Epstein-Barr virus infection. If your tests indicate you have an active infection with EBV, this may be causing or contributing to your ME/CFS symptoms. Dr A. Martin Lerner has shown that the antiviral drug
valacyclovir (Valtrex) at a dose of 1,000 mg four times daily often improves ME/CFS symptoms, though usually the benefits only begin to become noticeable after around 3.5 months of treatment.
1 The full improvements from this drug appear after 2 years of treatment.
1 Valacyclovir can cause decreased kidney function or kidney failure, so it is advisable to test kidney function while on this drug. Those who experience side effects from valacyclovir can substitute with
famciclovir (Famvir) at the same dosage; Famvir is usually much better tolerated.
In Dr Lerner's study on 142 ME/CFS patients with herpes virus infections, 75% of patients responded to the appropriate antiviral treatment (Valtrex/Famvir for EBV, and/or Valcyte for HHV-6 and cytomegalovirus); the average improvement in ME/CFS symptoms was a 2-point increase on the
Energy Index Point Score scale (for example, as a result of antiviral treatment, an average patient may go from level 4 to level 6 on this scale).
1
Professor Jose Montoya has found
valganciclovir (Valcyte) effective when there is an active EBV infection. This drug needs to be taken for 6 month in order to see improvements.
1 Valcyte can have serious side effects and thus patients taking it must be medically monitored.
More info on Lerner and Montoya's antiviral treatment for ME/CFS given in
this post. Dr Lerner posits that the herpesvirus infections found in ME/CFS patients are not regular infections, but chronic
abortive infections.