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Review
. 2010 Mar;6(3):165-74.
doi: 10.1038/nrrheum.2009.279. Epub 2010 Feb 9.

Tumor necrosis factor blockade and the risk of viral infection

Seo Young Kim  1 , Daniel H Solomon
Affiliations
Review

Tumor necrosis factor blockade and the risk of viral infection

Seo Young Kim et al. Nat Rev Rheumatol. 2010 Mar.

Abstract

Tumor necrosis factor (TNF) blockers are widely used to treat rheumatoid arthritis and other chronic inflammatory diseases. Many studies have demonstrated an increased risk of opportunistic infections such as tuberculosis and fungal infection in patients treated with TNF blockers, which is thought to be related to the primary role of TNF both in host defense and in the immune response. Little is known, however, about the association between TNF blockade and the development of viral infection. Owing to the critical role of TNF in the control of viral infection, depletion of this cytokine with TNF blockers could facilitate the development or reactivation of viral infection. A number of large observational studies have found an increased risk of herpes zoster in patients receiving TNF blockers for the treatment of rheumatoid arthritis. This Review draws attention to the risk of several viral infections, including HIV, varicella zoster virus, Epstein-Barr virus, cytomegalovirus, and human papillomavirus, in patients receiving TNF-blocking therapy for chronic inflammatory conditions. In addition, implications for clinical practice and possible preventative approaches are discussed.

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References

    1. Kollias G, Douni E, Kassiotis G, Kontoyiannis D. The function of tumour necrosis factor and receptors in models of multi-organ inflammation, rheumatoid arthritis, multiple sclerosis and inflammatory bowel disease. Ann Rheum Dis. 1999;58:132–9. - PMC - PubMed
    1. Furst D. The Risk of Infections with Biologic Therapies for Rheumatoid Arthritis. Semin Arthritis Rheum 2008 Dec 29. 2008 Epub ahead of print. - PubMed
    1. Crawford M, Curtis J. Tumor necrosis factor inhibitors and infection complications. Curr Rheumatol Rep. 2008;10:383–9. - PMC - PubMed
    1. Dixon W, Watson K, Lunt M, H KL, Silman A, Symmons D. 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. Arthritis Rheum. 2006;54:2368–76. - PubMed
    1. Wolfe F, Caplan L, Michaud K. Treatment for rheumatoid arthritis and the risk of hospitalization for pneumonia: associations with prednisone, disease-modifying antirheumatic drugs, and anti-tumor necrosis factor therapy. Arthritis Rheum. 2006;54:628–34. - PubMed

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