Chronic, persistent infection (s)

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Chronic, persistent infection (s)

Post by X-member » Fri 25 May 2012 22:34

I give you a quote from another topic:

http://www.lymeneteurope.org/forum/view ... =20#p28623
To date, I see no conclusive evidence for a persistent infection in chronic Lyme disease.
Yes, I know that borreliosis is not a viral infection, but it is the definitions I want to talk about.

"Medical Microbiology. 4th edition

Chapter 46 Persistent Viral Infections

Istvan Boldogh, Thomas Albrecht, and David D. Porter."

http://www.ncbi.nlm.nih.gov/books/NBK8538/

A quote (more to read on the link):
Definition

Persistent infections are characterized as those in which the virus is not cleared but remains in specific cells of infected individuals. Persistent infections may involve stages of both silent and productive infection without rapidly killing or even producing excessive damage of the host cells. There are three types of overlapping persistent virus-host interaction that may be defined as latent, chronic and slow infection.
A Lyme infection that have lasted for more than 6 month, is called a chronic infection in Sweden.

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Re: Chronic, persistent infection (s)

Post by X-member » Sat 26 May 2012 17:45

Another definition often used in LymeLand:

http://www.lymeneteurope.org/forum/view ... =20#p28626

A quote:
What more can I say. There is NO evidence that what some claim to be "chronic Lyme disease" is due to a persistent infection. In the absence of such proof, it makes no sense to recommend extended antibiotic therapy.
The quotation marks are used to point out that it is NOT chronic Lyme disease that they talk about.

Edit to add:

Or to point out that they don't think it is chronic Lyme disease!
Last edited by X-member on Sun 27 May 2012 16:22, edited 2 times in total.

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Re: Chronic, persistent infection (s)

Post by X-member » Sat 26 May 2012 17:57

Some European definitions from EUCALB.

http://meduni09.edis.at/eucalb/cms/inde ... ce=message
Late Lyme borreliosis.

This uncommon stage presents several years after the initial infection and may involve the joints (Lyme arthritis), skin (acrodermatitis chronica atrophicans) or, rarely, chronic neurological syndromes.
ACA (acrodermatitis):
....which is probably the most common manifestation of chronic Lyme borreliosis in Europe.

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Re: Chronic, persistent infection (s)

Post by X-member » Sun 27 May 2012 0:16

One example of a study on European (early and) chronic Lyme borreliosis:

http://www.ncbi.nlm.nih.gov/pubmed/3056202
Ann N Y Acad Sci. 1988;539:324-45.

Antibiotic therapy of early European Lyme borreliosis and acrodermatitis chronica atrophicans.

Weber K, Preac-Mursic V, Neubert U, Thurmayr R, Herzer P, Wilske B, Schierz G, Marget W.

Source

Department of Microbiology, University of Munich, Federal Republic of Germany.

Abstract

In a study on 121 consecutive patients with erythema migrans, 65 patients obtained oral penicillin, 36 tetracyclines, and 20 amoxicillin-clavulanic-acid. Follow-up was carried out for a median of 29, 17, and 7 months, respectively. In another limited trial on 29 patients with acrodermatitis chronica atrophicans (ACA), 14 patients received oral penicillin, 9 parenteral penicillin, and 6 tetracyclines. There was no statistically significant difference among treatment groups in both therapeutic trials, with the exception of different follow-ups due to the nonrandomized study design and different occurrence of the Jarisch-Herxheimer reaction in patients with erythema migrans. Later extracutaneous manifestations developed in 27% of the patients with erythema migrans and in 47% of the patients with ACA despite antibiotic therapy. We could not prove the superiority of any antibiotic tested in either early or late European Lyme borreliosis.
The study above is used in the Swedish recommendations, and they don't have any better studies. And this we also can find info about in IDSA:s guidelines, and IDSA say: "There are NO prospective, randomized studies on treatment."

And since there are no "prospective, randomized studies on treatment" then they have to use what they have, I think.

Edit to add:

No, they don't use the "4 major US studies" for European chronic Lyme borreliosis, in Sweden.
Last edited by X-member on Sun 27 May 2012 0:33, edited 2 times in total.

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Re: Chronic, persistent infection (s)

Post by X-member » Sun 27 May 2012 0:24

European chronic, persistent Lyme borreliosis:

"Prolonged antibiotic therapy in PCR confirmed persistent Lyme disease"

http://www.grin.com/en/e-book/166179/pr ... me-disease

A quote (more to read on the link):
Wolfgang Klemann, MD, PhD
Bernt-Dieter Huismans, MD, PhD
Stephan Heyl, MD, PhD

Abstract: We examined a sample of 90 individuals that had previously received a
course of appropriate antibiotics for Lyme disease without experiencing full
resolution of their symptoms and had evidence of persistent infection documented
by PCR analysis.

Mean duration of symptoms was 9.5 years (range 1 - 40 years). The treatment
was adapted to the individual case according to clinical response. Long term
antibiotic therapy was initiated and patients were treated continuously for at least 6
months, in some cases several years of intermittent therapy was administered.

About 38,8% of the patients experienced full remission of symptoms while about
56,7% reported a significant improvement, 5,6% of patients were deemed
refractory to therapy. Therapeutic modalities are discussed in detail.

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Re: Chronic, persistent infection (s)

Post by Spanky » Sun 27 May 2012 2:35

"Carina":

A quote:

Spanky: "What more can I say. There is NO evidence that what some claim to be "chronic Lyme disease" is due to a persistent infection. In the absence of such proof, it makes no sense to recommend extended antibiotic therapy".
Carina:

The quote above is from Henry. He was addressing me. The way you have it makes it look like I said it.

Would you mind editing out my name, please? Just for accuracy. (I don't really disagree with what Henry said, though).
The quotation marks are used to point out that it is NOT chronic Lyme disease that they talk about.
Well, you would have to ask Henry, but I think his use of quotation marks there is meant to indicate that someone else said that...that's not his term, but someone else's term for the condition.

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Re: Chronic, persistent infection (s)

Post by X-member » Sun 27 May 2012 17:08

Spanky:
Would you mind editing out my name, please? Just for accuracy.
Done.

Spanky:
(I don't really disagree with what Henry said, though.)
Spanky:
Carina:

The quotation marks are used to point out that it is NOT chronic Lyme disease that they talk about.

Well, you would have to ask Henry, but I think his use of quotation marks there is meant to indicate that someone else said that...that's not his term, but someone else's term for the condition.
But you don't disagree with Henry?

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Re: Chronic, persistent infection (s)

Post by Spanky » Sun 27 May 2012 17:14

"Carina":
Done.
Thanks! :D
But you don't disagree with Henry?
No. I don't disagree with him, necessarily...it's just not something that I would say.

I just don't have the expertise to make a statement like that. And I know it.

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Re: Chronic, persistent infection (s)

Post by X-member » Sun 27 May 2012 17:16

Spanky:
No. I don't disagree with him, necessarily...it's just not something that I would say.

I just don't have the expertise to make a statement like that. And I know it.

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Re: Chronic, persistent infection (s)

Post by Spanky » Sun 27 May 2012 17:23

Carina, is there some point you wish to make by repeating what I just said?

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