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ABSTRACTS

Antiviral treatment strategies in Chronic Fatigue Syndrome

Objective:have been studied by several research teams as possible candidates to be CFS related viruses. Our group has extensive clinical experience using antivirals, immune modulators and antioxidants in patients suffering from CFS, all of which seem to be useful tools in treatment strategies in subgroups. Human herpes-6 (HHV-6), Parvovirus B19, Epstein Barr virus (EBV) and enteroviruses

Methods:disorder and the outcome of various therapies in our own CFS patient population, using objective endpoints (qPCR, antibody titers, RNase L activity, exercise testing) and questionnaires. Amongst the antiviral drugs used are Valaciclovir, Amantadine and Famciclovir; for its combined antibacterialand antiviral effects Azithromycin was used in these patients. With regards to “antiviralimmunomodulators”, the treatment outcomes for respectively Ampligen, Kutapressin, Isoprinosine &Thymalfasin are presented.We present the scarcely available data in medical literature on antiviral treatments in this

Results: clinical effects, which did not last (relapse rate is high). Orally administered Amantadine resulted inmodest sustained positive clinical effects when given for months to several years. More than half ofthe CFS patients who were treated with Azithromycin for 6-18 months were responders, which ismore or less identical to what Vermeulen (Amsterdam) found ; in a 3 year follow-up most of theresponders did not have a relapse. A open label trial of 40 weeks Ampligen I.V. (1992-2002) in 160patients showed a statistically significant improvement when pre- and post- exercise capacity werecompared. This was confirmed in a double blind placebo controlled trial. Kutapressin administereddaily subcutaneously for at least 6 months in combination with B12 (= peroxynitrate scavenger) has a70% response rate in our practice. Other clinicians have reported similar results with Kutapressin. Apilot study with Isoprinosine (2003) showed that it may benefit a subgroup of patients. Recently,Thymalfasin was added as an alternative for the above. Fourteen weeks of therapy seem to result insimilar positive responses.Short term use of Valaciclovir or Famciclovir in a limited number of patients had positive

Conclusion: patients suffering from CFS. Outcome of these therapies in clinical studies is based on the selectionof specific subgroups of patients ; the latter depends largely on resolving outstandingdiagnostic issues.