Monitoreo y prevención de infecciones al inicio de terapias dirigidas en pacientes con enfermedades reumáticas inflamatorias crónicas y autoinmunes: ¿debe realizarse siempre y en todos los casos?
Resumen
Esta actualización resume la evidencia sobre el monitoreo y la eventual prevención de infecciones en aquellos pacientes con enfermedades reumáticas inflamatorias crónicas y autoinmunes, particularmente en aquellos que están por iniciar una terapia dirigida con inmunosupresores biológicos o sintéticos. Se revisan las infecciones más relevantes en nuestro medio como las respiratorias (influenza, neumococo, sincicial respiratorio y neumonía por Pneumocistis jiroveci -PJP-), tuberculosis (TBC), virus de las hepatitis, herpes virus, virus de la inmunodeficiencia humana (VIH), virus del papiloma humana (VPH) y entidades parasitarias como la enfermedad de Chagas. A su vez, se describen las indicaciones y los esquemas de profilaxis para TBC, hepatitis B y PJP. Finalmente, como la mejor manera de prevenir las infecciones es a través de la vacunación, se comenta sobre las vacunas disponibles, sus indicaciones y contraindicaciones, y la forma de administración.Citas
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