Thanks so much for this informative talk,
@Ben H,
@Janet Dafoe (Rose49) and Ron Davis!
I have a question for Ron:
He says that genetic material from viruses (EBV, CMV, HHV6, etc.) is undetectable in the patient's blood, and that, if a virus was active anywhere in the body, its residue would eventually enter the bloodstream to be flushed. (Love the sewer analogy) Since viral material could not be detected in the patients' blood, it is concluded that these viruses do not contribute to the ongoing symptoms of ME/CFS. Antivirals may be helping by effects other than their ability to destroy viruses.
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Question:
For patients with high viral antibody titres, is it possible that the viruses are active in the gut, so that they, and their genetic residue, are undetectable in the blood?
The serum antibodies would quickly kill the virus if it entered the bloodstream from the gut, and viral residue could be flushed before being detectable.
Antivirals could be acting on the gut virome. For example, valganciclovir is converted to the active form, ganciclovir, in the gut.
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Here is a somewhat related article:
A Role for the Intestinal Microbiota and Virome in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4929410/