Andrew,
I just posted a response under a thread about the Rituxan trial where I make some references to EBV. Here is the link if you are interested in taking a look at it.
http://forums.phoenixrising.me/showthread.php?16203-Status-of-Rituximab-ME-CFS-Studies/page4. All the of the herpesviruses remain in the host for life, so it is how the virus stays under the body's immune radar that appears to play a role in symptom suppression. The earlier the treatment of the viruses seems to also impact remission of symptoms, as well as actively treating when symptoms reappear. If I was guessing, Cher probably fits into a subset of viral CFS/ME patients. If you are involved in a line of work where ongoing insurability of the employee is necessary I think I would weigh heavily the risks of advertising my personal health issues.
I believe that EBV (or other herpesviruses) still remains one of the important clues in diagnosing CFS/ME patients. I thought Dr. Lerner's video lectures/published studies are very interesting in helping to understand why EBV may be so elusive. I would think that the particular lab conducting these tests may also play a role on whether or not EBV or one of the other viruses can be detected. Perhaps the current lab tests are only picking up a subset of patients with high enough EBV titers. Quest/Focus Labs is one of the labs most often used by infectious diseases doctors in the U.S. to look for these type of viruses.
I believe research conducted by Dr. Lerner, Dr. Montoya, Dr. Kogelnik and others has found that the dose and length of time for treatment with antivirals is a significant factor in suppressing EBV and other herpersviruses such as HHV-6 and CMV. Looking at the research related to the oral antivirals of Acyclovir, Valtrex, Famciclivor and Valcyte they all seem to have some effect on these herpesviruses, but it appears to be dose related. While Valcyte might be the strongest of these oral drugs and most effective on CMV (and possibly HHV-6). In looking at the limited research on these drugs at high doses it appears that all of these drugs may have some effect on EBV.
When you read or listen to Dr. Lerner's studies you will see that he substituted Famvir for Valtrex for his EBV patients who experienced certain side effects to Valtrex. Famvir or generic famciclivor has a higher rate of bioavailability than Valtrex or Acyclovir. However, there have not been very many published studies conducted on high doses of these drugs. Valcyte, Famciclivor and Valtrex continue to show some significant results in treatment of CFS/ME patients subject to the type of virus treated, dose amount and length of treatment. For Famciclivor, high doses ranging from 1 gram and up given every 6 hours for six months or more seems to be where the research is headed. The constant round the clock dosing is a critical factor in being able to knock the viruses down. One of the promising results from this research is that Valtrex and Famvir are now off patent (at least in the U.S.), so the cost of treatment with these drugs using generics has gone from thousands or dollars a month to less than $5.00 if covered by an insurance drug plan. Not sure of the status of the Valcyte patent.
At high doses for long periods of times any of these antivirals can have serious health risks (especially to the kidney and liver). Valcyte has the added problem that it can cause severe mood alterations including suicidal thoughts and possible carcinogenic effects. I think there is great concern by a number of the CFS/ME doctors that people are self treating with these medications because they are desperate for a treatment, but any high dosing of these drugs really needs careful monitoring by a clinician who is knowledgeable in this type of treatment.
Wally
Edit: I just looked at the Prohealth link noted above about Cher and EBV. It is interesting to note that Dr. Dantini talked about his belief that treatment of food allergies accelerates the antiviral treatment for EBV. [URL="http://forums.phoenixrising.me/content.php?388-A-Fibromyalgia-Doctor-Steps-Out-Dr.-Dantini-Treating-Fibromyalgia-and-CFS-ME-CFS-with-Antivirals"/URL]
