Ok, here's the abstract, which is all my brain is up for right now.
"Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex, multi-system disease whose etiological basis has not been established. Enteroviruses (EVs) as a cause of ME/CFS have sometimes been proposed, as they are known agents of acute respiratory and gastrointestinal infections that may persist in secondary infection sites, including the central nervous system, muscle, and heart. To date, the body of research that has investigated enterovirus infections in relation to ME/CFS supports an increased prevalence of chronic or persistent enteroviral infections in ME/CFS patient cohorts than in healthy individuals. Nevertheless, inconsistent results have fueled a decline in related studies over the past two decades. This review covers the aspects of ME/CFS pathophysiology that are consistent with a chronic enterovirus infection and critically reviews methodologies and approaches used in past EV-related ME/CFS studies. We describe the prior sample types that were interrogated, the methods used and the limitations to the approaches that were chosen. We conclude that there is considerable evidence that prior outbreaks of ME/CFS were caused by one or more enterovirus groups. Furthermore, we find that the methods used in prior studies were inadequate to rule out the presence of chronic enteroviral infections in individuals with ME/CFS. Given the possibility that such infections could be contributing to morbidity and preventing recovery, further studies of appropriate biological samples with the latest molecular methods are urgently needed."
I think it's important to note that Dr. Hanson says "Infections may persist", "inconsistent results", "given the possibility" and "could be contributing", and "further studies of appropriate biological samples are urgent necessary". The sum is that we don't know if ME/CFS is cause by a lingering infection, because the data isn't there. The studies have not been done yet. Jumping to the conclusion that you want-an ongoing infection easily cured if you can just fine the right antiviral- isn't warranted here. Yes, outbreaks in the past have ben caused by an infection. That's not the same as illness being sustained by an infection (compare how autoimmune diseases are frequently caused by an infection but cannot be treated with viral medications). It also isn't the same as any specific current patient's illness being caused by an infection.
This article is a perfect example of how we don't know if viruses are causing ME/CFS. That's why Dr. Hanson wrote it- to point out our collective ignorance as much as our collective knowledge- and to goad someone into getting the knowledge we so badly need.
For me, until we have that knowledge, antivirals are powerful, and therefore risky, medications that could do more harm them good or at best completely misfire, as Dr. Davis and Dr. Naviaux describe. I recognize that other people have different levels of risk tolerance than I do, but for me I need a sureity of causation, not a possibility if I were to take this medication.
