How do you know if XMRV is the cause of CFS? If you treat the infection, and if you thus address the symptoms, then you know. Though others in his field may not agree the time is right, he would like to see a controlled clinical trial with antiretrovirals now: if they work to treat the symptoms, then we are on to something. . . .
When I asked how do we get a doctor on board without a paper confirming/replicating the link between XMRV and CFS, he said that this is the problem, can you get a controlled clinical trial before that association is confirmed? He said that is hard, but that he would like to see such a trial now, without more waiting. . . .
His hope would be that someone would set up a good controlled trial. Without doing a good placebo controlled trial, we can't move forward. But the issue is, could one justify starting a controlled trial now, without a clear association between XMRV and CFS. [Coffin says he thinks it a good idea to do this type of study now, though others may not agree.] You'd need a good way to measure that the meds are having a good virolological effect in this study. With HIV, they were surprised that the meds helped. But they did. They treat HIV with meds and the body will recover. With xmrv, he does not know if this will happen. Usually a retrovirus causes early damage, and that is the damage to the body, and treating the virus in the present does not help. This was not the case with HIV. With HIV, treating the virus *did* help, much to their surprise. If this is the same case with XMRV, that would be a good thing. But he has no idea which type of retrovirus XMRV is. We need to lobby for a controlled trial to be set up. It would not be a bad idea to do this, though others in his field would not agree.