Programa de Pós-graduação em Ciências Médicas, Hospital Universitário de Brasília, SGAN 605. Av. L2 Norte, CEP: 70910-900, Brasília, Distrito Federal, Brazil.
Programa de Pós-graduação em Ciências Médicas, SGAN 605. Av. L2 Norte, CEP: 70910-900, Brasília, Distrito Federal, Brazil.
Best Pract Res Clin Rheumatol. 2020 Aug;34(4):101509. doi: 10.1016/j.berh.2020.101509. Epub 2020 Apr 13.
Autoimmune and autoinflammatory diseases are associated with severe morbidity, and represent an impactful health and economic burden worldwide. The treatment of these diseases can include a course with detrimental side effects. Immunosuppression increases the risk of opportunistic infections, but in some cases, the abrupt discontinuation of these medications can result in immune reconstitution inflammatory syndrome. Special attention must be directed to endemic tropical infections, such as leishmaniasis, Chagas disease, malaria, arbovirosis, yellow fever, leprosy, paracoccidioidomycosis, disseminated strongyloidiasis, and ectoparasitosis. These endemic diseases of developing countries can be considered as possible emerging diseases in developed regions partially because of environmental factors and migration. In the present article, we aim to review the evidence-based aspects of the most important opportunistic tropical infections in immunosuppressed patients. We also aim to review the important aspects of vaccination, chemical prophylaxis, and treatment for these infections in people with medication-induced immunosuppression.
自身免疫和自身炎症性疾病与严重的发病率相关，在全球范围内造成了重大的健康和经济负担。这些疾病的治疗可能包括具有有害副作用的疗程。免疫抑制会增加机会性感染的风险，但在某些情况下，突然停止这些药物治疗可能会导致免疫重建炎症综合征。必须特别注意地方性热带感染，如利什曼病、恰加斯病、疟疾、虫媒病毒病、黄热病、麻风病、副球孢子菌病、播散性粪类圆线虫病和外寄生虫病。这些发展中国家的地方性疾病在部分发达国家可能被视为新出现的疾病，这是由于环境因素和移民的影响。在本文中，我们旨在回顾免疫抑制患者中最重要的机会性热带感染的循证方面。我们还旨在回顾药物诱导免疫抑制人群中针对这些感染的疫苗接种、化学预防和治疗的重要方面。
