Abstract
ObjectivesAlthough statins have anti-inflammatory and potentially also antimicrobial (including antiviral) activity, their therapeutic impact on infectious diseases is controversial. In this study, we evaluated whether pre-existing statin use influenced the course and outcome of tick-borne encephalitis.MethodsTo assess the influence of statin usage on the severity of acute illness and the outcome of tick-borne encephalitis, univariate and multivariable analyses were performed for 700 adult patients with tick-borne encephalitis of whom 77 (11%) were being treated with statins, and for 410 patients of whom 53 (13%) were receiving statins, respectively.ResultsMultivariable analyses found no statistically significant association between statin usage and having a milder acute illness. There was also no statistically significant benefit with respect to a favorable outcome defined by the absence of post-encephalitic syndrome (ORs for a favorable outcome at 6 months was 0.96, 95% CI: 0.46–2.04, P = 0.926; at 12 months 0.29, 95% CI: 0.06–1.33, P = 0.111; at 2–7 years after acute illness 0.44, 95% CI: 0.09–2.22, P = 0.321), by a reduction in the frequency of six nonspecific symptoms (fatigue, myalgia/arthralgia memory disturbances, headache, concentration disturbances, irritability) occurring during the 4 week period before the last examination, or by higher SF-36 scores in any of the eight separate domains of health as well as in the physical and mental global overall component. Furthermore, there were no significant differences between patients receiving statins and those who were not in the cerebrospinal fluid or serum levels for any of the 24 cytokines/chemokines measured.ConclusionsIn this observational study, we could not prove that pre-existing use of statins affected either the severity of the acute illness or the long-term outcome of tick-borne encephalitis.
Highlights
Tick-borne encephalitis (TBE) is a central nervous system infection caused by three subtypes of TBE virus, i.e. European, Siberian and Far-Eastern
There was no statistically significant benefit with respect to a favorable outcome defined by the absence of post-encephalitic syndrome (ORs for a favorable outcome at 6 months was 0.96, 95% confidence intervals (CIs): 0.46–2.04, P = 0.926; at 12 months 0.29, 95% CI: 0.06–1.33, P = 0.111; at 2–7 years after acute illness 0.44, 95% CI: 0.09– 2.22, P = 0.321), by a reduction in the frequency of six nonspecific symptoms occurring during the 4 week period before the last examination, or by higher SF-36 scores in any of the eight separate domains of health as well as in the physical and mental global overall component
We could not prove that pre-existing use of statins affected either the severity of the acute illness or the long-term outcome of tick-borne encephalitis
Summary
Tick-borne encephalitis (TBE) is a central nervous system infection caused by three subtypes of TBE virus, i.e. European, Siberian and Far-Eastern. TBE caused by the European virus subtype has a milder course and better outcome than TBE caused by the Siberian or Far-Eastern subtypes [1,2,3]. In the majority of patients with TBE caused by the European virus subtype, the disease has a biphasic course that begins with a nonspecific febrile illness with headache (which corresponds to viremia), followed by improvement of a few days duration, and by the development of higher fever and signs of central nervous system involvement. In central Europe the case fatality rate is between 0.5 and 2%, about 5% of patients are affected by permanent pareses, and at least 30% suffer from a postencephalitic syndrome (PES). Potentially preventable by vaccination, infection by the TBE virus (TBEV) is responsible for more than 10,000 hospitalizations every year in endemic areas of Europe and Asia [5]
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