Arthritis Associated with Alphavirus Infections: Chikungunya

  • Olga Lidia Vera-Lastra
  • Jesús Sepúlveda-Delgado
  • Julio Granados
  • María del Pilar Cruz-Domínguez
  • Gabriela Medina
  • Luis J. Jara


Since 2004, the epidemic of alphavirus, mainly chikungunya viral (CHIKV) infection, has spread throughout the world and will continue to produce outbreaks due to viral mutations and the spread caused by travelers visiting endemic areas.

The main clinical manifestations of CHIKV infection are fever and arthritis, which has become a real clinical challenge, because a high percentage of patients develop chronic post-infectious arthritis. The most vulnerable population groups are children, the elderly, and those who have chronic comorbidity, including chronic diseases as respiratory, cardiovascular, autoimmune, diabetes, etc., which are a risk factor for aggravation of this infection and turn it into a chronic infection. During the viremic phase, CHIKV is detectable by viral culture and reverse transcriptase PCR. After about 5 days of illness, following viremia, CHIKV can be diagnosed serologically by ELISA.

Viral load, evasion of immune responses, and induction of autophagy, as well as guest factors such as innate immune response, host proteins, adaptive immune response, osteoblasts, cytokines, chemokines, growth factors, and genetic factors, especially those related to the main histocompatibility complex, contribute to the pathogenesis of viral infection and the development of arthritis.

The treatment consists in taking preventive sanitary measures to diminish the presence of the vector Aedes mosquitoes and treating the patient with various medications in order to reduce pain and joint inflammation, improve their quality of life, and limit or prevent chronic damage.


Chikungunya viral infection Chikungunya arthritis Chikungunya viral mutations Postviral chronic arthritis 



Barmah Forest virus


Chemokine (C-C motif) ligand 2


Chikungunya virus


Cross-linking immunoprecipitation


Cytopathic effect


Cytotoxic T lymphocytes


C-X-C motif chemokine 10


Granulocyte-macrophage colony-stimulating factor


Mayaro virus


Nuclear factor-kappa B


O’nyong-nyong virus


Rough endoplasmic reticulum


Ross River virus


Sindbis virus


Venezuelan equine encephalitis virus


Western equine encephalitis virus


World Health Organization Disability Assessment Schedule, version 2


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Olga Lidia Vera-Lastra
    • 1
    • 2
  • Jesús Sepúlveda-Delgado
    • 2
    • 3
  • Julio Granados
    • 4
  • María del Pilar Cruz-Domínguez
    • 5
  • Gabriela Medina
    • 6
  • Luis J. Jara
    • 2
    • 7
  1. 1.Internal Medicine DepartmentHospital de Especialidades “Dr Antonio Fraga Mouret”, Centro Médico La RazaMexico CityMexico
  2. 2.Universidad Nacional Autónoma de MéxicoMexico CityMexico
  3. 3.Research and Diagnosis DivisionHospital Regional de Alta Especialidad Ciudad Salud, Centro Regional de Alta Especialidad de ChiapasTapachulaMexico
  4. 4.Immunogenetics Division, Department of TransplantsInstituto Nacional de Ciencias Medica y Nutricion Salvador ZubiránMexico CityMexico
  5. 5.Health Research DivisionHospital de Especialidades, Centro Médico La RazaMexico CityMexico
  6. 6.Clinical Research Unit, Hospital de Especialidades, Centro Medico La RazaMexico CityMexico
  7. 7.Education and Research, Hospital de Especialidades, Centro Médico La Raza, Instituto Mexicano del Seguro SocialMexico CityMexico

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