Valtrex therapy for Epstein-Barr virus reactivation and upper respiratory symptoms in elite runners

Amanda J Cox, Maree Gleeson, David B Pyne, Philo U Saunders, Robert L Clancy, Peter A. Fricker

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

PURPOSE: The aim of the study was to examine the effectiveness of prophylactic administration of the antiviral agent Valtrex for control of Epstein-Barr virus (EBV) reactivation and upper respiratory symptoms in elite distance runners.

METHODS: Twenty elite male distance runners were randomized into a 4-month double-blind, placebo-controlled cross-over trial. Saliva samples were collected weekly and mucosal immune status assessed by measurement of secretory IgA (SIgA) using an enzyme-linked immunosorbent assay (ELISA). EBV reactivation was monitored at the same time by detection of EBV in saliva using a quantitative real-time polymerase chain reaction. The initial EBV status of the runners was determined by detecting EBV antibodies in serum using an ELISA. Upper respiratory symptoms were recorded using self-reporting illness logs.

RESULTS: There was no evidence of any marked change in maximal oxygen uptake (P = 0.86), training volume (P = 0.30), or mucosal immunity (P = 0.21) over the study period. Valtrex treatment resulted in an 82% reduction in the detectable EBV load in saliva for EBV seropositive runners compared with the placebo treatment (P = 0.04). The incidence of upper respiratory symptoms was not reduced by Valtrex treatment.

CONCLUSIONS: The prophylactic administration of Valtrex reduced EBV reactivation but was not an effective intervention strategy for limiting upper respiratory symptoms in this cohort of elite distance runners. The upper respiratory symptoms in the distance runners could not be directly attributed to infection and may be of a noninfectious inflammatory nature.

Original languageEnglish
Pages (from-to)1104-1110
Number of pages7
JournalMedicine and Science in Sports and Exercise
Volume36
Issue number7
Publication statusPublished - Jul 2004

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valacyclovir
Human Herpesvirus 4
Saliva
Therapeutics
Enzyme-Linked Immunosorbent Assay
Placebos
Secretory Immunoglobulin A
Mucosal Immunity

Cite this

Cox, A. J., Gleeson, M., Pyne, D. B., Saunders, P. U., Clancy, R. L., & Fricker, P. A. (2004). Valtrex therapy for Epstein-Barr virus reactivation and upper respiratory symptoms in elite runners. Medicine and Science in Sports and Exercise, 36(7), 1104-1110.
Cox, Amanda J ; Gleeson, Maree ; Pyne, David B ; Saunders, Philo U ; Clancy, Robert L ; Fricker, Peter A. / Valtrex therapy for Epstein-Barr virus reactivation and upper respiratory symptoms in elite runners. In: Medicine and Science in Sports and Exercise. 2004 ; Vol. 36, No. 7. pp. 1104-1110.
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abstract = "PURPOSE: The aim of the study was to examine the effectiveness of prophylactic administration of the antiviral agent Valtrex for control of Epstein-Barr virus (EBV) reactivation and upper respiratory symptoms in elite distance runners.METHODS: Twenty elite male distance runners were randomized into a 4-month double-blind, placebo-controlled cross-over trial. Saliva samples were collected weekly and mucosal immune status assessed by measurement of secretory IgA (SIgA) using an enzyme-linked immunosorbent assay (ELISA). EBV reactivation was monitored at the same time by detection of EBV in saliva using a quantitative real-time polymerase chain reaction. The initial EBV status of the runners was determined by detecting EBV antibodies in serum using an ELISA. Upper respiratory symptoms were recorded using self-reporting illness logs.RESULTS: There was no evidence of any marked change in maximal oxygen uptake (P = 0.86), training volume (P = 0.30), or mucosal immunity (P = 0.21) over the study period. Valtrex treatment resulted in an 82{\%} reduction in the detectable EBV load in saliva for EBV seropositive runners compared with the placebo treatment (P = 0.04). The incidence of upper respiratory symptoms was not reduced by Valtrex treatment.CONCLUSIONS: The prophylactic administration of Valtrex reduced EBV reactivation but was not an effective intervention strategy for limiting upper respiratory symptoms in this cohort of elite distance runners. The upper respiratory symptoms in the distance runners could not be directly attributed to infection and may be of a noninfectious inflammatory nature.",
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Cox, AJ, Gleeson, M, Pyne, DB, Saunders, PU, Clancy, RL & Fricker, PA 2004, 'Valtrex therapy for Epstein-Barr virus reactivation and upper respiratory symptoms in elite runners', Medicine and Science in Sports and Exercise, vol. 36, no. 7, pp. 1104-1110.

Valtrex therapy for Epstein-Barr virus reactivation and upper respiratory symptoms in elite runners. / Cox, Amanda J; Gleeson, Maree; Pyne, David B; Saunders, Philo U; Clancy, Robert L; Fricker, Peter A.

In: Medicine and Science in Sports and Exercise, Vol. 36, No. 7, 07.2004, p. 1104-1110.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Valtrex therapy for Epstein-Barr virus reactivation and upper respiratory symptoms in elite runners

AU - Cox, Amanda J

AU - Gleeson, Maree

AU - Pyne, David B

AU - Saunders, Philo U

AU - Clancy, Robert L

AU - Fricker, Peter A.

PY - 2004/7

Y1 - 2004/7

N2 - PURPOSE: The aim of the study was to examine the effectiveness of prophylactic administration of the antiviral agent Valtrex for control of Epstein-Barr virus (EBV) reactivation and upper respiratory symptoms in elite distance runners.METHODS: Twenty elite male distance runners were randomized into a 4-month double-blind, placebo-controlled cross-over trial. Saliva samples were collected weekly and mucosal immune status assessed by measurement of secretory IgA (SIgA) using an enzyme-linked immunosorbent assay (ELISA). EBV reactivation was monitored at the same time by detection of EBV in saliva using a quantitative real-time polymerase chain reaction. The initial EBV status of the runners was determined by detecting EBV antibodies in serum using an ELISA. Upper respiratory symptoms were recorded using self-reporting illness logs.RESULTS: There was no evidence of any marked change in maximal oxygen uptake (P = 0.86), training volume (P = 0.30), or mucosal immunity (P = 0.21) over the study period. Valtrex treatment resulted in an 82% reduction in the detectable EBV load in saliva for EBV seropositive runners compared with the placebo treatment (P = 0.04). The incidence of upper respiratory symptoms was not reduced by Valtrex treatment.CONCLUSIONS: The prophylactic administration of Valtrex reduced EBV reactivation but was not an effective intervention strategy for limiting upper respiratory symptoms in this cohort of elite distance runners. The upper respiratory symptoms in the distance runners could not be directly attributed to infection and may be of a noninfectious inflammatory nature.

AB - PURPOSE: The aim of the study was to examine the effectiveness of prophylactic administration of the antiviral agent Valtrex for control of Epstein-Barr virus (EBV) reactivation and upper respiratory symptoms in elite distance runners.METHODS: Twenty elite male distance runners were randomized into a 4-month double-blind, placebo-controlled cross-over trial. Saliva samples were collected weekly and mucosal immune status assessed by measurement of secretory IgA (SIgA) using an enzyme-linked immunosorbent assay (ELISA). EBV reactivation was monitored at the same time by detection of EBV in saliva using a quantitative real-time polymerase chain reaction. The initial EBV status of the runners was determined by detecting EBV antibodies in serum using an ELISA. Upper respiratory symptoms were recorded using self-reporting illness logs.RESULTS: There was no evidence of any marked change in maximal oxygen uptake (P = 0.86), training volume (P = 0.30), or mucosal immunity (P = 0.21) over the study period. Valtrex treatment resulted in an 82% reduction in the detectable EBV load in saliva for EBV seropositive runners compared with the placebo treatment (P = 0.04). The incidence of upper respiratory symptoms was not reduced by Valtrex treatment.CONCLUSIONS: The prophylactic administration of Valtrex reduced EBV reactivation but was not an effective intervention strategy for limiting upper respiratory symptoms in this cohort of elite distance runners. The upper respiratory symptoms in the distance runners could not be directly attributed to infection and may be of a noninfectious inflammatory nature.

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KW - Adolescent

KW - Adult

KW - Antiviral Agents

KW - Dose-Response Relationship, Drug

KW - Double-Blind Method

KW - Enzyme-Linked Immunosorbent Assay

KW - Epstein-Barr Virus Infections

KW - Herpesvirus 4, Human

KW - Humans

KW - Male

KW - Placebos

KW - Respiratory Tract Infections

KW - Running

KW - Valine

KW - Virus Activation

KW - Clinical Trial

KW - Journal Article

KW - Randomized Controlled Trial

KW - Research Support, Non-U.S. Gov't

M3 - Article

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SP - 1104

EP - 1110

JO - Medicine Science in Sports Exercise

JF - Medicine Science in Sports Exercise

SN - 0195-9131

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ER -