Chikungunya physiopathology: Infection data from acute to chronic phase

Abstract

During the 2005-2006 austral summer, an outbreak of fever associated with joint pain hit the Reunion Island inhabitants. Chikungunya virus (CHIKV), the agent involved in this epidemic, was known since 50 years and was thus brought to general attention together with the risk of emergence or re-emergence of arboviral infections. This arbovirus rapidly spread worldwide, specifically in India with millions of cases, but also in Europe through imported cases (>2,000) and fewautochthonous cases in Italy and in France. Human pathology is characterized by arthralgia and myalgia, which persist for months or years. Development of macaque model of CHIKV disease evidenced the key role of monocytesmacrophages in viral persistence.We are reporting herein the present knowledge about physiopathology of the virus and the CHIKV disease. Comparison of animal model data in chronic phase of infection and data acquired in follow-up of patients allows us to propose explanation of mechanisms of inflammation associated with viral infection. This review is aimed at opening discussion about the relationship between the CHIKV, the immune response and the development of virus-induced chronic arthralgia and myalgia.