The George Washington University, Washington, DC.
Allied Research Society, Barranquilla, Colombia.
Arthritis Rheumatol. 2018 Apr;70(4):578-584. doi: 10.1002/art.40384. Epub 2018 Mar 2.
To estimate the frequency of chronic joint pain after infection with chikungunya virus in a Latin American cohort.
A cross-sectional follow-up of a prospective cohort of 500 patients from the Atlántico Department, Colombia who were clinically diagnosed as having chikungunya virus during the 2014-2015 epidemic was conducted. Baseline symptoms and follow-up symptoms at 20 months were evaluated in serologically confirmed cases.
Among the 500 patients enrolled, 485 had serologically confirmed chikungunya virus and reported joint pain status. Patients were predominantly adults (mean ± SD age 49 ± 16 years) and female, had an education level of high school or less, and were of Mestizo ethnicity. The most commonly affected joints were the small joints, including the wrists, ankles, and fingers. The initial virus symptoms lasted a median of 4 days (interquartile range [IQR] 3-8 days). Sixteen percent of the participants reported missing school or work (median 4 days [IQR 2-7 days]). After 20 months, one-fourth of the participants had persistent joint pain. A multivariable analysis indicated that significant predictors of persistent joint pain included college graduate status, initial symptoms of headache or knee pain, missed work, normal activities affected, ≥4 days of initial symptoms, and ≥4 weeks of initial joint pain.
This is the first report to describe the frequency of chikungunya virus-related arthritis in the Americas after a 20-month follow-up. The high frequency of chronic disease highlights the need for the development of prevention and treatment methods.
估计感染基孔肯雅病毒后慢性关节疼痛的频率在拉丁美洲队列中。
对哥伦比亚亚特兰蒂科省的 500 名患者进行了一项前瞻性队列的横断面随访，这些患者在 2014-2015 年流行期间被临床诊断为感染了基孔肯雅病毒。对血清学确诊病例进行基线症状和 20 个月时的随访症状评估。
在纳入的 500 名患者中，485 名有血清学确诊的基孔肯雅病毒，报告了关节疼痛状况。患者主要为成年人（平均年龄 49 ± 16 岁）和女性，受教育程度为高中或以下，属于梅斯蒂索人。受影响最常见的关节是小关节，包括手腕、脚踝和手指。最初的病毒症状持续时间中位数为 4 天（四分位距 [IQR] 3-8 天）。16%的参与者报告缺课或旷工（中位数 4 天 [IQR 2-7 天]）。20 个月后，四分之一的参与者仍有关节疼痛。多变量分析表明，持续性关节疼痛的显著预测因素包括大学毕业、初始症状为头痛或膝关节疼痛、旷工、正常活动受影响、初始症状持续≥4 天以及初始关节疼痛持续≥4 周。
这是第一篇描述在 20 个月随访后美洲基孔肯雅病毒相关关节炎频率的报告。慢性疾病的高频率突显了开发预防和治疗方法的必要性。
