Implications of RNA virus persistence for post-acute sequelae and chronic inflammatory syndromes

Viral persistence refers to the ability of a virus to remain in its host for an extended period. Although most non-retroviral RNA viruses are traditionally known for causing acute, self-limiting infections, accumulating evidence of the detection of viral products long after the infectious virus is cleared suggests that RNA viruses can establish persistent infections. Persistent viral products include replication-competent viral genomes, viral proteins, mutated viruses or non-standard viral genomes. The persistence of viral products entails a continuous interaction with the host and is often associated with prolonged tissue inflammation and chronic disease. Here, we discuss emerging evidence of the persistence of viral products from viruses commonly considered to cause acute infections. We explore the known requirements for virus persistence and the implications for the development of post-acute sequelae and predisposition to chronic inflammatory syndromes.