Prevalence of chronic chikungunya and associated risks factors in the French West Indies (La Martinique): A prospective cohort study

BackgroundThe chikungunya virus (CHIKV) is a re-emerging alphavirus that can cause chronic and potentially incapacitating rheumatic musculoskeletal disorders known as chronic chikungunya arthritis (CCA). We conducted a prospective cohort study of CHIKV-infected subjects during the 2013 chikungunya outbreak in Martinique. The aim of this study was to assess the prevalence of CCA at 12 months and to search for acute phase factors significantly associated with chronicity.Methodology/Principal findingsA total of 193 patients who tested positive for CHIKV RNA via qRT-PCR underwent clinical investigations in the acute phase (ConclusionsThis cohort study conducted in Martinique confirms that CCA is a common complication of acute chikungunya disease. Our analysis emphasized the importance of age and female sex for CCA occurrence, and highlighted the aggravating role of dehydration during the acute phase. Early and adequate hydration were found to reduce the risk chronic chikungunya disorders.Trial registrationclinicaltrials.gov (NCT01099852).研究背景：基孔肯雅病毒（Chikungunya Virus, CHIKV）是一种重新暴发流行的甲病毒属（alphavirus）病毒，可引发慢性且可能致残的风湿性肌肉骨骼疾病，即慢性基孔肯雅关节炎（Chronic Chikungunya Arthritis, CCA）。本研究针对2013年马提尼克岛基孔肯雅热暴发期间感染CHIKV的受试者开展了一项前瞻性队列研究，旨在评估感染后12个月时CCA的患病率，并筛选与慢性化进程显著相关的急性期相关因素。 方法与主要结果：总计193名经定量逆转录聚合酶链反应（qRT-PCR）检测CHIKV RNA呈阳性的患者在急性期接受了临床评估。 结论：本项在马提尼克岛开展的队列研究证实，CCA是急性基孔肯雅热的常见并发症。本研究分析明确了年龄与女性性别为CCA发生的重要危险因素，并揭示了急性期脱水对病情迁延的加重作用。研究发现，早期充分补液可降低慢性基孔肯雅疾病的发病风险。 试验注册：ClinicalTrials.gov（NCT01099852）