QUESTION: What is the best drug therapy for EBV reactivation? Can you recommend any supplements for it?

ANSWER: In reactivated cases of EBV with symptoms (pending a negative HIV) I learned from the Chief of Infectious Disease at San Fran General to give 800 mg Acyclovir TID with food for 60 days and re-assess. (You can also use 1 gram Acyclovir BID with food for 60 days). I add in something like Priority-1 “H-2 Plex” which is a good acute HHV family therapy AND covers the immune supportive part the Acyclovir cannot as the immune system still has clean up to do and I see it synergize as a therapy. Depending on other factors, more may be needed and some need Acyclo / Valacyclo for another month or two at lower doses etc. But you’ll see that on f/u assessment. If there is throat involvement, I always do a Strep test as that is commonly superimposed on the HHV flare, and killing the beta hemolytics will speed recovery. (Also – always run an ASO on the EBV flared folks). This is what I have seen help the most people the quickest (and really cheapest). If Insurance covers I’ll trade Valtrex 1 gram BID with food for the TID Acyclovir simply for less pills per day.

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