Risk factors for opportunistic infections in infliximab-treated patients: the importance of screening in prevention

被引：79

作者：

Garcia-Vidal, C. ^{[1
,2
]}

Rodriguez-Fernandez, S. ^{[2
]}

Teijon, S. ^{[2
]}

Esteve, M. ^{[3
]}

Rodriguez-Carballeira, M. ^{[2
]}

Lacasa, J. M. ^{[2
]}

Salvador, G. ^{[4
]}

Garau, J. ^{[2
]}

机构：

[1] Hosp Univ Bellvitge, Infect Dis Serv, Barcelona 08907, Spain

[2] Univ Barcelona, Hosp Mutua Terrassa, Serv Internal Med, Barcelona, Spain

[3] Univ Barcelona, Hosp Mutua Terrassa, Serv Gastroenterol, Barcelona, Spain

[4] Univ Barcelona, Hosp Mutua Terrassa, Serv Rheumatol, Barcelona, Spain

来源：

EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES | 2009年 / 28卷 / 04期

关键词：

TUBERCULIN SKIN-TEST; NECROSIS-FACTOR ANTAGONISTS; FACTOR-ALPHA ANTAGONISTS; GAMMA RELEASE ASSAYS; RHEUMATOID-ARTHRITIS; LATENT TUBERCULOSIS; HEPATITIS-B; THERAPY; METHOTREXATE; REACTIVATION;

D O I：

10.1007/s10096-008-0628-x

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

We sought to determine factors associated with opportunistic infections (OI) in infliximab-treated patients. A retrospective study cohort (1999-2004) was examined. Nine OI were diagnosed in 94 infliximab-treated patients: tuberculosis (four), visceral leishmaniasis (one), pyogenic muscular abscess (one Salmonella spp. and one Streptococcus pneumoniae), and two viral infections (hepatitis B virus [HBV] and zoster ophthalmicus). The risk for OI was significantly higher in the first year of treatment (odds ratio [OR] 8; 95% confidence interval [CI] 2-50). Previous treatment with more than two immunosuppressive drugs was the only factor related to OI (OR 8.686; 95% CI 1.889-39.943). We identified the subset of patients treated with infliximab who had a higher risk for OI. The screening of latent infections is key to diminishing the incidence of these infections.

引用

页码：331 / 337

页数：7

共 28 条

[1] Increased risk of coccidioidomycosis in patients treated with tumor necrosis factor α antagonists [J].

Bergstrom, L ;

Yocum, DE ;

Ampel, NM ;

Villanueva, I ;

Lisse, J ;

Gluck, O ;

Tesser, J ;

Posever, J ;

Miller, M ;

Araujo, J ;

Kageyama, DM ;

Berry, M ;

Karl, L ;

Yung, CM .

ARTHRITIS AND RHEUMATISM, 2004, 50 (06) :1959-1966

[2] Effectiveness of recommendations to prevent reactivation of latent tuberculosis infection in patients treated with tumor necrosis factor antagonists [J].

Carmona, L ;

Gómez-Reino, JJ ;

Rodríguez-Valverde, V ;

Montero, D ;

Pascual-Gómez, E ;

Mola, EM ;

Carreño, L ;

Figueroa, T .

ARTHRITIS AND RHEUMATISM, 2005, 52 (06) :1766-1772

[3] Infections associated with tumor necrosis factor-α antagonists [J].

Crum, NF ;

Lederman, ER ;

Wallace, MR .

MEDICINE, 2005, 84 (05) :291-302

[4] Infections and biological therapy in rheumatoid arthritis [J].

Cunnane, G ;

Doran, M ;

Bresnihan, B .

BEST PRACTICE & RESEARCH IN CLINICAL RHEUMATOLOGY, 2003, 17 (02) :345-363

[5] Rates of serious infection, including site-specific and bacterial intracellular infection, in rheumatoid arthritis patients receiving anti-tumor necrosis factor therapy - Results from the British Society for Rheumatology Biologics Register [J].

Dixon, W. G. ;

Watson, K. ;

Lunt, M. ;

Hyrich, K. L. ;

Silman, A. J. ;

Symmons, D. P. M. .

ARTHRITIS AND RHEUMATISM, 2006, 54 (08) :2368-2376

[6] Predictors of infection in rheumatoid arthritis [J].

Doran, MF ;

Crowson, CS ;

Pond, GR ;

O'Fallon, WM ;

Gabriel, SE .

ARTHRITIS AND RHEUMATISM, 2002, 46 (09) :2294-2300

[7] The effect of tumor necrosis factor blockade on the response to pneumococcal vaccination in patients with rheumatoid arthritis and ankylosing spondylitis [J].

Elkayam, O ;

Caspi, D ;

Reitblatt, T ;

Charboneau, D ;

Rubins, JB .

SEMINARS IN ARTHRITIS AND RHEUMATISM, 2004, 33 (04) :283-288

[8] Chronic hepatitis B reactivation following infliximab therapy in Crohn's disease patients:: need for primary prophylaxis [J].

Esteve, M ;

Saro, C ;

González-Huix, F ;

Suarez, F ;

Forné, M ;

Viver, JM .

GUT, 2004, 53 (09) :1363-1365

[9] Lamivudine resistance and exacerbation of hepatitis B in infliximab-treated Crohn's disease patient [J].

Esteve, Maria ;

Loras, Carme ;

Gonzalez-Huixt, Ferran .

INFLAMMATORY BOWEL DISEASES, 2007, 13 (11) :1450-1451

[10] Vaccination against influenza in rheumatoid arthritis:: the effect of disease modifying drugs, including TNFα blockers [J].

Fomin, I ;

Caspi, D ;

Levy, V ;

Varsano, N ;

Shalev, Y ;

Paran, D ;

Levartovsky, D ;

Litinsky, I ;

Kaufman, I ;

Wigler, I ;

Mendelson, E ;

Elkayam, O .

ANNALS OF THE RHEUMATIC DISEASES, 2006, 65 (02) :191-194

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