TY - JOUR
T1 - Risk of post-treatment Lyme disease in patients with ideally-treated early Lyme disease
T2 - A prospective cohort study.
AU - Aucott, John N.
AU - Yang, Ting
AU - Yoon, Isaac
AU - Powell, Debra
AU - Geller, Steven A.
AU - Rebman, Alison W.
N1 - Funding Information:
The following financial relationships have been disclosed by the authors: all are not directly related to the submitted work. JNA received grants for work on Lyme disease from the Steven and Alexandra Cohen Foundation, the Global Lyme Alliance (GLA), and the Bay Area Lyme Foundation (BALF); received support for the present manuscript from the Steven and Alexandra Cohen Foundation; received consulting fees from Pfizer North America Lyme Disease Vaccine Ad Board and Tarsus Pharmaceuticals Inc. Lyme Disease Advisory Board; received payment for expert testimony in a 2021 plaintiff malpractice case for Lyme disease; served on the Bay Area Lyme Disease Scientific Advisory Board; was a Past Chair, 2018, HHS Tick-borne Disease Working Group, Office of HIV/AIDS and Infectious Disease Policy, Office of the Assistant Secretary of Health, Department of Health and Human Services; and had the following patent – John Aucott, MD, Inventor, Title: Elevated CCL19 after Completion of Therapy for Acute Lyme disease Identifies Patients at Risk for Development of Post-treatment Lyme disease syndrome who will benefit from further antibiotic therapy. Patent approved US patent application (16/058,316). JNA, TY, and AWR currently receive salary support from the Steven and Alexandra Cohen Foundation. IY, DP, and SAG have nothing to declare.
Funding Information:
This work was supported by the Steven and Alexandra Cohen Foundation, the Global Lyme Alliance (GLA), and the Bay Area Lyme Foundation (BALF). This publication was also made possible by the Johns Hopkins Institute for Clinical and Translational Research (ICTR), which is funded in part by Grant Number UL1 TR003098 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH); and NIH Roadmap for Medical Research; and the Johns Hopkins Clinical Research Network (JHCRN). Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the Johns Hopkins ICTR, JHCRN, NCATS, NIH, the Steven and Alexandra Cohen Foundation, GLA, or BALF. The funders did not have any role in study design; collection, analysis, and interpretation of data; writing of this manuscript; or the decision to submit for publication.
Funding Information:
This work was supported by the Steven and Alexandra Cohen Foundation, the Global Lyme Alliance (GLA), and the Bay Area Lyme Foundation (BALF). This publication was also made possible by the Johns Hopkins Institute for Clinical and Translational Research (ICTR), which is funded in part by Grant Number UL1 TR003098 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH); and NIH Roadmap for Medical Research; and the Johns Hopkins Clinical Research Network (JHCRN). Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the Johns Hopkins ICTR, JHCRN, NCATS, NIH, the Steven and Alexandra Cohen Foundation, GLA, or BALF. The funders did not have any role in study design; collection, analysis, and interpretation of data; writing of this manuscript; or the decision to submit for publication. We have read the policy of the journal on ethical consent and the standards of animal care. This work has been approved by the Johns Hopkins Institutional Review Board and complies with its human subject research informed consent regulations. No animals were a part to this research. The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request. The code generated for analyses during the current study is available from the corresponding author on reasonable request. Not Applicable.
Publisher Copyright:
© 2022 The Author(s)
PY - 2022/3
Y1 - 2022/3
N2 - Purpose: Post-treatment Lyme disease (PTLD) is characterized by patient-reported symptoms after treatment for Borrelia burgdorferi infection. The primary aim of this study was to assess whether participants with a history of Lyme disease (LD) would be more likely to meet criteria for PTLD than those without a history of LD. Methods: We conducted a longitudinal, prospective study among 234 participants with and 49 participants without prior LD. All completed survey metrics for fatigue, pain, sleep, depression, and quality of life. An operationalized PTLD definition was applied to both cohorts, and the distributions of clinical outcomes and symptoms were examined. Results: In total, 13·7% of participants with a history of prior LD met criteria for PTLD compared with 4·1% of those without a history of prior LD. Participants with prior LD were approximately 5·28 times as likely to meet PTLD criteria compared with those without prior LD (p = 0·042) and had 8-15 times as high odds of reporting moderate or severe fatigue and muscle pain (p = 0·002, 0·047, respectively). Risk of meeting PTLD criteria was also independently increased among females and those with higher exposure to previous traumatic life events. Conclusion: Participants ideally diagnosed and treated for prior LD reported more symptoms on standardized surveys and were more likely to meet criteria for PTLD than those without prior LD.
AB - Purpose: Post-treatment Lyme disease (PTLD) is characterized by patient-reported symptoms after treatment for Borrelia burgdorferi infection. The primary aim of this study was to assess whether participants with a history of Lyme disease (LD) would be more likely to meet criteria for PTLD than those without a history of LD. Methods: We conducted a longitudinal, prospective study among 234 participants with and 49 participants without prior LD. All completed survey metrics for fatigue, pain, sleep, depression, and quality of life. An operationalized PTLD definition was applied to both cohorts, and the distributions of clinical outcomes and symptoms were examined. Results: In total, 13·7% of participants with a history of prior LD met criteria for PTLD compared with 4·1% of those without a history of prior LD. Participants with prior LD were approximately 5·28 times as likely to meet PTLD criteria compared with those without prior LD (p = 0·042) and had 8-15 times as high odds of reporting moderate or severe fatigue and muscle pain (p = 0·002, 0·047, respectively). Risk of meeting PTLD criteria was also independently increased among females and those with higher exposure to previous traumatic life events. Conclusion: Participants ideally diagnosed and treated for prior LD reported more symptoms on standardized surveys and were more likely to meet criteria for PTLD than those without prior LD.
KW - Lyme Disease
KW - Post-Treatment Lyme Disease
KW - Symptom Measurement
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UR - http://www.scopus.com/inward/citedby.url?scp=85124021686&partnerID=8YFLogxK
U2 - 10.1016/j.ijid.2022.01.033
DO - 10.1016/j.ijid.2022.01.033
M3 - Article
C2 - 35066160
AN - SCOPUS:85124021686
SN - 1201-9712
VL - 116
SP - 230
EP - 237
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
ER -