Monitoring and Prevention of Infections at the Initiation of Targeted Therapies in Patients with Chronic Autoimmune Inflammatory Rheumatic Diseases: Is It Necessary in Every Case?

Autores: Emilce Edith Schneeberger

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This update summarizes the evidence on monitoring and the eventual prevention of infections in patients with chronic inflammatory rheumatic and autoimmune diseases—particularly those about to initiate targeted therapy with biologic or synthetic immunosuppressants. It reviewed the most relevant infections in our region, such as respiratory infections (influenza, pneumococcal disease, respiratory syncytial virus, and Pneumocystis jirovecii pneumonia—PJP), tuberculosis (TB), hepatitis viruses, herpesviruses, human immunodeficiency virus (HIV), human papillomavirus (HPV), and parasitic conditions such as Chagas disease. Furthermore, the indications and prophylactic regimens for TB, hepatitis B, and PJP were described. Finally, given that vaccination remains the most effective means of preventing infections, the available vaccines—including their indications, contraindications, and methods of administration—were discussed.