J.M. Varela

Hospital Universitario Virgen del Rocío

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Enrique J. Calderón

Instituto de Biomedicina de Sevilla

Francisco J. Medrano

Hospital Universitario Virgen del Rocío

N. Respaldiza

Hospital Universitario Virgen del Rocío

Carmen de la Horra

Hospital Universitario Virgen del Rocío

M. Montes-Cano

Universidad de Sevilla

Vicente Friaza

Universidad de Sevilla

Marco Antonio Montes‐Cano

Instituto de Biomedicina de Sevilla

Rubén Morilla

Universidad de Sevilla

I. Wichmann

Hospital Universitario Virgen del Rocío

C. González-Becerra

Hospital Universitario Virgen del Rocío

Cooperative Institutions

Hospital Universitario Virgen del Rocío

Universidad de Sevilla

Instituto de Biomedicina de Sevilla

Instituto de Salud Carlos III

Consejo Superior de Investigaciones Científicas

Andalusian Health Service

Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública

University of Cincinnati

Centro de Investigación Biomédica en Red

Instituto Nacional de Toxicología y Ciencias Forenses

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Enoxaparin for the Prevention of Venous Thromboembolism

New England Journal of Medicine (2000)

Enrique J. Calderón J.M. Varela M.A. González de la Puente

10.1056/nejm200001133420215

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Citations (4)

GC Subtyping and HIV Infection in a Spanish Population: No Evidence of an Association between GC Subtypes and AIDS

Human Heredity (1990)

Antonio Alonso M. Montesino M. J. Iturralde Gavidia Vallejo Maribel Iglesias Sancho

Group-specific component (GC) subtyping was performed by isoelectric focusing in 318 Spanish drug users at risk for infection or infected by HIV (85 HIV seronegatives, 111 HIV seropositives without symptoms, 89 seropositives with symptoms, 33 AIDS patients) and 187 healthy individuals. There was no significant association between GC subtypes and susceptibility to HIV infection and/or progression to AIDS.

Subtyping

10.1159/000153900

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Citations (9)

Usefulness Of Oropharyngeal Washings For Identifying Pneumocystis jirovecii Carriers

Journal of Eukaryotic Microbiology (2006)

N. Respaldiza Marco Antonio Montes‐Cano Vicente Friaza Fernando Muñoz-Lobato Francisco J. Medrano

10.1111/j.1550-7408.2006.00188.x

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Citations (22)

Pneumocystis jiroveci isolates with dihydropteroate synthase mutations in patients with chronic bronchitis

European Journal of Clinical Microbiology & Infectious Diseases (2004)

Ernesto Calder�n Carmen de la Horra Francisco J. Medrano A. L�pez-Su�rez M. Montes-Cano

Dihydropteroate synthase

DHPS

Chronic bronchitis

Pneumocystis pneumonia

10.1007/s10096-004-1151-3

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Citations (56)

Fatal Hepatotoxicity Associated with Enalapril

Annals of Pharmacotherapy (2001)

Miguel Puente Enrique J. Calderón Ricardo Espinosa Manuel Rincón J.M. Varela

10.1345/aph.10404

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Citations (18)

Epidemiology of Pneumocystis carinii pneumonia in southern Spain

Clinical Microbiology and Infection (2004)

Enrique J. Calderón J.M. Varela Francisco J. Medrano Víctor Manuel García Nieto C. González-Becerra

Pneumocystosis

10.1111/j.1469-0691.2004.00921.x

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Citations (37)

El ser humano como reservorio de Pneumocystis

Enfermedades Infecciosas y Microbiología Clínica (2009)

Gustavo Wissmann Rubén Morilla Vicente Friaza Enrique J. Calderón J.M. Varela

10.1016/j.eimc.2008.07.008

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Citations (24)

THU0363 Latent tuberculosis infection and viral hepatitis in a colombian cohort of patients with biological therapy

Annals of the Rheumatic Diseases (2013)

F. Gonzalez-Malaver C.M. Guzman-Vergara Juan Manuel Bello-Gualtero J.M. Varela Ana Maria Mesa-Betancourt

Background

Biological therapy have revolutionized the treatment of some autoimmune diseases, such as rheumatoid arthritis (RA), and spondyloarthropathies (SpA). Patients receiving biologics have a increased risk of opportunistic infections, particularly of reactivating latent tuberculosis (LTB).

Objectives

To describe the presence of LTB and viral hepatitis in a cohort of patients (pts) with biologic therapy.

Methods

Cross-sectional study. 157 patients of a rheumatology center treated with biological therapy were evaluated. Medical records were reviewed. Variables: sex, mean age, diagnosis, current biological therapy, PPD (>10mm), hepatitis B virus surface antigen reactivity, hepatitis C virus antibody reactivity, chest x-ray, biological therapy since 2001, antinuclear antibodies (ANAS), and associated autoimmunity. Descriptive analysis was done for qualitative and categorical variables (percentages and averages) using STATA11.

Results

In 23 patients (14.7%) was documented LTB. 12 pts (52.2%) are women and 11 pts (47.8%) are male. Mean age: 50,6 y/o. 13 pts (56.5%) have diagnosis of SpA, 9 patients (39,1%) RA, and 1 patient (4.37%) psoriatic arthritis (PsA). 9 pts (39,1%) receive Adalimumab, 7 pts (30,43%) Infliximab, 3 pts (13%) Etanercept, 3 pts (13%) Rituximab, and 1 pt (4,4%) Tocilizumab. Since year 2001, 16 patients (69,6%) have received just one biologic as treatment, 4 pts (17.4%) 3 biologics, 2 pts (8,7%) 2 biologics, and 1 pts (4,3%) 6 biologics. Infliximab is the biologic more prescribed (12 pts, 52,2%) as first choice since 2001. Adalimumab (57,1%) is the one most formulated in the group that have received more tan one biologic. All patients chest X-ray were reported as normal. 14 pts (60.87%) have positive ANAS. Associated autoimmunity: 3 pts (13.4%) uveitis, and 2 pts (8.70%) Sjogren syndrome (SS). Pneumology prescribed all patients Isoniazid for minimun 9 months. The biologic was started o continued after three months on Isoniazid. In 5 patients (3.18%) was documented seropositivity for Hepatitis B (HBV). 3 pts (60%)) are men and 2 pts (40%) are women. Mean age: 56.1 y/o. 4 pts (80%) have diagnosis of RA, and 1 pt (20%) have diagnosis of SpA. 2 pts receive adalimumab (40%), 2 pts Etanercept (40%), and 1 pt Abatacept (20%). Since year 2001, 1 pt (20%) have received 2 biologics, and 1 pt (20%) 4 biologics. Infliximab (40%) and Adalimumab (40%) are the biologic more prescribed. 2 pts (40%) have positive ANAS. Associated autoimmunity: 1 pt (20%) inflammatory bowel disease, and 1 pt (20%) SS. In a 58 y/o female patient with diagnosis of SpA, in treatment with Adalimumab was found seropositivity for Hepatitis C. Associated autoimmunity: Uveitis. All patients were evaluated by gastroenterology. None of these biologic was discontinued.

Conclusions

LBT prevalence in this cohort is higher that reported in other cohorts^1. Adalimumab is the biologic more used in patients with LBT. Normal chest x-ray does not exclude LTB. HBV prevalence is similar to previous data reported.¹The surveillance of LBT and viral hepatitis must be mandatory in patients receiving biological therapy.

References

Nacci F, Matucci-Cerinic M. Tuberculosis and other infections in the anti-tumour necrosis factor-alpha (anti-TNF-α) era. Best Pract Res Clin Rheumatol. 2011 Jun;25(3):375-88.