Maltsev, Dmitry · Microbiology and immunology · 2022 · DOI
This study tested three antiviral medications in ME/CFS patients who had reactivated herpesvirus infections (HHV-6 and HHV-7). Over three months, the drug artesunate was more effective at clearing the virus from the blood than two other antivirals (valaciclovir and valganciclovir). By the third month, artesunate cleared the virus in about 68% of HHV-6 cases and 63% of HHV-7 cases, compared to 37% and 34% with valaciclovir.
Since some ME/CFS patients have evidence of herpesvirus reactivation, identifying more effective antiviral treatments could offer therapeutic options for a subset of the patient population. This study directly compares three potential treatment approaches, providing preliminary evidence that artesunate may warrant further investigation in ME/CFS-associated herpesvirus infections.
This study does not prove that HHV-6/HHV-7 reactivation causes ME/CFS or that clearing these viruses will improve ME/CFS symptoms. As an observational study without random assignment and without documented clinical outcome measures, it establishes viral clearance rates but not clinical efficacy. The lack of blinding and control group details limits conclusions about causal treatment effects.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Maltsev, Dmitry (2022). A comparative study of valaciclovir, valganciclovir, and artesunate efficacy in reactivated HHV-6 and HHV-7 infections associated with chronic fatigue syndrome/myalgic encephalomyelitis.. Microbiology and immunology. https://doi.org/10.1111/1348-0421.12966
BibTeX
@article{mecfsatlas-maltsev-2022-comparative-study,
author = {Maltsev, Dmitry},
title = {A comparative study of valaciclovir, valganciclovir, and artesunate efficacy in reactivated HHV-6 and HHV-7 infections associated with chronic fatigue syndrome/myalgic encephalomyelitis.},
journal = {Microbiology and immunology},
year = {2022},
doi = {10.1111/1348-0421.12966},
note = {PubMed: 35102619},
url = {https://www.mecfsatlas.com/evidence/maltsev-2022-comparative-study},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/maltsev-2022-comparative-study
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