A lot of experts on chronic fatigue syndrome (CFS or ME/CFS) believe that humanherpes virus 6 (HHV-6) is the culprit in many cases of the condition. So shouldn't people with ME/CFS just get treated for HHV-6 and see what happens?
It's not that simple. The problem is that antiviral drugs strong enough to kill HHV-6 are also rather toxic to people.
But at the June 2008 Symposium on Viruses in Chronic Fatigue Syndrome, Dr. M.N. Prichard talked about upcoming antivirals that are expected to be more effective and less toxic.
Keep your eyes open for developments involving these drugs:
- Artesunate (already approved in Europe for malaria)
- Arysulfone derivatives
- Cycloprovir
- CMX001
- CMV423
- HPMP-5-azal
- Marabavir (MBV)
Of course, these drugs are years away from being in regular use (sometimes research time seems on par with geological time), but at least with 7 promising drugs in the pipeline, odd are good that better treatment is coming. Someday.
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As more and more evidence stacks up showing a relationship between certain viruses and chronic fatigue syndrome (CFS or ME/CFS), doctors are treating the condition more and more often with antiviral drugs. Still, we don't have a lot of hard evidence that these drugs work.
Does that mean it's a dead end? Not at all! The big roadblock here is that doctors don't have biomarkers to show them exactly which viruses they're dealing with, which means they don't know which antiviral to give you. They're stuck with broad-spectrum drugs, which often have little or no effect on particular bugs.
At the June 2008 Symptosium on Viruses in Chronic Fatigue Syndrome, Dr. Kenny De Meirleir, who's treated thousands of people with ME/CFS, reviewed antivirals currently in use. (* indicates those approved, for other uses, in the U.S.)
- Ampligen (poly I: poly C12U): May be most effective in post-Epstein-Barr virus cases. Some studies show increased cognitive function and exercise capacity. Awaiting approval by the FDA.
- *Symmetrel (amantadine): Inhibits cellular infection and boosts dopamine activity. Currently used to fight fatigue in MS. Anecdotal success in ME/CFS is not supported by studies.
- *AzaSite (azithromycin): Shows promise against central nervous system infections.
Studies report response in 50% of people with ME/CFS.
- Immunoglobulins: May neutralize viral antigens and rebalance the immune system. Mixed results in studies.
- Kutapressin (aka Nexavir): Lab tests show it's effective against EBV. Anecdotal reports of success rate are very promising - as high as 75% in De Meirleir's practice in Australia.
- Zadaxin (thymalfasin): Hepatitis C drug used off-label in Europe for ME/CFS. Placebo-controlled trial is planned.
Research into protein and gene expression, which is expected to separate people with ME/CFS into different subsets, is expected to be a big help with zeroing in on the correct treatment down the road.
Do you have experience with any of these drugs? How did they work? Let us know, either here or in About.com's Fibromyalgia & Chronic Fatigue Syndrome forum.
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