Alternative treatments for the Epstein-Barr virus (EBV)

DEFINITION: A disease-causing agent classified as a herpesvirus and associated with a variety of infectious illnesses.

Etiological Agent of Disease

Epstein-Barr virus (EBV) is the known etiological agent for several diseases, including infectious mononucleosis (IM), Hodgkin Lymphoma (HL), Diffuse Large B cell Lymphoma (DLBCL), Burkitt’s lymphoma (BL), and nasopharyngeal carcinoma (NPC). The virus has been suggested as the etiological agent associated with chronic fatigue syndrome (CFS), a condition of extreme fatigue that is not relieved through sleep. As with all herpesviruses, infection by EBV establishes a lifelong carrier state of the virus.

Treatments

Nutritional supplements. Infectious mononucleosis, also known as the kissing disease, is by far the most common result of infection by EBV. More serious EBV illnesses include BL and NPC, which, while life-threatening, are relatively rare and are generally associated only with certain ethnic populations. The cause of CFS is unclear, but increasingly, the evidence points to the involvement of EBV.

Because EBV-related illnesses are viral infections, antibiotic treatment, which is effective against bacteria, is largely useless for other than addressing EBV illnesses with secondary bacterial infections. BL and NPC are cancers, and they are treated using the standard methods of chemotherapy utilized for many forms of the disease. Few standard treatments beyond those that are palliative have proven effective in treating either IM or CFS.

Alternative treatments for EBV disease are generally built upon the idea of improving the body’s nutritional levels, with secondary improvement in the immune system. Vitamin supplements that include both vitamin C and vitamin K have been recommended, as has the inclusion of minerals such as magnesium and potassium. Omega-3 oil supplements, such as those found in fish or flaxseed oils, also have been suggested as useful. Beyond the general health benefits provided by these nutritional supplements, there is minimal evidence to support their use in the treatment of EBV-related illnesses.

Aromatherapy.Aromatherapy applies the volatile properties of purified plant oils to treat illnesses. The oils can be delivered as an aerosol (hence the term “aroma”) or through direct application and absorption through the skin. Proponents have argued that such therapy can be used to treat either bacterial or viral infections, including those caused by EBV, without the side effects associated with pharmaceuticals, such as antibiotics. The oil is often delivered as a spray but can be included with warm bath water. The theory for aromatherapy’s efficacy as an antibacterial agent argues that the oil enters the microbe and prevents access to oxygen. As an antiviral agent, plant oils are believed to improve immune function, but to do so in an unknown manner. No controlled studies have demonstrated aromatherapy's effectiveness in treating EBV-related diseases.

Chelation therapy.Chelation therapy utilizes chelating agents, such as ethylenediaminetetraacetic acid (EDTA), chemicals that bind and remove minerals that may be found in tissues or blood. The usefulness of chelation therapy dates to the 1940s, when it was found that EDTA is useful in treating lead and mercury poisoning. Intravenous use of EDTA or other chelators has been suggested for the treatment of certain cardiovascular diseases, too, although there is little evidence of its effectiveness, and the treatment may even exacerbate problems.

Supplements. Certain nutritional supplements, such as vitamin C, garlic, zinc, and some amino acids, which have some chelation properties, have been tested for the treatment of chronic fatigue syndrome. As with other alternative treatments, no success has been reported anecdotally, and no controlled studies have shown their usefulness in treating EBV infections. Other natural products containing resveratrol, curcumin, moronic acid, epigallocatechin gallate, and andrographolide have been shown in various studies to be effective antiviral agents. These findings require further study, as EBV infections cause around 200,000 malignancies annually across the globe, and utilizing these antiviral effects could be life-saving.

A variety of herbal supplements also have adherents in the treatment of EBV disease. Echinacea is allegedly an immune promoter and blood cleanser, the Chinese herb astragalus is claimed to relieve fatigue, and arsenicum is suggested for use by some holistic proponents. While available over the counter, these herbs have the potential for significant deleterious side effects and should be used only after consultation with a physician.

Usefulness of Alternative Treatments

For most people, using treatments such as aromatherapy or nutritional supplements will have no undesirable side effects. If the person is nutritionally deficient, adding supplements may ameliorate the problem. Indeed, the mineral zinc has been shown in some studies to decrease recovery time from minor respiratory infections. Zinc also has been shown to improve immune function under some circumstances. While there is little evidence supporting its usefulness in treating EBV infections specifically, it is certainly possible that in boosting immune function in respiratory infections in general, this usefulness also may apply to those infections caused by EBV.

Aromatherapy and other relaxation techniques may play a palliative role in decreasing stress. Chronic stress produces various deleterious effects, including those that affect immune function; stress hormones, in particular, may cause immune problems. Relaxation techniques, including aromatherapy, may not directly impact immune function, but lowering stress levels may indirectly have a positive effect on the immune system.

Additionally, some alternative treatments may aid symptoms brought on by EBV, such as drinking warm tea with honey for sore throat and hydration. Eating a healthy diet and getting plenty of rest are also important.

Bibliography

Anderson, John, and Larry Trivieri, eds. Alternative Medicine: The Definitive Guide. 2nd ed. Celestial Arts/Random House, 2002.

Begum, Jabeen. "Epstein-Barr Virus (EBV) Infection: Symptoms, Diagnosis, and Treatment." WebMD, 1 Dec. 2023, www.webmd.com/a-to-z-guides/epstein-barr-virus. Accessed 1 Oct. 2024.

Cohen, J. I. “Epstein-Barr Virus Infections, Including Infectious Mononucleosis.” In Harrison’s Principles of Internal Medicine, edited by Joan Butterton. 21st ed., McGraw-Hill, 2022.

Eladwy, Radwa A., et al. “The Fight against the Carcinogenic Epstein-Barr Virus: Gut Microbiota, Natural Medicines, and Beyond.” International Journal of Molecular Sciences, vol. 24, no. 2, Jan 2023, p. 1716, doi:10.3390/ijms24021716.

Freeman, Lyn. Mosby’s Complementary and Alternative Medicine: A Research-Based Approach. 3rd ed. Mosby/Elsevier, 2009.

Pennisi, Rosamaria, et al. “Update of Natural Products and Their Derivatives Targeting Epstein-Barr Infection.” Viruses, vol. 16, no. 1, 2024, doi:10.3390/v16010124.