title: Rheumatic manifestations associated with Chikungunya virus infection: A study of 307 patients with 32-month follow-up (RHUMATOCHIK study).
abstract: In the wake of the Chikungunya epidemic which struck Reunion Island in 2005 and 2006, we conducted a prospective, multicentre study (RHUMATOCHIK) whose main objective was analyse the characteristics and progression of rheumatic manifestations in patients with post-Chikungunya joint pain.
  
  
  
  A cohort of 307 consecutively included patients underwent rheumatological examinations for pain secondary to Chikungunya virus infection. The long-term evaluation was conducted by telephone survey 1 and 2 years after the onset of the viral infection.
  
  
  
  At inclusion, mean age was 54 years (24-87) and 83.1% of the patients were female. Chronic joint pain was associated with synovitis in 64.2% of the patients, affecting primarily the wrists, the proximal interphalangeal joints of the fingers, and the ankles. Attempts to detect the viral genome in joint fluid (10 patients) and synovial tissue (6 patients) using the RT-PCR technique were repeatedly unsuccessful. With a mean follow-up of 32 months, joint pain persisted in 83.1% of the patients. Functional impairment, however, was moderate, with a HAQ score of 0.44±0.5.
  
  
  
  Chikungunya virus infection is frequently the cause of joint manifestations that can persist for several months, or even several years. In some cases, the clinical symptoms closely resemble those usually associated with rheumatoid arthritis. Further studies are necessary to improve the therapeutic management of these patients.
authors.affiliation: 97410 Saint-Pierre, Reunion.
authors.forename: Eric
authors.initials: E
authors.lastname: Bouquillard
authors.affiliation: Inserm CIC 1410, CHU de La Réunion, 97448 Saint-Pierre cedex, Reunion.
authors.forename: Adrian
authors.initials: A
authors.lastname: Fianu
authors.affiliation: 97460 Saint-Paul, Reunion.
authors.forename: Marianne
authors.initials: M
authors.lastname: Bangil
authors.affiliation: 97460 Saint-Paul, Reunion.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Charlette
authors.affiliation: 97400 Saint-Denis, Reunion.
authors.forename: Anne
authors.initials: A
authors.lastname: Ribéra
authors.affiliation: Department of Bacteriology, Parasitology & Virology, CHR, Reunion.
authors.forename: Alain
authors.initials: A
authors.lastname: Michault
authors.affiliation: Inserm CIC 1410, CHU de La Réunion, 97448 Saint-Pierre cedex, Reunion.
authors.forename: François
authors.initials: F
authors.lastname: Favier
authors.affiliation: Department of Infectious and Tropical Diseases, Laveran Military Training Hospital, 13013 Marseille, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Simon
authors.affiliation: Department of Rheumatology, Roger-Salengro Hospital, University of Lille 2, avenue du Professeur-Emile-Laine, 59047 Lille cedex, France. Electronic address: rene-marc.flipo@chru-lille.fr.
authors.forename: René-Marc
authors.initials: RM
authors.lastname: Flipo
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000453:epidemiology* / Q000821:virology*; D065632:Chikungunya Fever / Q000175:diagnosis / Q000453:epidemiology*; D002646:Chikungunya virus / Q000302:isolation & purification; D015331:Cohort Studies; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D015995:Prevalence; D011379:Prognosis; D016059:Range of Motion, Articular / Q000502:physiology; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods; D012189:Retrospective Studies; D017508:Reunion / Q000453:epidemiology; D012216:Rheumatic Diseases / Q000453:epidemiology* / Q000821:virology*; D012720:Severity of Illness Index; D017678:Sex Distribution; D055815:Young Adult
keywords: Arbovirus infection; Arthritis; Chikungunya; Evolution; Rheumatic manifestations