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- Title
Cryptococcosis Associated With Biologic Therapy: A Narrative Review.
- Authors
Li, Xin; Paccoud, Olivier; Chan, Koon-Ho; Yuen, Kwok-Yung; Manchon, Romain; Lanternier, Fanny; Slavin, Monica A; Veerdonk, Frank L van de; Bicanic, Tihana; Lortholary, Olivier
- Abstract
Cryptococcus is an opportunistic fungal pathogen that can cause disseminated infection with predominant central nervous system involvement in patients with compromised immunity. Biologics are increasingly used in the treatment of neoplasms and autoimmune/inflammatory conditions and the prevention of transplant rejection, which may affect human defense mechanisms against cryptococcosis. In this review, we comprehensively investigate the association between cryptococcosis and various biologics, highlighting their risks of infection, clinical manifestations, and clinical outcomes. Clinicians should remain vigilant for the risk of cryptococcosis in patients receiving biologics that affect the Th1/macrophage activation pathways, such as tumor necrosis factor α antagonists, Bruton tyrosine kinase inhibitors, fingolimod, JAK/STAT inhibitors (Janus kinase/signal transducer and activator of transcription), and monoclonal antibody against CD52. Other risk factors—such as age, underlying condition, and concurrent immunosuppressants, especially corticosteroids—should also be taken into account during risk stratification.
- Subjects
CENTRAL nervous system infections; BRUTON tyrosine kinase; TUMOR necrosis factors; NARRATIVE therapy; PROTEIN-tyrosine kinase inhibitors
- Publication
Open Forum Infectious Diseases, 2024, Vol 11, Issue 7, p1
- ISSN
2328-8957
- Publication type
Article
- DOI
10.1093/ofid/ofae316