Prevalence of chronic chikungunya and associated risks factors in the French West Indies (La Martinique): A prospective cohort study

Abstract

Background The chikungunya virus (CHIKV) is a re-emerging alphavirus that can cause chronic and potentially incapacitating rheumatic musculoskeletal disorders known as chronic chikungunya arthritis (CCA). We conducted a prospective cohort study of CHIKV-infected subjects during the 2013 chikungunya outbreak in Martinique. The aim of this study was to assess the prevalence of CCA at 12 months and to search for acute phase factors significantly associated with chronicity. Methodology/Principal findings A total of 193 patients who tested positive for CHIKV RNA via qRT-PCR underwent clinical investigations in the acute phase (<21 days), and then 3, 6, and 12 months after inclusion. The Asian lineage was identified as the circulating genotype. A total of 167 participants were classified as either with or without CCA, and were analyzed using logistic regression models. The overall prevalence of CCA at 12 months was 52.1% (95%CI: 44.5-59.7). In

Rheumatic manifestations of Chikungunya virus infection: Prevalence, patterns, and enthesitis

“…This variation depends on the definition of chronic CHIKV, the assessor's specialty, and the assessment time. The prevalence of chronic CHIKV in our cohort was 55.5% at three-month evaluation, which was higher than that reported in previous studies with a similar time of assessment (27.5%-40.2%) [5,45].…”

“…The prevalence of enthesitis in our study was 38.4%, which was higher than that reported in other studies [3,5]. A prevalence of 2.7% was reported for the acute to subacute phases [5] and between10.1% and 19.4% for the chronic phase. However, these studies did not provide detail on the anatomical sites of enthesitis [3,5], with only one case report having described the presence of enthesitis at the insertions of both Achilles tendons in CHIKV infection [46].…”

“…The tissue in this transitional zone is composed of fibrocartilage, and is populated by fibroblasts [47]. The prevalence of enthesitis in our study was 38.4%, which was higher than that reported in other studies [3,5]. A prevalence of 2.7% was reported for the acute to subacute phases [5] and between10.1% and 19.4% for the chronic phase.…”

“…The prevalence of chronic CHIKV infection varies between 5.9% and 84.3%, with the time at the assessment ranging from 3 to 81 months [5,25,[36][37][38][39][40][41][42][43][44]. This variation depends on the definition of chronic CHIKV, the assessor's specialty, and the assessment time.…”

“…The classic symptoms of CHIKV infection include an abrupt onset of fever, rash, and incapacitating joint pain. Clinically, CHIKV infection may lead to a broad spectrum of chronic rheumatic symptoms similar to rheumatoid arthritis (RA), spondyloarthritis (SpA), undifferentiated arthritis (UA), psoriatic arthritis, and soft-tissue rheumatism [3][4][5]. In individual patients, arthralgia or arthritis may persist for months or years.…”