Chikungunya on kidney transplant recipients: Is it the same?

Background Chikungunya virus (CHIKV) infection is an acute febrile illness with polyarthralgia and arthritis. There are few data about CHIKV infection in kidney transplant recipients (KTR). We report the largest case series of CHIKV infection in this population. Methods We retrospectively analyzed 32 cases of CHIKV infection in KTR between January 2016 and December 2017 at Hospital Universitário Walter Cantídio of Federal University of Ceará. Results All patients had been in endemic area before the beginning of the symptoms. All cases presented arthralgia, fifteen (46.9%) with joint inflammatory symptoms and 14 (43.8%) evolved to chronic arthralgia. Seven (21.9%) showed acute kidney injury (AKI) by KDIGO criteria during the acute phase. AKI was not related to prednisone use (OR 0.3, 95% CI 0.04 – 2.61, p=0.3) nor chronic arthralgia (OR 1.2, 95% CI 0.2 – 8.4, p=0.8) as well as male sex, chronic kidney disease and age above 60 years (OR 1.7, 95% CI 0.3 – 10.3, p=0.58; OR 0.4, 95% CI 0.1 – 2.7, p=0.4 and OR 2.1, 95% CI 0.3 – 14.9, p=0.45, respectively). Hospitalization was associated to AKI (OR 44.0, 95% CI 3.8 – 503.1, p=0.002), probably due to diarrhea or dehydration. One patient died during the study period, possibly not related to CHIKV infection. Conclusion The chance of CHIKV infection becoming chronic arthralgia in KTR was not different from data in literature. Seven patients presented AKI in the acute phase of infection, although that did not persist. Previous costicosteroids use did not relate with AKI or chronic arthralgia. Correspondence information: Bruno M. Tavares, Hospital São José de Doenças Infecciosas, Rua Nestor Barbosa, 315 – Parquelândia, Fortaleza – CE, Brazil 60455-610, E-mail: brunomelotavares@gmail.com. Telephone: +55-11-95981-1898 AUTHORSHIP PAGE Bruno M. Tavares: Participated in data collection, analysis and interpretation, preparing the figures and writing the article. Paula FCBC Fernandes: Participated in research design, data collection, analysis and interpretation and critical revision of the article. Cláudia Maria C. Oliveira: Participated in research design, data collection, analysis and interpretation, writing and critical revision of the article. Sônia L. Silva: Participated in data collection Márcia U. Mota: Participated in data collection Tacilla HS Andrade: Participated in data collection Samuel F. Cunha: Participated in data collection Evelyne S. Girão: Participated in research design, data collection, analysis and interpretation, writing and critical revision of the article. Disclosure: The authors declare no conflicts of interest. Funding: The authors declare no funding for this work. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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