Review article: chronic viral infection in the anti‐tumour necrosis factor therapy era in inflammatory bowel disease

Summary Background  Anti‐Tumour necrosis factor (TNF) therapy is now well established in the treatment of inflammatory bowel disease and the risk of opportunistic infection is recognized. However, specific considerations regarding screening, detection, prevention and treatment of chronic viral infec...

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Veröffentlicht in:Alimentary pharmacology & therapeutics 2010-01, Vol.31 (1), p.20-34
Hauptverfasser: SHALE, M. J., SEOW, C. H., COFFIN, C. S., KAPLAN, G. G., PANACCIONE, R., GHOSH, S.
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container_issue 1
container_start_page 20
container_title Alimentary pharmacology & therapeutics
container_volume 31
creator SHALE, M. J.
SEOW, C. H.
COFFIN, C. S.
KAPLAN, G. G.
PANACCIONE, R.
GHOSH, S.
description Summary Background  Anti‐Tumour necrosis factor (TNF) therapy is now well established in the treatment of inflammatory bowel disease and the risk of opportunistic infection is recognized. However, specific considerations regarding screening, detection, prevention and treatment of chronic viral infections in the context of anti‐TNF therapy in inflammatory bowel disease are not widely adopted in practice. Aim  To provide a detailed and comprehensive review of the relevance of chronic viral infections in the context of anti‐TNF therapy in inflammatory bowel disease. Methods  Literature search was conducted using Medline, Pubmed and Embase using the terms viral infection, hepatitis, herpes, CMV, EBV, HPV, anti‐TNF, infliximab, adalimumab, certolizumab pegol and etanercept. Hepatitis B and C and HIV had the largest literature associated and these have been summarized in Tables. Results  Particular risks are associated with the use of anti‐TNF drugs in patients with hepatitis B infection, in whom reactivation is common unless anti‐viral prophylaxis is used. Reactivation of herpes zoster is the most common viral problem associated with anti‐TNF treatment, and may be particularly severe. Primary varicella infection may present with atypical features in patients on anti‐TNF. Conclusion  Appreciation of risks of chronic viral disease associated with anti‐TNF therapy may permit early recognition, prophylaxis and treatment.
doi_str_mv 10.1111/j.1365-2036.2009.04112.x
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Hepatitis B and C and HIV had the largest literature associated and these have been summarized in Tables. Results  Particular risks are associated with the use of anti‐TNF drugs in patients with hepatitis B infection, in whom reactivation is common unless anti‐viral prophylaxis is used. Reactivation of herpes zoster is the most common viral problem associated with anti‐TNF treatment, and may be particularly severe. Primary varicella infection may present with atypical features in patients on anti‐TNF. 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G.</au><au>PANACCIONE, R.</au><au>GHOSH, S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Review article: chronic viral infection in the anti‐tumour necrosis factor therapy era in inflammatory bowel disease</atitle><jtitle>Alimentary pharmacology &amp; therapeutics</jtitle><addtitle>Aliment Pharmacol Ther</addtitle><date>2010-01</date><risdate>2010</risdate><volume>31</volume><issue>1</issue><spage>20</spage><epage>34</epage><pages>20-34</pages><issn>0269-2813</issn><eissn>1365-2036</eissn><abstract>Summary Background  Anti‐Tumour necrosis factor (TNF) therapy is now well established in the treatment of inflammatory bowel disease and the risk of opportunistic infection is recognized. However, specific considerations regarding screening, detection, prevention and treatment of chronic viral infections in the context of anti‐TNF therapy in inflammatory bowel disease are not widely adopted in practice. Aim  To provide a detailed and comprehensive review of the relevance of chronic viral infections in the context of anti‐TNF therapy in inflammatory bowel disease. Methods  Literature search was conducted using Medline, Pubmed and Embase using the terms viral infection, hepatitis, herpes, CMV, EBV, HPV, anti‐TNF, infliximab, adalimumab, certolizumab pegol and etanercept. Hepatitis B and C and HIV had the largest literature associated and these have been summarized in Tables. Results  Particular risks are associated with the use of anti‐TNF drugs in patients with hepatitis B infection, in whom reactivation is common unless anti‐viral prophylaxis is used. Reactivation of herpes zoster is the most common viral problem associated with anti‐TNF treatment, and may be particularly severe. Primary varicella infection may present with atypical features in patients on anti‐TNF. 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subjects Biological and medical sciences
Chronic Disease
Digestive system
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Immunosuppressive Agents - adverse effects
Immunosuppressive Agents - antagonists & inhibitors
Infectious diseases
Inflammatory Bowel Diseases - complications
Inflammatory Bowel Diseases - drug therapy
Medical sciences
Opportunistic Infections - chemically induced
Opportunistic Infections - drug therapy
Other diseases. Semiology
Pharmacology. Drug treatments
Practice Guidelines as Topic
Recurrence
Risk Factors
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Tumor Necrosis Factor-alpha - adverse effects
Tumor Necrosis Factor-alpha - antagonists & inhibitors
Viral diseases
Virus Activation
Virus Diseases - chemically induced
Virus Diseases - etiology
title Review article: chronic viral infection in the anti‐tumour necrosis factor therapy era in inflammatory bowel disease
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