Chronic joint pain and stiffness may persist for up to 3 years after active chikungunya infection, according to study data published in the Journal of Rheumatology.
Investigators conducted a cross-sectional follow-up of individuals with clinically confirmed chikungunya infection in the Atlántico Department, Colombia. At baseline, patients were given a survey to capture demographic characteristics, exposure history, and symptoms; at a median of 20 months’ follow-up, patients completed a telephone survey, which assessed postinfection arthritis symptoms. Patients who reported persistent arthritis at this first follow-up were included in the present analysis. These patients were given another follow-up survey at a median of 40 months postinfection; some patients also attended an in-person assessment of arthritis symptoms. The 40-month survey responses were compared with information obtained at 20 months to assess trends in chronic pain after chikungunya infection.
Among 482 patients with serologically confirmed chikungunya infection at baseline, 123 reported joint pain 20 months after infection. More than half (54%) of the patients who reported pain at 20 months also endorsed joint pain at 40 months; about 1 in 8 patients experienced persistent joint pain 3 years postinfection. Participants who were followed up in-person at the 40-month point (n=82) were adults with mean age 51±14 years, and they were predominantly women (86%).
These patients most commonly described their pain as having periods of relief with subsequent reoccurrence. In addition, more than 75% reported stiffness after immobility, and 39% experienced morning stiffness.
The high prevalence of postinfection chronic joint pain underscores the necessity of chikungunya prevention and treatment. Additional research should focus on characterizing post-chikungunya joint pain. Specifically, exploring similarities between postinfection joint pain and rheumatoid arthritis may elucidate the most effective means of management.
Tritsch SR, Encinales L, Pacheco N, et al. Chronic joint pain 3 years after chikungunya virus infection largely characterized by relapsing-remitting symptoms [published online July 1, 2019]. J Rheumatol. doi:10.3899/jrheum.190162