title: Infliximab-induced tuberculosis in patients with UC: Experience from India-a country with high prevalence of tuberculosis.
abstract: OBJECTIVE
  Tuberculosis (TB) is a well-recognized iatrogenic adverse event following administration of biologic therapy given for a variety of clinical indications. There is paucity of data on the development of TB following the use of biologics from countries with a high prevalence of TB. The aim of this study was to determine the risk of development of TB following biological therapy in a country, which is highly endemic for TB.
  
  
  METHODS
  The article retrospectively analyse data from three referral inflammatory bowel disease centers to evaluate the risk of development of TB following biological therapy for patients with ulcerative colitis.
  
  
  RESULTS
  Of the 79 patients with ulcerative colitis treated with infliximab, seven (8.8%) developed TB at a median interval of 8 weeks after the first exposure despite screening for latent TB. Three of the seven (42%) patients developed disseminated disease, whereas pulmonary disease was documented in four patients (57%). All patients were successfully treated with anti-tuberculous drugs for a period of 6-13 months. In contrast to data from the West, none of the patients in our study had a fatal outcome. None of the patients required a colectomy after a median follow up of 2 years following cessation of the infliximab therapy.
  
  
  CONCLUSIONS
  These data suggest that despite the significantly higher prevalence, the outcome of TB after infliximab therapy is quite sanguine in the Indian subcontinent.
authors.affiliation: Department of Gastroenterology, GB Pant Institute of Postgraduate Medical Education and Research, New Delhi, India.
authors.forename: Amarender S
authors.initials: AS
authors.lastname: Puri
authors.affiliation: Department of Gastroenterology, PD Hinduja Hospital Mumbai, Mumbai, India.
authors.forename: Devendra
authors.initials: D
authors.lastname: Desai
authors.affiliation: Department of Gastroenterology, Dayanand Medical College, Ludhiana, India.
authors.forename: Ajit
authors.initials: A
authors.lastname: Sood
authors.affiliation: Department of Gastroenterology, GB Pant Institute of Postgraduate Medical Education and Research, New Delhi, India.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Sachdeva
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000150:complications / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India / Q000453:epidemiology; D000069285:Infliximab / Q000009:adverse effects* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012306:Risk; D013997:Time Factors; D016896:Treatment Outcome; D014376:Tuberculosis / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology*
chemical_list: D000995:Antitubercular Agents; D000069285:Infliximab
keywords: biological therapy; inflammatory bowel disease; tuberculosis; ulcerative colitis