Lovastatin for adult patients with dengue: protocol for a randomised controlled trial

James Whitehorn, Nguyen Van Vinh Chau, Nguyen Thanh Truong, Luong Thi Hue Tai, Nguyen Van Hao, Tran Tinh Hien, Marcel Wolbers, Laura Merson, Nguyen Thi Phuong Dung, Rosanna Peeling, Cameron Simmons, Bridget Wills, Jeremy Farrar

Dengue is the most important vector-borne viral infection of man, with approximately 2 billion people living in areas at risk. Infection results in a range of manifestations from asymptomatic infection through to life-threatening shock and haemorrhage. One of the hallmarks of severe dengue is vascular endothelial disruption. There is currently no specific therapy and clinical management is limited to supportive care. Statins are a class of drug initially developed for lipid lowering. There has been considerable recent interest in their effects beyond lipid lowering. These include anti-inflammatory effects at the endothelium. In addition, it is possible that lovastatin may have an anti-viral effect against dengue. Observational data suggest that the use of statins may improve outcomes for such conditions as sepsis and pneumonia. This paper describes the protocol for a randomised controlled trial investigating a short course of lovastatin therapy in adult patients with dengue.