01883nas a2200265   4500000000100000008004100001260001300042653002100055653001100076653001100087653002700098653002900125653001700154653000900171653003200180653001900212100001100231700001300242700001500255245014500270300001200415490000800427520116800435022001401603       2008                            d  c2008 Dec10aAntiviral Agents10aFemale10aHumans10aImmune System Diseases10aImmunosuppressive Agents10aInflammation10aMale10aTumor Necrosis Factor-alpha10aVirus Diseases1 aDomm S1 aCinatl J1 aMrowietz U00aThe impact of treatment with tumour necrosis factor-alpha antagonists on the course of chronic viral infections: a review of the literature.  a1217-280 v1593 a<p>Biologics that antagonize the biological activity of tumour necrosis factor (TNF)-alpha, namely infliximab, etanercept and adalimumab, are increasingly used for treatment of immune-mediated inflammatory diseases, including psoriasis, worldwide. TNF-alpha antagonists are known to increase the risk of reactivation and infection, particularly of infections with intracellular bacteria such as Mycobacterium tuberculosis. More frequently these agents are given to patients with viral infections. Viral hepatitis and human immunodeficiency virus infections are often present in these patients, with a considerable geographical variation. Other concomitant viral infections such as herpes, cytomegalovirus and varicella zoster virus may occur much more frequently than tuberculosis or leprosy. General recommendations about the management related to possible problems associated with anti-TNF-alpha treatment and these viral infections are lacking. This short review will give an overview of the most recent data available on the effects of anti-TNF-alpha therapy on viral infections with a particular focus on patient management and screening recommendations.</p>  a1365-2133