So I wonder if ebv and other viruses could cause a lack of igg or even the subclasses. Even at low replication levels
Yes, I think so.
I also wonder what effect antivirals might have on igg levels.
Maybe so, though hard to tell if one is getting gammaglobulin replacement.
I really do think a lot of ME patients could be mis diagnosed and actually have PID or SID because it's so hard to diagnose anyway. I mean my GP did check but he didn't do subclasses. Thing is most GP's do NOT check. And igg and subclasses isn't enough to check this anyway.
There are a fair number of us with low immunoglobulins. And many of us of us that have had gammaglobulin replacement along with anti infectives have improved. However, many of us also have autoimmunity, so that needs to be treated too.
Given your history, your GP should be checking subclasses - one can have a barely adequate total IgG but be low in the subclasses that fight bacteria and viruses.
I know Joan on the s4me forum has PID low igg subclasses. She started bactrim 4 years ago and went from very severe to remission within about 2 years. Obviously bactrim is broad spectrum with some nasty side effects. But for her that's worked to correct a lot of the issues that her doctors tell her is caused by PID. Yet she was diagnosed with ME for 12 years originally
Obviously Joan had a chronic bacterial infection of Bactrim helped her. I'm allergic to it, it wouldn't help me. But treating the 5 active viruses I had with antivirals and 2 atypical pneumonias with a triple antibiotic (azithromycin, rifampin, doxycycline) combo given IV after oral abx failed, along with IVIG helped. Then dealing with the oxalate problem in my gut that the antibiotics gave me also helped. Wonder what's left in Joan's gut after all that Bactrim?