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Vagus nerve infection hypothesis
(section)
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=== [[Antiviral]] treatments === Potential problems with [[antiviral]]s are that these drugs would need to be a broad spectrum antiviral because a specific virus may not be identified and that antiviral drugs tend not to be effective on the vagal paraganglia.<ref name="hhv6f-vnih" /> Dr. [[Jose Montoya]] and Dr. [[Martin Lerner]], have published studies suggesting that IV valganciclovir therapy may be effective for the subset of CFS patients suspected of having elevated IgG for [[Epstein-Barr virus|EBV]]. Lerner also included patients with elevated IgG for [[CMV]]. Both Montoya and Lerner have shown that longer treatment terms (>6 months) have achieved greater success than short-term antiviral therapy.<ref name="Lerner2010">{{Cite journal | last1 = Lerner | first1 = AM | authorlink1 = A Martin Lerner | last2 = Beqaj | first2 = S | authorlink2 = Safedin Beqaj| last3 = Fitzgerald | first3 = JT | authorlink3 = James T Fitzgerald | last4 = Gill | first4 = K | authorlink4 = Ken Gill | last5 = Gill | first5 = C | authorlink5 = Carol Gil | last6 = Edington | first6 = J | authorlink6 = James Edington| title = Subset-directed antiviral treatment of 142 herpesvirus patients with chronic fatigue syndrome| journal = Virus adaptation and treatment| volume = 2 | pages = 47-57 | date = 2010| url = https://www.dovepress.com/subset-directed-antiviral-treatment-of-142-herpesvirus-patients-with-c-peer-reviewed-article-VAAT}}</ref><ref name="Montoya2013">{{Cite journal | last1 = Montoya | first1 = JG | authorlink1 = Jose Montoya | last2 = Kogelnik | first2 = AM | authorlink2 = Andreas Kogelnik | last3 = Bhangoo | first3 = M | authorlink3 = | last4 = Lunn |first4 = MR | authorlink4 = | last5 = Flamand |first5 = L | author-link5 = |last6 = Merrihew |first6 = LE | author-link6 = |last7 = Watt |first7 = T | author-link7 =|last8 = Kubo |first8 = JT | author-link8 =|last9 = Paik |first9 = J | author-link9 = | last10 = Desai | first10 = M | authorlink10 =| title = Randomized clinical trial to evaluate the efficacy and safety of valganciclovir in a subset of patients with chronic fatigue syndrome.| journal = Journal of Medical Virology| volume = 85 | pages = 2101-9| date = 2013| doi = 10.1002/jmv.23713| url=http://www.ncbi.nlm.nih.gov/pubmed/23959519}}</ref> Rodent studies have shown that the antiviral [[Famciclovir|Famvir]] (famciclovir) penetrates peripheral nerve ganglia better than other antivirals (e.g., Thackray & Feld 1996 J Infect Dis 173; Thackray & Feld 1998 Antimicrob Agents & Chemother 42), which makes it an attractive option if symptoms are driven by latent or active [[Herpesviruses|herpesvirus]] infection of peripheral vagus ganglia.
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