Several immune abnormalities – most notably natural killer cell dysfunction – have been identified in ME/CFS patients. Other countries are racing to replicate the success of a small Norwegian trial of the auto-immune drug rituximab.
The role that pathogens play in ME/CFS is controversial. Although the disease is often triggered by an infection some researchers believe the triggering infection is simply the last stressor that tipped the patient over into disease.
Others believe that undiagnosed and untreated infections from pathogens such as EBV, HHV-6A, enteroviruses, Borrelia (Lyme disease) and others are playing a major role in the disease.
Still others believe that endocrine and immune dysfunctions caused early in the disease set the stage for latent viruses to reactivate themselves. While these viruses may or may not cause ME/CFS, they could exacerbate its symptoms greatly.
Given the wide variety of ME/CFS patients it’s possible that all the above scenarios are correct, but for different patients.
Several doctors regularly use antiviral and immunomodulatory drugs or supplements in their practices. The distinction isn’t always clearcut: some antiviral and antibiotic drugs have immunomodulatory properties.
Some drugs have worked very well for some patients, somewhat well in others, and not at all in others. Few studies of the effectiveness of these drugs, however, have been done.