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Non-cytolytic enterovirus
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== Treatment of non-cytolytic infections == [[Interferon]] alpha therapy has been found temporarily effective for enterovirus-associated ME/CFS in some studies,<ref>{{Cite journal | last = Brook | first = M. G. | last2 = Bannister | first2 = B.A. | last3 = Weir | first3 = W.R. | date = Sep 1993 | title = Interferon-alpha therapy for patients with chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/8354926|journal=The Journal of Infectious Diseases|volume=168|issue=3 | pages = 791â792|issn=0022-1899|pmid=8354926}}</ref><ref name="Chia2014">{{Cite journal | last = Chia | first = John | authorlink = John Chia | last2 = Chia | first2 = A.Y. | authorlink2 = Andrew Chia | date = 2004 | title = Ribavirin and interferon-Îą for the treatment of patients with chronic fatigue syndrome associated with persistent coxsackievirus B infection: A preliminary observation | url =http://www.jarcet.com/articles/Vol4Iss2/Chia2-Jar-spring.pdf|journal=Journal of Applied Research|volume=4|issue =2|pages=286-292|via=}}</ref><ref name="Chia2005-8" /> with treatment often resulting in large improvements in symptoms. In one experiment by Dr John Chia, ribavirin plus interferon alpha therapy resulted in 7 out of 10 enterovirus ME/CFS patients obtaining substantial improvements in symptoms, elimination of enteroviral RNA from their peripheral blood mononuclear cells (PBMC) and a fourfold reduction in their coxsackievirus B antibody titers. However, relapse typically occurred 4 to 5 months after therapy was completed, along with antibody titers increasing to pretreatment values and enteroviral RNA returning to the PBMC. In another experiment by Dr Chia, interferon alpha plus interferon delta were used in combination to treat severe bedbound ME/CFS patients with chronic enterovirus infections: 6 out of 11 treated patients were able to return to full- or part-time work as a result, but again relapse occurred some months later; the relapse was typically triggered by a bout of heavy exertion. Thus interferon therapy does not appear to be a long-term solution for ME/CFS; however, the large improvements many enterovirus ME/CFS patients experience after interferon therapy does provide some evidence that enterovirus is playing an ongoing causal role in ME/CFS. Further details: [[Interferon|interferon therapy for ME/CFS]]. Clearly better treatments are required, and Dr Chia says there is an urgent priority to develop inhibitors for viral RNA replicase, the main mechanism for RNA replication which facilitates the persistence of non-cytolytic enteroviral RNA in infected cells.<ref name="Chia2005-8">{{Cite journal | last = Chia | first = J.K.S. | date = Nov 2005 | title = The role of enterovirus in chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/16254097/|journal=Journal of Clinical Pathology|volume=58|issue=11|pages=1126â1132|doi=10.1136/jcp.2004.020255|issn=0021-9746|pmc=1770761|pmid=16254097|quote= To develop inhibitors for viral RNA replicase, the main mechanism for RNA replication, which allows the persistence of the viral genome in infected cells.|via=}}</ref>
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