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Research ArticleOther Arthritides

Chronic Joint Pain 3 Years after Chikungunya Virus Infection Largely Characterized by Relapsing-remitting Symptoms

Sarah R. Tritsch, Liliana Encinales, Nelly Pacheco, Andres Cadena, Carlos Cure, Elizabeth McMahon, Hugh Watson, Alexandra Porras Ramirez, Alejandro Rico Mendoza, Guangzhao Li, Kunal Khurana, Juan Jose Jaller-Raad, Stella Mejia Castillo, Onaldo Barrios Taborda, Juan Jose Jaller-Char, Lil Avendaño Echavez, Dennys Jiménez, Andres Gonzalez Coba, Magda Alarcon Gomez, Dores Ariza Orozco, Eyda Bravo, Victor Martinez, Brenda Guerra, Gary Simon, Gary S. Firestein and Aileen Y. Chang
The Journal of Rheumatology August 2020, 47 (8) 1267-1274; DOI: https://doi.org/10.3899/jrheum.190162
Sarah R. Tritsch
From George Washington University; George Mason University, Washington, DC; University of California, San Diego, San Diego, California, USA; Allied Research Society LLC; Clinica de La Costa Ltda.; Biomelab; Centro de Reumatología y Ortopedia; Universidad Simón Bolívar, Barranquilla, Atlántico; Universidad El Bosque, Bogotá, Colombia; Evotec ID, Lyon, France.
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Liliana Encinales
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Nelly Pacheco
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Andres Cadena
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Carlos Cure
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Elizabeth McMahon
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Hugh Watson
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Alexandra Porras Ramirez
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Alejandro Rico Mendoza
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Guangzhao Li
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Kunal Khurana
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Juan Jose Jaller-Raad
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Stella Mejia Castillo
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Onaldo Barrios Taborda
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Juan Jose Jaller-Char
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Lil Avendaño Echavez
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Dennys Jiménez
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Andres Gonzalez Coba
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Magda Alarcon Gomez
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Dores Ariza Orozco
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Eyda Bravo
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Victor Martinez
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Brenda Guerra
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Gary Simon
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Gary S. Firestein
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Aileen Y. Chang
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  • For correspondence: chang@email.gwu.edu
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Abstract

Objective. To determine the frequency of chronic joint pain and stiffness 3 years after infection with chikungunya virus (CHIKV) in a Latin American cohort.

Methods. A cross-sectional followup of 120 patients from an initial cohort of 500 patients who reported joint pain 2 years after infection from the Atlántico Department, Colombia. Patients were clinically diagnosed as having CHIKV during the 2014–2015 epidemic, and baseline and followup symptoms at 40 months were evaluated in serologically confirmed cases.

Results. Of the initial 500 patients enrolled in the study, 482 had serologically confirmed chikungunya infection. From this group, 123 patients reported joint pain 20 months after infection, and 54% of those patients reported continued joint pain 40 months after infection. Therefore, 1 out of every 8 people who tested serologically positive for CHIKV infection had persistent joint pain 3 years after infection. Participants who followed up in person were predominantly adult (mean ± SD age 51 ± 14 yrs) and female (86%). The most common type of pain reported in these patients at 40 months post-infection was pain with periods of relief and subsequent reoccurrence, and over 75% reported stiffness after immobility, with 39% experiencing morning stiffness.

Conclusion. To our knowledge, this is the first report to describe persistent joint pain and stiffness 40 months after viral infection. The high frequency of chronic disease highlights the need to develop prevention and treatment methods. Further studies should be conducted to understand the similarities between post-chikungunya joint pain and rheumatoid arthritis.

Key Indexing Terms:
  • INFECTION
  • ARTHRITIS
  • CLINICAL TRIALS
  • MORNING STIFFNESS
  • INFLAMMATION

Footnotes

  • This study was supported by a pilot award from the Rheumatology Research Foundation and the US National Institutes of Health (NIH; National Center for Advancing Translational Sciences grants UL1-TR-001876 and KL2-TR-001877). The views expressed herein are solely the responsibility of the authors and do not necessarily represent the official views of the Rheumatology Research Foundation or the NIH.

  • Accepted for publication June 19, 2019.
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Chronic Joint Pain 3 Years after Chikungunya Virus Infection Largely Characterized by Relapsing-remitting Symptoms
Sarah R. Tritsch, Liliana Encinales, Nelly Pacheco, Andres Cadena, Carlos Cure, Elizabeth McMahon, Hugh Watson, Alexandra Porras Ramirez, Alejandro Rico Mendoza, Guangzhao Li, Kunal Khurana, Juan Jose Jaller-Raad, Stella Mejia Castillo, Onaldo Barrios Taborda, Juan Jose Jaller-Char, Lil Avendaño Echavez, Dennys Jiménez, Andres Gonzalez Coba, Magda Alarcon Gomez, Dores Ariza Orozco, Eyda Bravo, Victor Martinez, Brenda Guerra, Gary Simon, Gary S. Firestein, Aileen Y. Chang
The Journal of Rheumatology Aug 2020, 47 (8) 1267-1274; DOI: 10.3899/jrheum.190162

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Chronic Joint Pain 3 Years after Chikungunya Virus Infection Largely Characterized by Relapsing-remitting Symptoms
Sarah R. Tritsch, Liliana Encinales, Nelly Pacheco, Andres Cadena, Carlos Cure, Elizabeth McMahon, Hugh Watson, Alexandra Porras Ramirez, Alejandro Rico Mendoza, Guangzhao Li, Kunal Khurana, Juan Jose Jaller-Raad, Stella Mejia Castillo, Onaldo Barrios Taborda, Juan Jose Jaller-Char, Lil Avendaño Echavez, Dennys Jiménez, Andres Gonzalez Coba, Magda Alarcon Gomez, Dores Ariza Orozco, Eyda Bravo, Victor Martinez, Brenda Guerra, Gary Simon, Gary S. Firestein, Aileen Y. Chang
The Journal of Rheumatology Aug 2020, 47 (8) 1267-1274; DOI: 10.3899/jrheum.190162
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Keywords

INFECTION
ARTHRITIS
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MORNING STIFFNESS
INFLAMMATION

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