You have titers of 1:320 for echovirus 30 in the ARUP Lab tests? I believe Dr Chia would consider that evidence of a chronic active enterovirus infection. Dr Chia says the coxsackievirus B and echovirus serotypes that most commonly cause ME/CFS are: CVB3 and CVB4 first and foremost Then CVB2, EV6, EV7 and EV9 And then much less EV11 He does not mention EV30, but I would think it may be able to cause ME/CFS along with these other serotypes. So EC30 could be behind your ME/CFS. Your CVB4 titers of 1:160 are one level below the threshold of 1:320 that Chia uses as the indication for active infection. But note that the test-retest accuracy of these types of antibody assays is often give or take one level. So for example, if you tested again the next day, you might find your CVB4 comes out as one level higher at 1:320, or equally one level lower at 1:80, just due to the inherent slight day to day inaccuracy of the antibody assay. So you might want to focus on EV30, but remain suspicious of CVB4, especially as CVB4 seems to be one of the most common enteroviruses that Dr Chia finds active in his ME/CFS patients. In any case, whether it is EV30 and/or CVB4 that night be behind your ME/CFS, the treatment Dr Chia uses for such enterovirus infections is oxymatrine. Sometimes he adds in another immunomodulator inosine. He also uses the antiviral Epivir against some enteroviruses, and more recently has been using tenofovir.