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by Editor
May 25, 2006
A drug normally used to treat herpes infections has produced a dramatic improvement in patients suffering from Chronic Fatigue Syndrome (CFS). Patients that had formerly been house-bound report being restored to normal life activities. CFS affects about 1 million patients in the United States, and about 240,000 in Britain. There is no cure for CFS, only ways to manage the condition.
The London Daily Mail newspaper reported the study results, which were delivered at a scientific conference earlier this month by Professor Jose Montoya, M.D., an infectious disease researcher and Associate Professor at Stanford University. The study took place in California, and involved 12 CFS patients who were given the drug valganciclovir, which targets the human herpes virus (HHV-6). Nine of the 12 patients reported a great improvement in their condition. The professor’s findings were reported at a conference on the HHV-6 virus held in Barcelona earlier this month.
Donna Flowers, a onetime champion figure skater now aged 50 and working as a physiotherapist, was quoted in the Daily Mail as saying “Two years ago, I was spending 14 hours a day in bed and my brain was so fogged I couldn't write a letter. I wasn't functioning at all. I'd been diagnosed with chronic fatigue, but the doctors didn't have anything to offer. I had to employ a full-time nanny just to look after my three-year-old twins.” Now she is now back to coaching young Olympic hopefuls, has fired the nanny, and has started taking ballet lessons.
Participants Report “Soaring energy levels”
“When Donna came to see us, her energy levels were around 10 per cent of what she considered normal,” Professor Montoya was quoted as saying. “Today, she is functioning at 90 per cent.” A patient who could hardly walk all the way around the block is now bicycling for up to three hours each day. Another patient who could not even leave the bed now comes to breakfast every day at 7:00 AM.
CFS patients often have signs of pre-existing viral infections, and viral infections have even been thought to be “triggering events” for the onset of CFS in some patients. This is the first clinical study to indicate that treating one of the viral infections would also be effective in the underlying CFS symptoms.
“I was amazed by the results,” Professor Montoya was quoted as saying at the infectious diseases clinic he heads at Stanford University. “Donna was sent to me because high levels of another virus (Epstein Barr) had been detected in her system. I found high levels of HHV-6 virus as well, so I treated her with valganciclovir to bring down her viral load. I'd hoped it might help a bit, but I didn't expect the results to be anything so dramatic. It was pure serendipity.”
Careful Patient monitoring is needed
Valganciclovir is a prescription drug approved for treating HHV-6 infections of the eye, which can occur in individuals with severely weakened immune systems, such as transplant or cancer patients. The HHV-6 virus is not the same as the herpes simplex virus that causes cold sores. Most commonly, it is associated with a condition called roseola infantum, a fever and a rash in children.
“I have treated hundreds of immune compromised patients with the drug, so I am very familiar with it,” stated Professor Montoya in The Daily Mail. “It can have serious side-effects including anemia, so you have to monitor patients very carefully. But so far none of the CFS/ ME patients have reacted badly to it.” These preliminary results will have to be studied in many more patients before the drug valganciclovir can be used as a standard treatment.
Charles Shepherd, a medical advisor to the charity Action For ME (CFS is known as ME in England) told The Daily Mail that CFS/ME has long been associated with prior viral infections. “About 75 per cent of cases begin with an infection which the patient never properly recovers from, so it is quite likely infectious agents lurk in the body. While the role of HHV-6 is certainly plausible, we will have to wait for a larger trial that is properly controlled.”
Professor Montoya commented on the possibility that the results were just due to a placebo effect. He told the newspaper “that is unlikely because we saw a worsening of each patient's condition around week three to four of the treatment, probably when infected cells were dying off. After that came the improvement. That is not a pattern you get with placebos. But we don't know yet why the drug makes such a difference.”
The possibility that a drug has been found that could eventually provide an effective treatment for some patients with CFS is just one part of the puzzle being studied by researchers. Genetic research is also providing clues that may lead to new treatments and therapies.
Traditionally, it has been assumed that CFS had no known cause, no direct diagnosis, and no known cure. Some practitioners considered CFS symptoms to be “all in the head,” and recommended psychotherapy as the primary treatment.
Now research is showing that these patients have “a disturbance in their body's natural way of dealing with infection,” Professor Malcolm Hooper, Emeritus Professor of Medicinal Chemistry at the University of Sunderland told The Daily Mail. “Anti-viral drugs such as valganciclovir may be allowing it to re-set itself.”
Dr Jonathan Kerr of St George's Medical School in London, a published researcher on the interplay between gene activity and CFS/ME, told a recent symposium that “We've found that the genes in patients' white blood cells — a key part of the immune system — are switched on and off in an abnormal fashion.” A controlled research study on interferon beta, a relatively old drug, is in the planning stages to see if it can help restore the genetic balance. It is hoped that studies involving the interplay of viral infections, genetic action and immune system functioning will provide new options for the treatment of CFS patients and the management of CFS symptoms.
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