Clinical and immunological features of post-chikungunya virus chronic arthritis and its effect on functional ability and quality of life in a cohort of Colombian patients

Abstract

IntroductionPost-chikungunya virus (CHIKV) chronic arthritis is a common complication of the acute infection caused by this virus, with high risk of progression to functional and quality of life sequelae. ObjectiveTo identify the clinical and immunological characteristics, functional disabilities, and quality of life decline in a sample of Colombian patients with chronic arthropathy associated with chikungunya virus (CHIKV). MethodsA group of 94 patients was evaluated in a City in Colombia during the CHIKV epidemics from 2014 to 2015 ResultsThe mean age of the 94 patients was 57 years; 76% were women, and 100% came from low socioeconomic groups. Typically, the joint disease was symmetrical, with joint swelling present in 30% of the cases, mostly involving the small and large joints of the upper limbs. Rheumatoid factor was positive in 1.06% and anti-citrulline antibodies in 0%. There were detectable levels of IL6 in 64.9%, and IL 17 in 7.45% of the patients. The severity of disease activity was determined using the DAS28 score, identifying 55.3% with moderate activity, 40.4% with mild activity, and 4.2% with high activity. The HAQ-DI identified a moderate functional limitation in 45.7% of the cases, with a mean score of 1.02. The quality of life measured with the SF-36 scale showed that all of the domains evaluated were affected but pain and the physical and emotional domains were significantly more affected. ConclusionsPatients with post-chikungunya chronic arthritis, presented in most cases arthralgia, arthritis, functional impairment, and poor quality of life. It is then necessary to adopt comprehensive therapeutic measures for a sound intervention of this pathology.