If you think having high antibody titers always means infection, read this!

Discussion in 'General Discussion' started by Remy, Nov 10, 2017.

  1. Remy

    Remy Administrator

    For everyone with elevated antibody titers to common infections, From Dr Naviaux:

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  2. Hope

    Hope Active Member

    But I've read that PCR is not an accurate way to test for a virus, by blood anyway (not sure if lymph nodes might be more accurate) as its hit or miss whether that particular blood sample might contain viral DNA.

    So to say that PCR can prove that high viral titers are meaningless seems a big stretch. Maybe viral titers really are meaningless if the immune system is impaired but I just don't think PCR proves it when it shows negative for viral fragments.
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  3. IrisRV

    IrisRV Well-Known Member

    My infectious disease doc told me that old latent infections that get deep in the tissues don't shed much virus into the blood so PCR is not a ruling-out test. In other words, a PCR positive test definitely shows an infection, but the negative test does not guarantee no infection.

    As I understood it, most people don't have deep tissue infection, which may be the result of an immune system weakness that lets the infection smoulder and spread cell-to-cell through tissue slowly over many years. This wouldn't be the usual case with supertitres, I imagine, but may be the case in some patients.

    These may be the exceptions OMF was referring to.

    It's clear a number of patients improve significantly with AVs, so something is going on in those cases. It may not be suppression of viral replication, but some other effect of the AVs that helps. Or maybe some patients really do have reactivated infections.

    My daughter fights EBV. She gets mono symptoms and her IgG titres rise. If we wait long enough, her EBV Early Antigen titre gets high enough to confirm viral reactivation, but it's harder to fight the infection back into latency if we wait for the EA titre than if we go by symptoms and increasing titres. Make of that what you will.
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  4. Remy

    Remy Administrator

    I’ve read that same thing too about viral shed into blood and consequently treated with Valtrex, Valcyte, cidofovir, Famvir etc etc for almost 2 years.

    Surely these research scientists know that this is the common lore. Many of their clinical colleagues are still prescribing antivirals based on high antibody titers. I believe that they are saying that is the wrong approach with full knowledge of the controversy.

    I’m also not ruling out antiviral drugs working in as yet unidentified ways, like modulating adenosine too. Lots of drugs “work” and we don’t really understand how or why.
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  5. Hip

    Hip Well-Known Member

    I've recently been reading about Dr Martin Lerner's abortive infection theory of ME/CFS.

    Abortive infections can create high antibody titers, yet nothing much shows up on PCR blood tests, because in abortive infections, although cells are virally infected, they do not create any new viral particles (this is similar in some ways to latent viral infections, but abortive infections are distinct from latent infections). Lerner posited that abortive herpesvirus infections are the cause of ME/CFS.

    I just started a thread about Dr Martin Lerner's abortive herpesvirus infection theory of ME/CFS here.
    Last edited: Nov 10, 2017
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  6. Merida

    Merida Well-Known Member

    Important information. I am lost in this conundrum with high titers to Borrelia/ Lyme ( considered positive by CDC criteria) but a negative PCR. The CDC has stated that PCR is not adequate for the diagnosis of Borrelia/ Lyme. Yet, my doc says negative PCR - no treatment needed. And he is a great physician - double board certified in infectious disease and internal medicine. Anyone else caught in this ?
  7. Remy

    Remy Administrator

    It's quite the conundrum. I don't think anyone really knows for sure. I'm inclined to think it means dsyregulated immune system vs active infection when PCR is negative, but you really could make an argument either way. That's why there is no consensus at the moment.
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  8. Hip

    Hip Well-Known Member

    I think most non-ME/CFS doctors tend to believe that the high antibody titers found in ME/CFS patients are just the result of a dysfunctional immune system, especially because PCR blood tests usually find no evidence of viruses in the blood. So they believe that there is no ongoing infection, and the high titers are just red herrings.

    However, ME/CFS specialists view these high titers as evidence of an ongoing infection in the tissues.

    In the case of enterovirus associated ME/CFS, you can actually detect these tissue infections by using PCR on tissue samples (rather than on the blood). All the early ME/CFS research in the UK dating back the 1970s used to take muscle tissue biopsies from ME/CFS patients, and test those tissue samples using PCR, and here the PCR comes back positive. In these tissue PCRs, the muscles of ME/CFS patients were found to be riddle with enterovirus infection.

    But these muscle tissue enterovirus infections are non-cytolytic infection, which produce no new viral particles; and this is why you don't see viruses in the blood using PCR. (Similarly, the abortive herpesvirus infections in Dr Lerner's theory of ME/CFS produce no new viral particles, hence the negative PCR blood tests).

    Historically, the reason this British research was discounted in the US was because the CDC conducted an (unpublished) study on ME/CFS patients which used PCR blood tests, and unsurprisingly, it found no enterovirus. Whereas the researchers in the UK had been using PCR on muscle tissue, where they found ample evidence of chronic infections in ME/CFS patients. Dr Chia explains this in his Invest in ME 2009 Conference presentation, available on DVD.

    That I believe is why in the US, interest switched to researching herpesviruses as the possible cause of ME/CFS. Which I guess is a good thing, because it seems that both enteroviruses and herpesviruses are linked to ME/CFS, and in the UK, the focus was solely on enterovirus; so it's good that the US went down the herpesvirus route.

    (Of course, after around the 1990s, the UK descended into promoting only psychobabble theories of ME/CFS, and is no longer pursuing the enterovirus research it pioneered).

    But I think now ME/CFS specialist doctors in the US should be testing for both enterovirus and herpesvirus. Yet there still seems to be this divide, with most of the specialists focusing just on herpesviruses, and only a few doctors like Dr Chia testing and treating enterovirus infections in ME/CFS.
    Last edited: Dec 30, 2017
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  9. Remy

    Remy Administrator

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  10. Hip

    Hip Well-Known Member

    Those are the two tests that Dr Chia uses. Dr Chia considered titers of 1:320 or higher in those tests as evidence of an active enterovirus in the tissues. In which case, he then uses oxymatrine (which he says leads to major improvements in 30% of enterovirus patients), Epivir (which he says leads to minor improvements in 1 in 3), and more recently tenofovir (again he finds 1 in 3 benefit).

    Sadly, if you are outside of the US, to my knowledge there are no tests available that can detect the chronic enterovirus infections found in ME/CFS.

    Only antibody tests by the neutralization method are sensitive enough (antibody tests by ELISA, IFA and CFT are not sensitive enough). And so far I have been unable to find a neutralization-type antibody test (like ARUP provide) in Europe or anywhere else. ARUP do not accept blood samples from abroad now (they used to).

    Which then makes chronic enterovirus a kind of invisible virus, which may be the cause of many cases of ME/CFS, but nobody provides the means to test for that virus. So outside the US, the situation for enterovirus testing is even worse than all the problems there is with Lyme disease testing.
    Last edited: Dec 30, 2017
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  11. Merida

    Merida Well-Known Member

    @Remy @Hip
    Thanks so much. I read the wonderful Lerner information you posted, Hip. It makes sense to me. You may know I have been a structure/function person, but I have come to think that the neck/ pelvic structure issues may be a stressor that alters the host immune- viral relationship.

    For me, I have high titers to all these viruses: CMV. Human Parvovirus, HHV6, EBV, and to C. pneunomiae and Borrelia. Plus, they found Pantoea agglomerans in my nose. I keep having small MRSA breakouts in sweaty, hot areas. Have not been tested for Enteroviruses. Ha! Probably have those too. So what on Earth do you treat??????????

    I guess I am seeing this as Immune System Failure. And considering that, WHAT is the real culprit behind the scenes? Geez. Could it be a stealthy retrovirus???????
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  12. Hip

    Hip Well-Known Member

    And for me too, it finally made sense.

    It was only after reading Dr Martin Lerner's ideas on abortive infections that the "penny dropped" for me, and viral theory of ME/CFS finally started to make sense. I never quite understood how ME/CFS patients could have these active herpesvirus infections, yet have very little virus in the blood. But that makes perfect sense if the infections are abortive ones, which chronically infect cells, but produce no new viral particles.

    And the nice thing about Dr Lerner's theories is that, to my mind, they seem tie together the enterovirus and the herpesvirus subsets of ME/CFS: because the both in enterovirus non-cytolytic infections in the tissues, and in herpesvirus abortive infections of the tissues, you get these chronic infections that smolder away inside cells, but which don't produce any viral particles.

    And this can nicely explain why antibody titers are high, yet PCR blood test are often negative in ME/CFS.
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  13. Hip

    Hip Well-Known Member

    That's quite a set; though EBV, HHV-6 and CMV can all be targeted by one antiviral: Valcyte.
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  14. Merida

    Merida Well-Known Member

    Just want to say again( before I lie down) how much I appreciate this viral input from from Remy, Hip, and others. I remember as a senior bio major having a round table on viruses ( 1969) : are they living organisms, are they very primitive or very advanced organisms, did they originate here on Earth or elsewhere in the Cosmos? Do they help or hinder evolutionary progress in humans? No use getting too philosophical.

    Will await your enteroviral results, Remy. This great info has put me in the mood to try some antivirals and see what happens.
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