Hépato-Gastro & Oncologie Digestive


Opportunistic infections and inflammatory bowel diseases Volume 16, issue 1, Janvier-Février 2009

Service d’hépatogastroentérologie, CHU de Saint-Étienne, 42055 Saint-Étienne, France

Inflammatory bowel diseases are associated with high rates of opportunistic infections. These infections increase morbidity and mortality rates. The main therapeutic classes (steroids, immunosuppressors, anti-TNF) are associated with increased risks, in particular when used in combination. These very diverse infections are frequently serious and hard to diagnose. Prevention should become an important part of our practice. A thorough pretherapeutic work-up identifies at risk groups and chemoprophylaxis can be offered in some cases. Detailed analysis of the immunisation status has to be done before any treatment and patients should receive booster doses or new vaccines accordingly. The infectious risk of a particular therapeutic strategy should be considered for each category of patients.