The results obtained could be explained with the different characterization of virus infection phases. It is known that while the acute phase of CHIKV infections is due to the development of viremia, the chronic phase is closely related to an immune-mediated phenomenon, as pro-inflammatory cytokines and chemokines play important roles in the pathogenesis of chikungunya arthritis [44]. Therefore, considering the results obtained from these clinical studies, it is possible to say that although HCQ does not affect viremia reduction, as demonstrated by the lack of activity in the first phase of infection, it can improve the chronic phase diseases by reducing inflammation.