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Persistent chikungunya arthritis in Roraima, Brazil

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Abstract

Background

The Amazon region of Brazil experienced a large epidemic of East Central South African (ECSA) chikungunya virus (CHIKV) in 2017 and continuous transmission of CHIKV persists. The impact of chronic arthritis caused by ECSA CHIKV is unknown.

Objective

The study aim was to describe the duration, severity, and characteristics of CHIKV arthritis in Roraima, Brazil, in comparison with local controls to further understand the long-term rheumatologic impact of ECSA CHIKV infection.

Methods

We performed a cross-sectional analysis comparing clinical arthritis outcomes among 40 cases with chronic (> 3 months) arthritis attributed to their CHIKV disease (n = 40) with control participants who were exposed to CHIKV but did not develop chronic arthritis (n = 40), rheumatoid arthritis controls (n = 40), and healthy controls lacking CHIKV exposure and arthritis (n = 40).

Findings

Our primary finding is that over 2 years post-infection, patients report moderate arthritis disease severity comparable with rheumatoid arthritis with the most significant impact on decreased quality of life from pain.

Main conclusions

These findings suggest that chronic arthritis caused by ECSA CHIKV infection has had a moderate impact in the Americas.

Key Points

• Chikungunya infection is responsible for moderate arthritis disease severity.

• The East Central South African (ECSA) strain of CHIKV is a cause of persistent arthritis in Roraima, Brazil.

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Acknowledgments

We would like to thank Professor Dr. Jackeline da Costa Maciel for her assistance in execution of this project.

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Authors and Affiliations

  1. Laboratorio de Parasitologia e Vetores da Amazonia, Curso de Enfermagem, Centro de Ciencias da Saude, Universidade Federal de Roraima, Boa Vista, RR, Brazil

    Ramão Luciano Nogueira Hayd & Maony Rodrigues Moreno

  2. Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane, FIOCRUZ, Manaus, Brazil

    Felipe Naveca

  3. Department of Surgery, George Washington University, Washington, DC, USA

    Richard Amdur

  4. Department of Medicine, George Washington University, 2150 Pennsylvania Ave Suite 5-416, Washington, DC, 20037, USA

    Karol Suchowiecki, Gary Simon & Aileen Y. Chang

  5. Evotec ID, Lyon, France

    Hugh Watson

  6. Department of Medicine, University of California San Diego, San Diego, CA, USA

    Gary S. Firestein

Authors
  1. Ramão Luciano Nogueira Hayd
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  2. Maony Rodrigues Moreno
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  3. Felipe Naveca
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  4. Richard Amdur
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  5. Karol Suchowiecki
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  6. Hugh Watson
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  7. Gary S. Firestein
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  8. Gary Simon
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  9. Aileen Y. Chang
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Contributions

Ramão Luciano Nogueira Hayd, Felipe Naveca, Gary Firestein, Gary Simon, and Aileen Chang contributed to study design. Ramão Luciano Nogueira Hayd and Maony Rodrigues Moreno contributed to study execution. Ramão Luciano Nogueira Hayd, Maony Rodrigues Moreno, Karol Suchowiecki, and Aileen Chang contributed to data management. Karol Suchowiecki, Richard Amdur, and Hugh Watson contributed to statistical analysis. Ramão Luciano Nogueira Hayd and Aileen Chang drafted the manuscript. All authors edited the manuscript.

Corresponding author

Correspondence to Aileen Y. Chang.

Ethics declarations

The study protocol was approved by the Committee for Ethics and Research at the Federal University of Roraima (Protocol number 3.406.0703). All research procedures were followed in accordance with the Helsinki Declaration of 1975, as revised in 1983. All persons gave informed consent prior to their inclusion in the study. No animals were used in this study.

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Hayd, R.L.N., Moreno, M.R., Naveca, F. et al. Persistent chikungunya arthritis in Roraima, Brazil. Clin Rheumatol 39, 2781–2787 (2020). https://doi.org/10.1007/s10067-020-05011-9

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  • DOI: https://doi.org/10.1007/s10067-020-05011-9

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