Arthritis care & research 2016 6 22() doi 10.1002/acr.22955
To estimate the incidence of serious infections in patients with HIV infection and autoimmune disease who were treated with tumor necrosis factor (TNF) -α inhibitor therapy, and to compare these rates among stratified viral load levels.
Using a unified search strategy, four centers identified HIV-infected patients exposed to TNF-α inhibitors. Patient characteristics and infection data were assessed via chart review in all patients who were ≥18 years old and received TNF-α inhibitor therapy after HIV diagnosis between January 1999 and March 2015.
Twenty-three patients with 26 uses of TNF-α inhibitor therapy provided 86.7 person-years of follow-up. Two (8.7%) experienced at least 1 serious infection episode, an overall incidence rate of 2.55 per 100 patient-years (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 viral load > 500 copies/mL at therapy initiation and 2.09 (0.03-11.65) among patients with viral load ≤ 500 copies/mL.
This study suggests that TNF-α inhibitors may have a comparable rate of serious infections to the range of those observed in registry databases when used in patients with HIV infection under active care. This article is protected by copyright. All rights reserved.