Viral Arthritis

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Parvovirus B19

Parovirus B19 causes the common rash illness in children, erythema infectiosum, or fifth disease. It is a member of the family of nonenveloped, single-stranded DNA viruses Parvoviridae. B19 encodes two capsid proteins, VP1 and VP2, and a nonstructural protein, NS1, that plays a pathogenic role in nonerythroid cells not permissive for replication [1]. Although B19 was once thought to be the sole human parvovirus, three human parvovirus genotypes with up to 10% DNA sequence variation have

Rubella

Rubella virus is the sole member of the rubivirus genus of the Togaviridae family of enveloped, positive-sense, single-stranded RNA viruses [18]. Spread occurs by way of airborne droplets, with peak incidence in late winter and spring. The success of near universal childhood vaccination has lulled physicians into overlooking rubella in the differential diagnosis of sudden onset arthritis. Before vaccination, rubella occurred in epidemic 6- to 9-year cycles amongst children. Postvaccination, the

Chikungunya

Alphaviruses are transmitted to humans by mosquitoes. This genus includes the equine encephalitis viruses, as well as a colorful group of viruses causing dramatic outbreaks of fever, rash, and arthritis in Asia, India, the Pacific, Scandinavia, and South America. Their names often reflect their memorable manifestations [30]. Chikungunya virus was isolated during an epidemic of febrile arthritis in Tanzania in 1952–1953. (“Chikungunya” means “that which twists or bends up” in the local dialect).

Hepatitis C and rheumatologic disease

Hepatitis C virus (HCV) is an enveloped single-stranded RNA flavivirus. HCV infects an estimated 170 million people worldwide [64]. In the United States alone, it is estimated that 1.8% of the population is chronically infected. HCV is parenterally transmitted, and becomes chronic in about 75% to 80% of patients [65]. Although HCV is a leading cause of end-stage liver disease worldwide, it does not lead directly to death in the majority of infected patients. HCV is also associated with a wide

Hepatitis B virus–associated articular disease

Hepatitis B virus (HBV) is an enveloped, partially double-stranded DNA virus member of the family Hepadnaviridae, transmitted by parenteral and sexual routes. An estimated one third of the world's population has been infected with hepatitis B. While infection is self-limited in most, it is chronic in 5% to 10% of those acquiring the infection in adulthood. HBV is a common cause of cirrhosis and hepatocellular carcinoma, as well as being associated with a variety of extrahepatic manifestations

HIV-related rheumatologic syndromes

Since its original description in 1981, HIV has infected nearly 100 million people worldwide and caused 40 million deaths [76]. The turning point in the HIV epidemic occurred in 1995 with the introduction of highly active anti-retroviral therapy (HAART). With such therapy, there has been a remarkable decline in deaths due to infectious illnesses, and HIV has become a complex but treatable chronic disease in many patients [77]. The complications observed in this population with ever-increasing

HTLV-I

HTLV-I is a human retrovirus endemic to the Caribbean, South America, West Africa, and Japan. It is seen to a far lesser extent in the United States, primarily among intravenous drug users in certain regions. HTLV-I causes T cell leukemia and lymphoma, tropical spastic paraparesis, and an infective dermatitis syndrome. It is also associated with a variety of autoimmune sequelae, including polymyositis, seronegative erosive polyarthritis, and uveitis [90].

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