Fantastic Lerner Paper
Hi Cort, I was just reading this article and thought I would post something here, only to find you had aready posted it - excellent!
Here is some stuff I selected from the paper as very interesting, but the full paper is very much worth reading and discussing:
Subset-directed antiviral treatment of 142
herpesvirus patients with chronic fatigue
syndrome
A Martin Lerner1
Safedin Beqaj2
James T Fitzgerald3
Ken Gill4
Carol Gill4
James Edington4
1Department of Medicine, William
Beaumont Hospital, Royal Oak;
2Wayne State University School of
Medicine, Detroit; 3Department
of Medical Education, University
of Michigan Medical School, Ann
Arbor, Michigan; 4The Dr A Martin
Lerner Chronic Fatigue Syndrome
Foundation, Beverly Hills, Michigan,
USA
Virus Adaptation and Treatment 2010:2 4757
http://www.dovepress.com/getfile.php?fileID=6394
Group A CFS responders and nonresponders were similar
for sex, age, BMI, and distributions of single and multiple
herpesvirus subsets (Table 4). However, these patients did
differ in average duration of CFS illness prior to initiation
of antiviral treatment (7.3 years for nonresponders versus
3.9 years for responders, P = 0.005). Duration of antiviral
therapy for responders averaged 2.70 years,
It is unclear whether XMRV gamma retrovirus infection
initiates the immunosuppression which may be responsible
for CFS. Nevertheless, specific herpesvirus antiviral
treatment reversed CFS illness in 79 of 106 Group A CFS
patients. Earlier studies suggesting a herpesvirus CFS causation
had not used either the diagnostic criteria or long-term
herpesvirus therapy, nor had previous herpesvirus CFS
research separated groups A and B CFS which is critical to
these results.4,5
Cardiac muscle disease, syncope, chest pain, positive tilt
table tests, tachycardias at rest, decreased left ventricular
ejection fraction, and left ventricular dilatation improved and/
or disappeared with antiviral treatment. The abnormal HM
is a reliable biomarker of CFS cardiac disease. The EIPS is
integral to follow severity and reversal of CFS illness.
Questions about the pathogenesis of CFS remain. There is
a preponderance of tick-borne B. burgdorferi, and Anaplasma
and Babesia coinfections in Group B CFS patients. Studies of
possible antibiotics in patients with suspected chronic Lyme
disease need to consider the possibility of an unrecognized
presence of Group B herpesvirus CFS.
We continue valacyclovir/valganciclovir until the EIPS
is 7. If no further antiviral therapy is necessary, the CFS
patient now independently maintains herpesvirus latency.
The biologic parameters to be followed in this ongoing
process are critical in our diagnostic panel and are described
fully under Methods. These are EBV VCA, IgM (returns to
negative), EBV, EA-D (decreases and returns to negative),
HCMV IgM p52 and IgM CM2 (return to normal), and
HM abnormalities (eg, T-waves normalize and tachycardias
disappear). This thesis predicts that mRNA to intermediateearly
herpesvirus genes is circulating in mononuclear cells
in the blood of CFS patients, but this mRNA is not present
in healthy subjects.