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Infections are a concern for many when using tumor necrosis factor-α inhibitor (TNFi) therapy to treat inflammatory disorders. Even moreso in those at higher risk.
A recent analysis of 23 HIV-infected patients, with 26 uses of TNFi from four centers examined the infectious outcomes with 86.7 person-years of follow-up between January 1999 and March 2015.
Two patients (8.7%) experienced at least 1 serious infection episode, an overall incidence rate of 2.55 per 100 patient-years (95% CI 0.28-9.23). In those with a viral load > 500 copies/mL at therapy initiation, the incidence rate 3.28/100PY (95% CI 0.04-18.26) and was 2.09/100PY (0.03-11.65) for those with a very low viral load ≤ 500 copies/mL.
This study suggests that TNF-α inhibitors do not impart a higher than expected SIE rate in patients infected with HIV infection. Underlying diagnosis, HIV viral loads and CD4+ cell counts did not appreciably alter these outcomes.
(Thanks to Dr. Len Calabrese for this notable citation)