F (1997), "Increased incidence of anti-beta-amyloid autoantibodies secreted by Epstein-Barr virus transformed B cell lines from patients with Alzheimer's disease", Mech Ageing Dev, Mar;94(1-3):213-22, PMID: 9147373

A cohort study

Vernon S, Whistler T, Cameron B, Hickie I, Reeves W, Lloyd A (2006), "Preliminary evidence of mitochondrial dysfunction associated with post-infective fatigue after acute infection with Epstein Barr Virus", BMC Infect Dis. Jan 31;6 (1):15, PMID: 16448567
 

ukxmrv

Senior Member
Messages
4,413
Location
London
Firestormm,
Valtrex has helped with the swollen glands and sore throats which have been core ME systems from day 1 (or night 1) as it was. Just wish that I could get Valcyte or try other similar medications.
Acyclovir didn't help me so this is a very individual thing and obviously we need clinical trails. Until we do I'll keep experimenting.