Abstract
BackgroundArthritogenic alphaviruses, including Chikungunya virus (CHIKV), are responsible for acute fever and arthralgia, but can also lead to chronic symptoms. In 2006, a Chikungunya outbreak occurred in La Réunion Island, during which we constituted a prospective cohort of viremic patients (n = 180) and defined the clinical and biological features of acute infection. Individuals were followed as part of a longitudinal study to investigate in details the long-term outcome of Chikungunya.Methodology/Principal FindingsPatients were submitted to clinical investigations 4, 6, 14 and 36 months after presentation with acute CHIKV infection. At 36 months, 22 patients with arthralgia and 20 patients without arthralgia were randomly selected from the cohort and consented for blood sampling. During the 3 years following acute infection, 60% of patients had experienced symptoms of arthralgia, with most reporting episodic relapse and recovery periods. Long-term arthralgias were typically polyarthralgia (70%), that were usually symmetrical (90%) and highly incapacitating (77%). They were often associated with local swelling (63%), asthenia (77%) or depression (56%). The age over 35 years and the presence of arthralgia 4 months after the disease onset are risk factors of long-term arthralgia. Patients with long-term arthralgia did not display biological markers typically found in autoimmune or rheumatoid diseases. These data helped define the features of CHIKV-associated chronic arthralgia and permitted an estimation of the economic burden associated with arthralgia.Conclusions/SignificanceThis study demonstrates that chronic arthralgia is a frequent complication of acute Chikungunya disease and suggests that it results from a local rather than systemic inflammation.
Highlights
Chikungunya virus (CHIKV) is an arthropod-borne virus that belongs to the Alphavirus genus
Conclusions/Significance: This study demonstrates that chronic arthralgia is a frequent complication of acute Chikungunya disease and suggests that it results from a local rather than systemic inflammation
We have conducted a prospective longitudinal study to investigate in details long-term outcome of CHIKV infection
Summary
Chikungunya virus (CHIKV) is an arthropod-borne virus that belongs to the Alphavirus genus. In 2005, CHIKV emerged in islands of Indian Ocean including La Reunion, a French overseas department, and approximately one third of the inhabitants 300,000) was infected at the end of the outbreak in 2006 [4,5]. In the wake of this outbreak, CHIKV re-emerged in India with over 1 million cases [8,9]. In 2007, CHIKV emerged for the first time in Europe, causing an outbreak in Italy [10]. Arthritogenic alphaviruses, including Chikungunya virus (CHIKV), are responsible for acute fever and arthralgia, but can lead to chronic symptoms. In 2006, a Chikungunya outbreak occurred in La Reunion Island, during which we constituted a prospective cohort of viremic patients (n = 180) and defined the clinical and biological features of acute infection.
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