Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University Medical Center, Palo Alto, CA, USA.
J Med Virol. 2012 Dec;84(12):1967-74. doi: 10.1002/jmv.23411.
Valganciclovir has been reported to improve physical and cognitive symptoms in patients with chronic fatigue syndrome (CFS) with elevated human herpesvirus 6 (HHV-6) and Epstein-Barr virus (EBV) IgG antibody titers. This study investigated whether antibody titers against HHV-6 and EBV were associated with clinical response to valganciclovir in a subset of CFS patients. An uncontrolled, unblinded retrospective chart review was performed on 61 CFS patients treated with 900 mg valganciclovir daily (55 of whom took an induction dose of 1,800 mg daily for the first 3 weeks). Antibody titers were considered high if HHV-6 IgG ≥ 1:320, EBV viral capsid antigen (VCA) IgG ≥ 1:640, and EBV early antigen (EA) IgG ≥ 1:160. Patients self-rated physical and cognitive functioning as a percentage of their functioning prior to illness. Patients were categorized as responders if they experienced at least 30% improvement in physical and/or cognitive functioning. Thirty-two patients (52%) were categorized as responders. Among these, 19 patients (59%) responded physically and 26 patients (81%) responded cognitively. Baseline antibody titers showed no significant association with response. After treatment, the average change in physical and cognitive functioning levels for all patients was +19% and +23%, respectively (P < 0.0001). Longer treatment was associated with improved response (P = 0.0002). No significant difference was found between responders and non-responders among other variables analyzed. Valganciclovir treatment, independent of the baseline antibody titers, was associated with self-rated improvement in physical and cognitive functioning for CFS patients who had positive HHV-6 and/or EBV serologies. Longer valganciclovir treatment correlated with an improved response.
缬更昔洛韦已被报道可改善人类疱疹病毒 6（HHV-6）和 Epstein-Barr 病毒（EBV）IgG 抗体滴度升高的慢性疲劳综合征（CFS）患者的躯体和认知症状。本研究旨在调查 HHV-6 和 EBV 抗体滴度是否与 CFS 患者亚组接受缬更昔洛韦治疗的临床反应相关。对 61 例接受 900mg 缬更昔洛韦（55 例患者前 3 周每日接受 1800mg 的诱导剂量）治疗的 CFS 患者进行了一项无对照、非盲回顾性图表审查。如果 HHV-6 IgG≥1:320、EBV 衣壳抗原（VCA）IgG≥1:640 和 EBV 早期抗原（EA）IgG≥1:160，则认为抗体滴度较高。患者自我评估躯体和认知功能相对于患病前的功能百分比。如果患者躯体和/或认知功能改善至少 30%，则将其归类为应答者。32 例（52%）患者被归类为应答者。其中，19 例（59%）患者躯体症状有应答，26 例（81%）患者认知症状有应答。基线抗体滴度与应答无显著相关性。治疗后，所有患者的躯体和认知功能水平平均变化分别为+19%和+23%（P<0.0001）。更长的治疗时间与改善的应答相关（P=0.0002）。在分析的其他变量中，未发现应答者和无应答者之间存在显著差异。缬更昔洛韦治疗与 HHV-6 和/或 EBV 血清学阳性的 CFS 患者的躯体和认知功能自我评估改善相关，而与基线抗体滴度无关。更长的缬更昔洛韦治疗与改善的应答相关。
