Ribavirin and Interferon-a for the Treatment of Patients with Chronic Fatigue Syndrome Associated with Persistent Coxsackievirus B Infection: A Preliminary Observation

Several studies have demonstrated elevated neutralizing antibodies to coxsackievirus B (CBV) and the presence of enteroviral RNA in peripheral blood in a subset of patients with chronic fatigue syndrome (CFS). Of 10 patients with stable, persistently high titer of neutralizing antibody against CBV-3 and CBV5 were treated with ribavirin for 4 months, and 5 patients were subsequently treated with interferon/ribavirin for 2 to 6 months. Seven of 10 patients had significant improvement of fatigue and viral symptoms during ribavirin therapy, along with more than a fourfold decrease of neutralizing antibody. Most patients relapsed within 1 to 2 weeks of medication discontinuation, with subsequent rebound of neutralizing antibody to pre-treatment baseline and had detectable enteroviral RNA in blood