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

Eur J Clin Microbiol Infect Dis. 2009 Apr;28(4):331-7. doi: 10.1007/s10096-008-0628-x. Epub 2008 Sep 17.

Abstract

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.

MeSH terms

  • Abscess / epidemiology
  • Abscess / etiology
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal / adverse effects*
  • Antibodies, Monoclonal / pharmacology
  • Antibodies, Monoclonal / therapeutic use
  • Arthritis, Rheumatoid / complications
  • Arthritis, Rheumatoid / drug therapy
  • Cohort Studies
  • Crohn Disease / complications
  • Crohn Disease / drug therapy
  • Female
  • Hepatitis B / epidemiology
  • Hepatitis B / etiology
  • Herpes Zoster Ophthalmicus / epidemiology
  • Herpes Zoster Ophthalmicus / etiology
  • Humans
  • Immune System / drug effects
  • Immunosuppression Therapy / adverse effects*
  • Immunosuppressive Agents / adverse effects*
  • Immunosuppressive Agents / pharmacology
  • Immunosuppressive Agents / therapeutic use
  • Infliximab
  • Leishmaniasis, Visceral / epidemiology
  • Leishmaniasis, Visceral / etiology
  • Male
  • Middle Aged
  • Opportunistic Infections* / epidemiology
  • Opportunistic Infections* / etiology
  • Risk Factors*
  • Statistics, Nonparametric
  • Tuberculosis / epidemiology
  • Tuberculosis / etiology

Substances

  • Antibodies, Monoclonal
  • Immunosuppressive Agents
  • Infliximab