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The Clinical Features, Pathogenesis and Methotrexate Therapy of Chronic Chikungunya Arthritis

1
Department of Infectious Diseases and Tropical Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais 31270-901, Brazil
2
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Oxford, OX3 7LDR, UK
3
Department of Biochemistry and Immunology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais 31270-901, Brazil
4
Department of Immunology and Microbiology, University of Colorado School of Medicine, Aurora, CO 80045, USA
5
Section of Rheumatology, Allery and Immunology, Yale University School of Medicine, New Haven, CT 06510, USA
*
Author to whom correspondence should be addressed.
Viruses 2019, 11(3), 289; https://doi.org/10.3390/v11030289
Received: 24 February 2019 / Revised: 18 March 2019 / Accepted: 19 March 2019 / Published: 22 March 2019
(This article belongs to the Special Issue Chikungunya Virus and (Re-) Emerging Alphaviruses)
Chikungunya fever (CHIKF) is an emerging viral infection that has spread widely, along with its Aedes vectors, throughout the tropics and beyond, causing explosive epidemics of acute illness and persistent disabling arthritis. The rheumatic symptoms associated with chikungunya virus (CHIKV) infection include polyarthralgia, polyarthritis, morning stiffness, joint edema, and erythema. Chronic CHIK arthritis (CCA) often causes severe pain and associated disability. The pathogenesis of CCA is not well understood. Proposed hypotheses include the persistence of a low level of replicating virus in the joints, the persistence of viral RNA in the synovium, and the induction of autoimmunity. In this review, we describe the main hypotheses of CCA pathogenesis, some of which support methotrexate (MTX) treatment which has been shown to be effective in preliminary studies in CCA. View Full-Text
Keywords: chikungunya virus; chronic chikungunya arthritis; pathogenesis; methotrexate chikungunya virus; chronic chikungunya arthritis; pathogenesis; methotrexate
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Amaral, J.K.; Taylor, P.C.; Teixeira, M.M.; Morrison, T.E.“.; Schoen, R.T. The Clinical Features, Pathogenesis and Methotrexate Therapy of Chronic Chikungunya Arthritis. Viruses 2019, 11, 289.

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