Rheumatic manifestations associated with Chikungunya virus infection: A study of 307 patients with 32-month follow-up (RHUMATOCHIK study)

Chikungunya in Colombia: a description of an epidemic within the framework of a COPCORD study

“…Like other studies, we found symmetrical arthralgia to be a frequent symptom in patients with suspicion of CHIKV infection [30,33,60–62]. Knees, hands and ankles the most affected joints [30,33,60,62–64].…”

“…In general, in our studied population the mean HAQ-DI was low when compared to patients with rheumatic diseases in Colombia (0.49), but higher than the general population (0.01) or patients with non-rheumatic diseases (0.06) [90]. Most patients developed mild to moderate disability, like reports by Bouquillard but with higher HAQ-DI values (0.44) [62]. Rahim et al also found that most CHIKV patients had mild disability (60%), however they reported a much higher percentage of patients with moderate to severe disability (16%) [91].…”

“…Most studies on disability in patients with CHIKV infection revealed that depression is commonly present [62,92,94–96]. In fact, some theories have been postulated to explain this finding, where the high levels of IL-6 present in CHIKV infected patients can be related to depression since this cytokine is also elevated in depressed patients [97–99].…”

Review: Chikungunya Arthritis: Implications of Acute and Chronic Inflammation Mechanisms on Disease Management

“…However, a separate study from Réunion Island showed that only 2.8% of the hospital‐based patients who had chronic chikungunya virus had preexisting joint disease . Given such discrepancies across studies, any link between preexisting joint disease and an increased risk of developing chikungunya arthritis remains unproven . Risk factors for the development of chronic chikungunya arthralgia include an age of >45 years , severe or long‐lasting acute chikungunya virus, a high viral load (>10 9 /ml) during the viremic phase , and an intense chikungunya virus immune response in the post‐viremic phase .…”

“…Experts have reached a consensus, however, that MTX should be recommended as first‐line treatment . Though the efficacy of HCQ and other DMARDs has not been established per se using randomized controlled trials, these treatments should be considered on a case‐by‐case basis, either as a complement to or as an alternative to MTX . DMARDs must be monitored for effectiveness (using the Disease Activity Score in 28 joints) and tolerance and should be stopped after a durable remission of several months has been achieved.…”