We describe a subset of patients with chronic fatigue syndrome (CFS) as defined by the CDC, a duration of overwhelming fatigue for <2 years, and oscillating repetitively abnormal aberrant T-waves at 24-hour electrocardiogram (ECG) recordings (Holter monitors). Baseline 12-lead ECG, 2-D echocardiogram, rest/stress myocardial perfusion (thallium 201 or TC-99 sestamibi) and rest/stress multiple-gaited acquisition studies, as well as coronary angiography excluded coronary artery disease. Patients in this CFS subset had significant Ig (with or without positive IgM) human cytomegalovirus enzyme-linked immunoassay antibody titers. They had little or no evidence of concurrent Epstein-Barr virus (EBV) multiplication, corroborated by negative viral capsid antigen IgM antibody titer and an EBV total early antigen antibody titer of ≤40. Patients were given intravenous ganciclovir (5 mg/kg q1 2h for 30 days). Before this treatment, none of 18 patients could work or manage a household. At evaluations, 24 weeks after ganciclovir, 13 patients (72%) returned to their premorbid healthy states (P <.05). There were no adverse effects from ganciclovir in these nonimmunosuppressed patients.
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Lerner et al. (1997) studied this question.