Identification of a TCR signature in peripheral blood derived CD4+ T cells, associated with chronic chikungunya disease, suggests a conducive, female-biased, background immune profile

A distinct CD4⁺ TCR signature detectable six months post-infection characterizes patients who develop CCD. The association of TRAV9-2 with chronic disease and its enrichment in females suggests an underlying immune predisposition rather than persistent virus-driven expansion. These findings support a role for CD4⁺ T cells in CCD pathophysiology and identify candidate TCR-based biomarkers for disease risk stratification.