Which doctor is right about chronic EBV?

[TenuousGrip]

My ridiculously simplistic view of this has always been that it's a bit like shadow boxing -- it may well be there there's nobody on the other side of the battle but that you're fighting the battle as if there was an enemy nonetheless.

This is my interpretation of at least part of the autoimmunity theory: it's quite possible that there is no physical infection left in the body but the fight goes on as if there were.

For those of us with documented exposure (ie, antibodies) to something like EBV ... our immune systems may think that they're Hiroo Onoda and never stop fighting the war. Intuitively, this could easily be exhausting and lead to no end of other problems -- maybe including chronic and systemic inflammation.

It's just kind of my surmise -- how I view this piece of the disease. No idea if it's valid or not.

 

[Patrick*]

I'm still 50/50. Dr. Lerner's theory seems equally as plausible as the others mentioned here who say that the titers are not due to an active infection.

The one thing I couldn't get past when considering if the test results were false positives was: what is causing consistent false positives? I could understand one or two false positives due to a fluke in testing conditions, but not 5 in a row. What I never considered was that there could actually be EBV antibodies circulating, but they're errant and not in response to an infection. If that's the case, the test results really aren't "false positive." They're accurate that the antibodies are present, they simply don't mean what standard medicine has taught is the only conclusion to draw from them: infection.

Here's another consideration for myself and others faced with this same dilemma (to treat or not to treat with antivirals):

"Q7. How would you respond to Dr. Ronald Davis’s recent statement: “What is important to note is that in the absence of evidence of an active infection, it is plausible that the long-term antimicrobial treatments often used for ME/CFS patients are doing more harm than good.”

I am in complete agreement. Many antibiotics like tetracyclines, erythromycin, and the fluoroquinolones (eg, Cipro), and antivirals like acyclovir, fialuridine, AZT, and ddC also inhibit mitochondrial functions when used chronically (usually for more than about 3 weeks). Because mitochondria are descendants of free-living bacteria, their machinery for protein synthesis, RNA synthesis, and DNA replication are susceptible to many antibiotics, and for reasons unique to mitochondrial DNA synthesis, they are also sensitive to antivirals. Chronic use of these drugs can do more harm than good if there is no longer good evidence for an active infection."

-from the Robert Naviaux interview linked by @ljimbo423 above.

Of course this isn't new. It's been noted here on PR in many antiviral threads that these drugs interfere with mitochondrial function.

 

[Hip]

The one thing I couldn't get past when considering if the test results were false positives was: what is causing consistent false positives? I could understand one or two false positives due to a fluke in testing conditions, but not 5 in a row. What I never considered was that there could actually be EBV antibodies circulating, but they're errant and not in response to an infection. If that's the case, the test results really aren't "false positive." They're accurate that the antibodies are present, they simply don't mean what standard medicine has taught is the only conclusion to draw from them: infection.

Yes that's right: these "false positive" antibody tests are correctly detecting high levels of antibodies. There are no errors in the test itself (to my knowledge). It's just the interpretation of those high antibody levels that is in question, and that leads to them being called "false positive".

Normally high antibodies suggest an active infection, such as an acute infection. But sometimes high antibodies will remain for a year or so after an acute infection is over, and then levels will subside. So you can get situations where there are high antibodies, but not necessarily an active infection. But ME/CFS patients have high antibodies for decades after their acute infection has cleared up.

You can interpret these chronic high antibody levels of ME/CFS as an malfunction of the immune system, where the immune system keeps pumping out these antibodies, but there is no active infection to be found. Or you can interpret the chronic high antibody levels as actual evidence for a real infection hidden somewhere in the body.

But which interpretation is right? If the latter were the case, then you would expect there to be a hidden infection somewhere in the body of ME/CFS patients, which in principle you could find.

And sure enough, if you look for evidence of a hidden enterovirus infection in ME/CFS, you can find it pretty easily, as the original British research on ME/CFS dating back to the 1970s used muscle tissue biopsies, and found that if you perform a PCR test on muscle tissue (rather than a PCR on the blood), you certainly find a chronic enterovirus infection in the muscles. Dr John Chia then extended this to finding chronic enterovirus infections in the intestinal tissues of ME/CFS patients as well.

So ME/CFS patients are riddled with enterovirus infections in their tissues, but because these are non-cytolytic intracellular infections which don't produce any viral particles, you actually find very few viral particles in the blood, which is why blood PCR tests are often negative in ME/CFS. But this contrasts to muscle tissue PCR tests, which are often positive.

 

[frederic83]

But most infectious disease specialists do not know about for example the intracellular non-cytolytic enterovirus infections that smolder away slowly within cells and do not produce any viral particles, even though such infections have been shown to occur in ME/CFS, chronic coxsackievirus B myocarditis, and may also be the cause of type 1 diabetes.

That's because a non replicating virus is not considered as a disease by the medical community. Big mistake, it certainly causes problem in some case, IMO.

 

[jodiesattva]

I'm still 50/50. Dr. Lerner's theory seems equally as plausible as the others mentioned here who say that the titers are not due to an active infection.

The one thing I couldn't get past when considering if the test results were false positives was: what is causing consistent false positives? I could understand one or two false positives due to a fluke in testing conditions, but not 5 in a row. What I never considered was that there could actually be EBV antibodies circulating, but they're errant and not in response to an infection. If that's the case, the test results really aren't "false positive." They're accurate that the antibodies are present, they simply don't mean what standard medicine has taught is the only conclusion to draw from them: infection.

Here's another consideration for myself and others faced with this same dilemma (to treat or not to treat with antivirals):



Of course this isn't new. It's been noted here on PR in many antiviral threads that these drugs interfere with mitochondrial function.

If these antivirals inhibit mitochondrial function, but could potentially help clear up the hidden EBV infection, which is the lesser evil?

Or is there an alternative? Are the herbal antivirals effective and safe for the mitochondria? And if so, which are the ones to go for?