Skip Navigation



British Medical Bulletin Advance Access published online on October 24, 2009
British Medical Bulletin, doi:10.1093/bmb/ldp036
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
92/1/61    most recent
ldp036v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Shale, M. J.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Shale, M. J.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author 2009. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

The implications of anti-tumour necrosis factor therapy for viral infection in patients with inflammatory bowel disease

Matthew J. Shale*

Gastrointestinal Section, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK

* Correspondence to: Dr M. J. Shale, Department of Gastroenterology, Hammersmith Hospital, 3rd Floor, Hammersmith House, Du Cane Road, London W12 0NN, UK. E-mail: m.shale{at}imperial.ac.uk

Introduction: Anti-tumour necrosis factor (TNF) therapy is increasingly used in the management of inflammatory bowel disease; however, concerns have been raised regarding risk of infection with such drugs. Little is known about their effect upon viral infection.

Sources of data: A search of PubMed using the terms ‘infliximab’, ‘etanercept’, ‘adalimumab’ or ‘anti-TNF therapy’ combined with the names of specific viruses was performed. A search of cited papers was used to identify further relevant reports.

Areas of agreement: Numerous reports of the use of anti-TNF in patients with chronic or latent viral infection appear in the literature. Specific problems related to hepatitis B virus and varicella zoster virus may exist. The safety profile of anti-TNF in chronic viral infection is generally reassuring.

Areas of controversy: Numerous consensus statements relating to pre-treatment serology or vaccination have recently appeared; however, significant variation exists in their recommendations.

Growing points: Increasing awareness of the implications of anti-TNF therapy on viral infection may allow safer use of such drugs.

Areas timely for developing research: The clinical and cost-effectiveness of screening for viral infections prior to anti-TNF requires further study.

Keywords: anti-TNF • viral infection • hepatitis B virus • varicella zoster virus

Accepted for publication September 18, 2009.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.