title: Treatment of severe non-infectious uveitis in high-risk conditions (Part 2): systemic infections; management and safety issues.
abstract: BACKGROUND
  Management of patients with severe immune-mediated uveitis requires the use of immunosuppressive (IS) drugs in selected cases. This may be particularly challenging in certain patients with associated conditions, which may increase the risk of side effects or modify guidelines for the use of such drugs. Chronic viral and mycobacterial infections in the setting of non-infectious uveitis create a number of diagnostic but also therapeutic dilemmas to clinicians because they can be exacerbated by IS therapies with detrimental effects.
  
  
  METHODS
  In this review, we will focus on very specific chronic infections that can be affected by IS therapies: human immunodeficiency virus infection, chronic hepatitis virus infection and tuberculosis. The main aim of this review is to provide an updated and comprehensive practical guide for practitioners regarding the therapeutic decision-making and management of patients with non-infectious uveitis affected by the aforementioned infectious conditions.
  
  
  CONCLUSIONS
  Clinicians should be aware of the risk of viral and mycobacterial reactivation of an underlying infection during IS therapy. However, most of these conditions do not represent an absolute contraindication if one were able to apply an appropriate prior screening and close monitoring of such therapy.
authors.affiliation: a 1 University of León, Instituto Biomedicina (IBIOMED), University Hospital of León , León, Spain +34 654403609 ; +34 987 233322 ; miguelcorderocoma@gmail.com.
authors.forename: Miguel
authors.initials: M
authors.lastname: Cordero-Coma
authors.forename: Raquel
authors.initials: R
authors.lastname: Salazar-Méndez
authors.forename: Taygan
authors.initials: T
authors.lastname: Yilmaz
mesh_terms: D002908:Chronic Disease; D015658:HIV Infections / Q000821:virology; D006521:Hepatitis, Chronic / Q000821:virology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D012720:Severity of Illness Index; D014376:Tuberculosis / Q000382:microbiology; D014605:Uveitis / Q000188:drug therapy* / Q000276:immunology; D014775:Virus Activation / Q000187:drug effects
chemical_list: D007166:Immunosuppressive Agents
keywords: acquired immunodeficiency syndrome; hepatitis viruses; human immunodeficiency virus; immunosuppressive agents; latent tuberculosis; uveitis; uveitis therapy