And why do some (!) get into full remission after antiviral therapies?
Viral infections could well be part of the central cause of ME/CFS. I have long suspected that ME/CFS has a dual-factor etiology, involving viruses like enterovirus or EBV, but also other secondary factors which allow that viral infection to create the symptoms of ME/CFS, and/or prevent the immune system from clearing the virus.
Mold for example has often been considered one of these secondary factors which plays a role in ME/CFS. Mold releases biotoxins which have known detrimental effects on the immune system, and/or modulate immunity. In the CBIS theory of ME/CFS, it is biotoxins released by bacteria in the kidneys that are posited to play a causal role.
Good evidence for a dual factor theory comes from the historical outbreaks of ME/CFS: these involved an infectious virus, but it was always found that once the virus travelled outside the area of the outbreak, it lost most of its ability to trigger ME/CFS. In my mind, the only thing that can explain that is a dual factor theory, where some biotoxins or a similar secondary factor exists only in the area of the outbreak. So it is only within that area that you can get exposed to both the virus and the secondary factor, and in this dual factor theory, both are required to trigger ME/CFS.
Dr Markov does not seem to think ongoing viral infections play a role in ME/CFS; he thinks it is just the biotoxins coming from the kidney infection that is the cause. But it could be that both these biotoxins and a viral infection act in concert to cause ME/CFS, via something like immune priming, which was mentioned earlier.
