Infliximab therapy for HIV positive Crohn's disease: A case report

Habib, Syed F.; Hasan, Muhammad; Salam, Irfana

doi:10.1016/j.crohns.2009.06.002

Cited by 19 publications

(8 citation statements)

References 12 publications

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“…In addition, and contrary to previous data, there are a number of reports indicating that biologic therapies can be safely and effectively used in the treatment of HIV-associated reactive arthritis, Crohn's disease and rheumatoid arthritis without any significant changes in HIV status (3,11,12). Furthermore, early in vitro studies demonstrated that TNF-α is able to stimulate the replication of HIV-1 in de novo infected CD4+ T cells and promyelocytes dependent upon the TNF-α dose (13,14).…”

mentioning

confidence: 77%

Effects of Biologic Therapies for Cutaneous Inflammatory Diseases in HIV-Infected Individuals: Reliable or Not?

Akarsu

Avci

2018

J Basic Clin Health Sci

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Purpose: Patients with cutaneous inflammatory diseases often present with more aggressive and refractory clinical course in the presence of accompanying human immunodeficiency virus (HIV) infection. Therefore, biologic therapies may be needed to improve outcomes of these patients. The use of biologic agents in HIV positive patients is conflicting because such treatment can lead to increase the risk of infection and malignancy in already immunocompromised patients. On the other hand, some researchers have recommended that HIV management should also include the blockade of tumour necrosis factor-alpha (TNF-α). We discuss the reliability and effectiveness of biologic therapies for patients with cutaneous inflammatory diseases and accompanying HIV infection. Methods: The Medline literature database search through PubMed using the key words 'human immunodeficiency virus', 'cutaneous inflammatory diseases', 'TNF-α inhibitor', 'biologic therapy', 'biologic treatment', 'adalimumab', 'etanercept', 'infliximab,' 'ustekinumab', and 'rituximab' was performed. Literature data associated with biologic therapies of cutaneous inflammatory diseases in HIV-positive patients were evaluated. Results: The literature search identified a total of 17 patients with HIV infection receiving biologic therapy for cutaneous inflammatory diseases (psoriasis, psoriatic arthritis, hidradenitis suppurativa and pemphigus vulgaris) from two case series and 12 case reports. Conclusion: In HIV-infected patients with severe and refractory cutaneous inflammatory diseases, biologic therapies should only be reserved for those whom HIV status is stable at baseline. Screening for tuberculosis prior to treatment and close monitoring for potential side effects are mandatory. Further multicentre randomised controlled trials about the use of biologic agents in these patient groups are necessary.

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mentioning

confidence: 77%

Effects of Biologic Therapies for Cutaneous Inflammatory Diseases in HIV-Infected Individuals: Reliable or Not?

Akarsu

Avci

2018

J Basic Clin Health Sci

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“…Elevated levels of TNF-α are correlated to advanced stages of HIV infection and with opportunistic infections 114. Two small studies evaluating the safety of anti-TNF therapy in HIV patients failed to show any change in plasma HIV ribonucleic acid cluster of differentiation-4+ lymphocyte count, or the occurrence of severe adverse effects 114,115. In conclusion, it appears the use of anti-TNF therapy in HIV patients is safe.…”

Section: Viral Infectionsmentioning

confidence: 92%

“…TNF-α has been implicated in the pathogenesis of HIV infection by contributing to HIV replication through activation of nuclear factor-κB 113. Elevated levels of TNF-α are correlated to advanced stages of HIV infection and with opportunistic infections 114. Two small studies evaluating the safety of anti-TNF therapy in HIV patients failed to show any change in plasma HIV ribonucleic acid cluster of differentiation-4+ lymphocyte count, or the occurrence of severe adverse effects 114,115.…”

Section: Viral Infectionsmentioning

confidence: 99%

Clinical use of anti-TNF therapy and increased risk of infections

Ali¹,

Kaitha²,

Mahmood³

et al. 2013

DHPS

201

171

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Biologics such as antitumor necrosis factor (anti-TNF) drugs have emerged as important agents in the treatment of many chronic inflammatory diseases, especially in cases refractory to conventional treatment modalities. However, opportunistic infections have become a major safety concern in patients on anti-TNF therapy, and physicians who utilize these agents must understand the increased risks of infection. A literature review of the published data on the risk of bacterial, viral, fungal, and parasitic infections associated with anti-TNF therapy was performed and the clinical presentation, diagnostic tests, management, and prevention of opportunistic infections in patients receiving anti-TNF therapy were reviewed. Awareness of the therapeutic potential and associated adverse events is necessary for maximizing therapeutic benefits while minimizing adverse effects from anti-TNF treatments. Patients should be adequately vaccinated when possible and closely monitored for early signs of infection. When serious infections occur, withdrawal of anti-TNF therapy may be necessary until the infection has been identified and properly treated.

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“…Experiences in treating individuals with HIV infection with anti-TNF therapies are limited. It is possible to prescribe with a reasonable ratio of benefits to risks if the patients have a low HIV viral load and are not severely immunosuppressed (>350 CD4 cells/μL), keeping them closely monitored[ 103 , 113 - 115 ].…”

Section: Viral Diseasesmentioning

confidence: 99%

Viral infections in inflammatory bowel disease: Tips and tricks for correct management

Craviotto¹,

Furfaro²,

Loy³

et al. 2021

WJG

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Over the past decades, the treatment of inflammatory bowel diseases (IBD) has become more targeted, anticipating the use of immune-modifying therapies at an earlier stage. This top-down approach has been correlated with favorable short and long-term outcomes, but it has also brought with it concerns regarding potential infectious complications. This large IBD population treated with immune-modifying therapies, especially if combined, has an increased risk of severe infections, including opportunistic infections that are sustained by viral, bacterial, parasitic, and fungal agents. Viral infections have emerged as a focal safety concern in patients with IBD, representing a challenge for the clinician: they are often difficult to diagnose and are associated with significant morbidity and mortality. The first step is to improve effective preventive strategies, such as applying vaccination protocols, adopt adequate prophylaxis and educate patients about potential risk factors. Since viral infections in immunosuppressed patients may present atypical signs and symptoms, the challenges for the gastroenterologist are to suspect, recognize and diagnose such complications. Appropriate treatment of common viral infections allows us to minimize their impact on disease outcomes and patients’ lives. This practical review supports this standard of care to improve knowledge in this subject area.

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Infliximab therapy for HIV positive Crohn's disease: A case report

Cited by 19 publications

References 12 publications

Effects of Biologic Therapies for Cutaneous Inflammatory Diseases in HIV-Infected Individuals: Reliable or Not?

Effects of Biologic Therapies for Cutaneous Inflammatory Diseases in HIV-Infected Individuals: Reliable or Not?

Clinical use of anti-TNF therapy and increased risk of infections

Viral infections in inflammatory bowel disease: Tips and tricks for correct management

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