title: Rates of Serious Infections in HIV-Infected Patients Receiving Tumor Necrosis Factor Inhibitor Therapy for Concomitant Autoimmune Diseases.
abstract: To estimate the incidence of serious infections in patients with HIV infection and autoimmune disease who were treated with tumor necrosis factor (TNF) inhibitors, and to compare these rates by stratified viral load levels.
  
  
  
  Using a unified search strategy, 4 centers identified HIV-infected patients exposed to TNF inhibitors. Patient characteristics and infection data were assessed via chart review in all patients who were ≥18 years old and who received TNF inhibitor therapy after HIV diagnosis, between January 1999 and March 2015.
  
  
  
  We studied 23 patients with 26 uses of TNF inhibitor therapy (86.7 person-years of followup). Two (8.7%) experienced at least 1 serious infection episode, for an overall incidence rate of 2.55 per 100 patient-years (95% confidence interval [95% CI] 0.28-9.23). The incidence rate per 100 patient-years was 3.28 (95% CI 0.04-18.26) among patients with a viral load >500 copies/ml at therapy initiation and 2.09 (0.03-11.65) among patients with a viral load ≤500 copies/ml.
  
  
  
  This study suggests that the rate of serious infections in patients with HIV infection under active care who have received treatment with TNF inhibitors may be comparable to the rates observed in registry databases.
authors.affiliation: Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Sintawat
authors.initials: S
authors.lastname: Wangsiricharoen
authors.affiliation: Johns Hopkins School of Medicine, Baltimore, Maryland.
authors.forename: Colin
authors.initials: C
authors.lastname: Ligon
authors.affiliation: Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Lydia
authors.initials: L
authors.lastname: Gedmintas
authors.affiliation: University of Miami School of Medicine, Miami, Florida.
authors.forename: Admad
authors.initials: A
authors.lastname: Dehrab
authors.affiliation: Cleveland Clinic Foundation, Cleveland, Ohio.
authors.forename: Marisa
authors.initials: M
authors.lastname: Tungsiripat
authors.affiliation: Johns Hopkins School of Medicine, Baltimore, Maryland.
authors.forename: Clifton
authors.initials: C
authors.lastname: Bingham
authors.affiliation: University of Miami School of Medicine, Miami, Florida.
authors.forename: Carlos
authors.initials: C
authors.lastname: Lozada
authors.affiliation: Cleveland Clinic Foundation, Cleveland, Ohio.
authors.forename: Leonard
authors.initials: L
authors.lastname: Calabrese
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D000328:Adult; D000368:Aged; D001327:Autoimmune Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology; D001688:Biological Products / Q000009:adverse effects*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology* / Q000821:virology; D006801:Humans; D016867:Immunocompromised Host; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000276:immunology; D014481:United States / Q000453:epidemiology; D019562:Viral Load; D055815:Young Adult
chemical_list: D001688:Biological Products; D014409:Tumor Necrosis Factor-alpha