ME,CFS, DIRE: High Titers of Herpesvirus CMV (cytomegalovirus)

by Helen Borel,RN,MFA,PhD

   High cytomegalovirus (CMV) titers along with high Epstein-Barr virus (EBV)) titers
have been found in many CFS:DIRE patients.  This herpesvirus, unlike the case with latent EBV which can be reactivated indefinitely, can be overcome provided the immune system is up to the task.  Once routed by the functioning immune system, immunity against subsequent CMV invasion is conferred for life.

                                 Cytomegalovirus and Splenomegaly
   Splenomegaly means "enlarged spleen".  Some cases of "true idiopathic splenomegaly,"
in which the investigators Hesdorffer et al. (Scandinavian Journal of Haematology, 1986)
felt splenectomy was contraindicated, demonstrated prior CMV infection.  They suggest a possible link between CMV infection and the development of splenomegaly, concluding that "The association between a previous cytomegalovirus infection and the development of splenomegaly is of particular importance in light of the possible association between the cytomegalovirus, the acquired immune deficiency syndrome and non-Hodgkin's lymphoma."

                                ME,CFS,DIRE Patients Must Protect 
                                   their Immune Systems from CMV
   As a sufferer of ME:CFS:DIRE, you must use all immunosupportive measures at your
disposal to prevent infection with the cytomegalovirus.  Patients who already have high
CMV titers need to sharply reduce their stress levels and markedly increase their vitamins and fluid intake levels.

                         CMV and Acquired Immunodeficiency Syndrome
   Unfortunately, severely immunodamaged AIDS patients are susceptible to blindness caused by CMV retinitis, stated Philip J. Hills, writing in The New York Times (Sept. 28, 1991).  CMV is considered an opportunistic infection in the case of AIDS.  At the time
I reported this information (in my 1992 book), Astra Pharmaceuticals Foscavir (R), that had to be administered intravenously, indefinitely, was available for these cases at the prohibitive cost of $58/day.  And that was merely the wholesale price!

   Syntex's less expensive Gancyclovir (R) had been used to treat CMV infections; however, about 50% of such treated patients suffered severe side effects, including leukopenia (low white blood cell count).  And AIDS and ME:CFS:DIRE patients can ill-afford decreases in WBCs.  Also, Foscavir's serious side effects can include renal damage and seizures possibly offset by close patient monitoring during treatment.

                Cytomegalovirus (CMV) is Only One of Many Etiologic Suspects
   No one has proposed CMV as a strong etiologic candidate for ME:CFS:DIRE, although
its presence in so many of such victims can do nothing but obstruct the overall course of recovery.  And its association with other immunocompromised states and lymphomas is not a pleasant caution to be aware of for stress-vulnerable Debilitating Immunopathic Relapsing Encephalomyelitis (DIRE) patients.

             (c) Copyright 1992 to 2018 by Dr. Helen Borel.  All rights reserved.