{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T04:08:25Z","timestamp":1792642105902,"version":"4.5.0"},"reference-count":40,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T00:00:00Z","timestamp":1739318400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Chikungunya fever (CHIKF) is a re-emerging infectious disease caused by the chikungunya virus (CHIKV), transmitted primarily by Aedes mosquitoes. A significant number progress to chronic chikungunya arthritis, which shares similarities with rheumatoid arthritis (RA). Despite evidence of a link between CHIKV infection and subsequent RA development, a comprehensive analysis of the relationship between these two diseases is lacking. This study systematically analyzes the incidence of RA after CHIKV infection and its immunological mechanisms, following PRISMA guidelines with literature searches across multiple databases up to 3 September 2024. Eligible studies included retrospective and prospective designs reporting RA diagnoses after CHIKV infection. Data extraction was performed independently, and the risk of bias was assessed using appropriate tools. Sixteen studies involving 2879 patients were included, with 449 individuals diagnosed with RA following CHIKV infection, resulting in a combined incidence of 13.7% (95% CI: 6.12% to 27.87%). High heterogeneity between studies was observed (I2 = 96%), indicating variability related to diagnostic criteria and population characteristics. This review highlights the significant RA incidence after CHIKV infection, emphasizing the need for research on autoimmune mechanisms, long-term rheumatological follow-up, early diagnostic biomarkers, and CHIKV\u2019s long-term health impacts.<\/jats:p>","DOI":"10.3390\/tropicalmed10020054","type":"journal-article","created":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T03:41:57Z","timestamp":1739331717000},"page":"54","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Chikungunya Fever and Rheumatoid Arthritis: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0528-8600","authenticated-orcid":false,"given":"Jos\u00e9 Kennedy","family":"Amaral","sequence":"first","affiliation":[{"name":"Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Cariri, 284 Divino Salvador Street, Barbalha 63090-000, Cear\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert Taylor","family":"Schoen","sequence":"additional","affiliation":[{"name":"Section of Rheumatology, Allergy, and Immunology, Yale University School of Medicine, 15 York Street, New Haven, CT 06510, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael E.","family":"Weinblatt","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Inflammation and Immunity, Harvard Medical School, Brigham and Women\u2019s Hospital, 60 Fenwood Road, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estelita Lima","family":"C\u00e2ndido","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Cariri, 284 Divino Salvador Street, Barbalha 63090-000, Cear\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Costa, L.B., Barreto, F.K.A., Barreto, M.C.A., dos Santos, T.H.P., Andrade, M.d.M.O.d., Farias, L.A.B.G., de Freitas, A.R.R., Martinez, M.J., and Cavalcanti, L.P.d.G. (2023). Epidemiology and Economic Burden of Chikungunya: A Systematic Literature Review. Trop. Med. Infect. Dis., 8.","DOI":"10.3390\/tropicalmed8060301"},{"key":"ref_2","first-page":"100571","article-title":"The Expansion of Chikungunya in Brazil","volume":"25","author":"Lana","year":"2023","journal-title":"Lancet Reg. Health Am."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1038\/s41572-023-00429-2","article-title":"Chikungunya Fever","volume":"9","author":"Bartholomeeusen","year":"2023","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1007\/s11908-022-00789-y","article-title":"Chikungunya: An Emerging Public Health Concern","volume":"24","author":"Mourad","year":"2022","journal-title":"Curr. Infect. Dis. Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e00404","DOI":"10.1590\/0037-8682-0433-2023","article-title":"Bone Erosions and Joint Damage Caused by Chikungunya Virus: A Systematic Review","volume":"57","author":"Amaral","year":"2024","journal-title":"Rev. Soc. Bras. Med. Trop."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.ijid.2017.03.006","article-title":"Global Expansion of Chikungunya Virus: Mapping the 64-Year History","volume":"58","author":"Wahid","year":"2017","journal-title":"Int. J. Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1056\/NEJMp078013","article-title":"Chikungunya Outbreaks\u2014The Globalization of Vector-Borne Diseases","volume":"356","author":"Charrel","year":"2007","journal-title":"N. Engl. J. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1007\/s42770-023-00976-6","article-title":"Synergism between Chikungunya Virus Infection and Rheumatoid Arthritis on Cytokine Levels: Clinical Implications?","volume":"54","author":"Bezerra","year":"2023","journal-title":"Braz. J. Microbiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2255","DOI":"10.1016\/j.immuni.2022.11.009","article-title":"The Pathogenesis of Rheumatoid Arthritis","volume":"55","author":"Alivernini","year":"2022","journal-title":"Immunity"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"102400","DOI":"10.1016\/j.jaut.2019.102400","article-title":"The Etiology of Rheumatoid Arthritis","volume":"110","author":"Scherer","year":"2020","journal-title":"J. Autoimmun."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2569","DOI":"10.1002\/art.27584","article-title":"2010 Rheumatoid Arthritis Classification Criteria: An American College of Rheumatology\/European League Against Rheumatism Collaborative Initiative","volume":"62","author":"Aletaha","year":"2010","journal-title":"Arthritis Rheum."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"102534","DOI":"10.1016\/j.tmaid.2022.102534","article-title":"Pathogenesis of Chronic Chikungunya Arthritis: Resemblances and Links with Rheumatoid Arthritis","volume":"52","author":"Amaral","year":"2023","journal-title":"Travel Med. Infect. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/j.semarthrit.2018.03.011","article-title":"A Systematic Review of Viral Exposures as a Risk for Rheumatoid Arthritis","volume":"48","author":"Kudaeva","year":"2019","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1146\/annurev-virology-091919-102021","article-title":"New Insights into Chikungunya Virus Infection and Pathogenesis","volume":"8","author":"Kril","year":"2021","journal-title":"Annu. Rev. Virol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 Statement: An Updated Guideline for Reporting Systematic Reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_16","unstructured":"Wells, G.A., Shea, B., O\u2019Connell, D.A., Peterson, J., Welch, V., Losos, M., Tugwell, P., and The Ottawa Hospital Research Institute (2024, September 14). The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-Analyses. Available online: http:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp."},{"key":"ref_17","first-page":"2127","article-title":"Methodological Quality of Case Series Studies: An Introduction to the JBI Critical Appraisal Tool","volume":"18","author":"Munn","year":"2020","journal-title":"JBI Evid. Synth."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Aromataris, E., and Munn, Z. (2020). Chapter 7: Systematic Reviews of Etiology and Risk. JBI Manual for Evidence Synthesis, JBI. Available online: https:\/\/synthesismanual.jbi.global.","DOI":"10.46658\/JBIRM-17-01"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: A Revised Tool for Assessing Risk of Bias in Randomised Trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2781","DOI":"10.1007\/s10067-020-05011-9","article-title":"Persistent Chikungunya Arthritis in Roraima, Brazil","volume":"39","author":"Hayd","year":"2020","journal-title":"Clin. Rheumatol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.3899\/jrheum.190162","article-title":"Chronic Joint Pain 3 Years After Chikungunya Virus Infection Largely Characterized by Relapsing-Remitting Symptoms","volume":"47","author":"Tritsch","year":"2020","journal-title":"J. Rheumatol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/s41182-022-00412-9","article-title":"Post-Chikungunya Arthritis: A Longitudinal Study in a Tertiary Care Hospital in Bangladesh","volume":"50","author":"Hossain","year":"2022","journal-title":"Trop. Med. Health"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Pollett, S., Hsieh, H.C., Lu, D., Grance, M., Richard, S., Nowak, G., Lanteri, C., Tribble, D., and Burgess, T. (2024). The Risk and Risk Factors of Chikungunya Virus Infection and Rheumatological Sequelae in a Cohort of U.S. Military Health System Beneficiaries: Implications for the Vaccine Era. PLoS Negl. Trop. Dis., 18.","DOI":"10.1371\/journal.pntd.0011810"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.jbspin.2017.01.014","article-title":"Rheumatic Manifestations Associated with Chikungunya Virus Infection: A Study of 307 Patients with 32-Month Follow-Up (RHUMATOCHIK Study)","volume":"85","author":"Bouquillard","year":"2018","journal-title":"Jt. Bone Spine"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/j.trstmh.2010.01.011","article-title":"Clinical Progression of Chikungunya Fever During Acute and Chronic Arthritic Stages and the Changes in Joint Morphology as Revealed by Imaging","volume":"104","author":"Manimunda","year":"2010","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1177\/0973369820110103","article-title":"Clinical Profile and Long-Term Sequelae of Chikungunya Fever","volume":"6","author":"Paul","year":"2011","journal-title":"Indian J. Rheumatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.1111\/j.1742-1241.2011.02792.x","article-title":"Rheumatic-Musculoskeletal Pain and Disorders in a Na\u00efve Group of Individuals 15 Months Following a Chikungunya Viral Epidemic in South India: A Population-Based Observational Study","volume":"65","author":"Mathew","year":"2011","journal-title":"Int. J. Clin. Pract."},{"key":"ref_28","first-page":"456","article-title":"Musculoskeletal Disorders Due to Chikungunya Virus: A Real Experience in a Rheumatology Department in Neiva, Huila","volume":"17","year":"2021","journal-title":"Reumatol. Clin."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"360","DOI":"10.12688\/f1000research.8235.1","article-title":"Post-Chikungunya Chronic Inflammatory Rheumatism: Results from a Retrospective Follow-Up Study of 283 Adult and Child Cases in La Virginia, Risaralda, Colombia","volume":"5","year":"2016","journal-title":"F1000Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1740","DOI":"10.1093\/infdis\/jiaa261","article-title":"Chikungunya-Induced Arthritis in Reunion Island: A Long-Term Observational Follow-Up Study Showing Frequently Persistent Joint Symptoms, Some Cases of Persistent Chikungunya Immunoglobulin M Positivity, and no Anticyclic Citrullinated Peptide Seroconversion After 13 Years","volume":"222","author":"Guillot","year":"2020","journal-title":"J. Infect. Dis."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1214","DOI":"10.1002\/art.39027","article-title":"Chikungunya Viral Arthritis in the United States: A Mimic of Seronegative Rheumatoid Arthritis","volume":"67","author":"Miner","year":"2015","journal-title":"Arthritis Rheumatol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1016\/j.jbspin.2009.08.005","article-title":"A Report of 21 Cases of Rheumatoid Arthritis Following Chikungunya Fever: A Mean Follow-Up of Two Years","volume":"76","author":"Bouquillard","year":"2009","journal-title":"Jt. Bone Spine"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Javelle, E., Ribera, A., Degasne, I., Ga\u00fcz\u00e8re, B.A., Marimoutou, C., and Simon, F. (2015). Specific Management of Post-Chikungunya Rheumatic Disorders: A Retrospective Study of 159 Cases in Reunion Island from 2006\u20132012. PLoS Negl. Trop. Dis., 9.","DOI":"10.1371\/journal.pntd.0003603"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1097\/RHU.0000000000000943","article-title":"Successful Methotrexate Treatment of Chronic Chikungunya Arthritis","volume":"26","author":"Amaral","year":"2020","journal-title":"J. Clin. Rheumatol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1007\/s10067-016-3429-0","article-title":"Efficacy of Combination DMARD Therapy vs. Hydroxychloroquine Monotherapy in Chronic Persistent Chikungunya Arthritis: A 24-Week Randomized Controlled Open Label Study","volume":"36","author":"Ravindran","year":"2017","journal-title":"Clin. Rheumatol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1849","DOI":"10.1002\/acr.22900","article-title":"Prevalence of Post-Chikungunya Infection Chronic Inflammatory Arthritis: A Systematic Review and Meta-Analysis","volume":"68","year":"2016","journal-title":"Arthritis Care Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1016\/j.jbspin.2018.03.019","article-title":"Incidence of Articular Pain and Arthritis After Chikungunya Fever in the Americas: A Systematic Review of the Literature and Meta-Analysis","volume":"85","author":"Edington","year":"2018","journal-title":"Joint Bone Spine"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Rama, K., de Roo, A.M., Louwsma, T., Hofstra, H.S., Amaral, G.S.G.D., Vondeling, G.T., Postma, M.J., and Freriks, R.D. (2024). Clinical Outcomes of Chikungunya: A Systematic Literature Review and Meta-Analysis. PLoS Negl. Trop. Dis., 18.","DOI":"10.1371\/journal.pntd.0012254"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1093\/trstmh\/try063","article-title":"Chikungunya Chronic Disease: A Systematic Review and Meta-Analysis","volume":"112","author":"Rodrigues","year":"2018","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1093\/trstmh\/trac045","article-title":"Treatment of Chikungunya-Associated Joint Pain: A Systematic Review of Controlled Clinical Trials","volume":"116","author":"Rodrigo","year":"2022","journal-title":"Trans. R. Soc. Trop. Med. Hyg."}],"container-title":["Tropical Medicine and Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-6366\/10\/2\/54\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:31:41Z","timestamp":1760027501000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-6366\/10\/2\/54"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,12]]},"references-count":40,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["tropicalmed10020054"],"URL":"https:\/\/doi.org\/10.3390\/tropicalmed10020054","relation":{},"ISSN":["2414-6366"],"issn-type":[{"value":"2414-6366","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,12]]}}}