Chikungunya virus (CHIKV) causes a febrile disease associated with chronic arthralgia, which 52 may progress to neurological impairment. Chikungunya fever (CF) is a consolidated public health problem, 53 in tropical and subtropical regions of the world, where control of CHIKV vector, mosquitos of the Aedes 54 genus, failed. Since there is no vaccine or specific treatment against CHIKV, infected patients receive only 55 palliative care to alleviate pain and arthralgia. Thus, drug repurposing is necessary to identify antivirals 56 against CHIKV. Recently, the structure and activity of CHIKV RNA polymerase was partially resolved, 57 revealing similar aspects with the enzyme counterparner on other positive sense RNA viruses, such as 58 members of the Flaviviridae family. We then evaluated if sofosbuvir, clinically approved against hepatitis C 59 virus RNA polymerase, which also aims to dengue, Zika and yellow fever viruses replication, would inhibit 60 CHIKV replication. Indeed, sofosbuvir was 5-times more selective in inhibiting CHIKV production in 61 human hepatoma cells than ribavirin, a pan-antiviral drug. Although CHIKV replication in human induced 62 pluripotent stem cell (iPS)-derived astrocytes was less sensitive to sofosbuvir's, compared to hepatoma cells 63 this drug still impaired virus production and cell death in a MOI-dependent manner. Sofosbuvir also 64 exhibited antiviral activity in vivo, by preventing CHIKV-induced paw oedeme in adult mice, at 20 65 mg/kg/day, and mortality on neonate mice model, at 40 and 80 mg/kg/day. Our data demonstrates that a 66 prototypic alphavirus, CHIKV, is also susceptible to sofosbuvir. Since this is a clinically approved drug, it 67 could pave the way to become a therapeutic option against CF. 68 69 70 71 72 73 74 75 76 77 78 4 1. Introduction 79 Chikungunya virus (CHIKV) is a member of the Togaviridae family, genus alphavirus, which 80 causes febrile debilitating illness associated with arthralgia and skin rash (1). Although prolonged and 81 debilitating joint pain and oedema differentiate CHIKV infection among contemporary arboviruses, like 82 dengue (DENV) and Zika (ZIKV) viruses, most often these agents display similar clinical signs and 83 symptoms during the early phase of infection (1). Severe outcomes of CHIKV infection, leading to acute 84 and convalescent neurological impairment, have also been described (2, 3). 85 Chikungunya fever (CF) is a consolidated public health problem with substantial impact in tropical 86 and subtropical regions of the world, where Aedes spp mosquitoes are prevalent and control measures failed 87(1). In last 5 years, the Americas, African and Eurasian regions have been severely impacted by CHIKV (4).
88For instance, in Brazil, since 2014, the Asian and East-Central-South-African (ECSA) genotypes of CHIKV 89 co-circulate (5-7), highlighting a substantial viral activity in a country historically hyperendemic for DENV.
90Since no specific treatment or vaccine against CHIKV exist, repurposing of clinically approved drugs, 91 preferent...