Infliximab is used for refractory Crohn's disease but there are concerns regarding long-term safety.
Recently, JC-polyomavirus (JCV) was studied after 3 cases of progressive multifocal leukoencephalopathy (PML) were found after treatment with natalizumab.
Dr Alessandro Lavagna and colleagues from Italy investigated the short-term effect of infliximab on reactivation of several harmful latent viruses.
| All patients were negative for HHV and JCV|
|Inflammatory Bowel Diseases
60 consecutive patients scheduled for infliximab induction course were prospectively enrolled and blood samples were taken before each infliximab infusion at 0, 2, 6, and 14 weeks.
Specific polymerase chain reaction (PCR) analyses were performed to detect JCV, Epstein-Barr virus (EBV), human herpes virus-6, (HHV-6), -7, -8, and cytomegalovirus (CMV).
Indications to infliximab were luminal and fistulizing disease in 49 and 15 cases, respectively.
Clinical improvement and remission were achieved in 54 (90%) and 39 (65%) of patients, respectively, at 6 weeks.
No patient was JCV-positive at any timepoint.
EBV serology was positive for 59/60 patients (98%); EBV-PCR tests were transiently positive (>40 copies/105 Peripheral blood mononuclear cells, PBMC) in 4 (7%) patients after infliximab, but in each case were negative at subsequent time points.
All patients were negative for HHV-6, -7, and -8 at all time points.
CMV serology was positive in 42 patients (70%), but no CMV-PCR-positive patient was observed.
There was no association between concomitant treatments or clinical characteristics and viral status.
Dr Lavagna concluded that, "Our results support the safety of short-term infliximab treatment with respect to latent virus reactivation. The long-term effects of infliximab, particularly for the issue of lymphoproliferative disorders, warrant further studies with larger populations, but so far data are reassuring".