DMARDs II therapy is associated with serious infections of which?

DMARDs II therapy is associated with serious infections of which?

• A. Hep A and TB
• B. HIV and malaria
• C. Hep B and TB
• D. RSV and influenza

Answer: (C)

Biologic DMARDs suppress parts of the immune system that keep latent infections in check, especially TNF. TNF helps maintain granulomas that trap latent Mycobacterium tuberculosis; when TNF is blocked, those granulomas can break down and latent TB may reactivate, causing serious TB infection. Hepatitis B behaves similarly—immune control of latent HBV can wane under these therapies, leading to reactivation and potentially severe hepatitis. Because of these risks, screening for TB and hepatitis B before starting DMARDs II and considering antiviral prevention when indicated are essential. While other infections can occur with immunosuppression, TB reactivation and HBV reactivation are the infections most specifically associated with this class.

Biologic DMARDs suppress parts of the immune system that keep latent infections in check, especially TNF. TNF helps maintain granulomas that trap latent Mycobacterium tuberculosis; when TNF is blocked, those granulomas can break down and latent TB may reactivate, causing serious TB infection. Hepatitis B behaves similarly—immune control of latent HBV can wane under these therapies, leading to reactivation and potentially severe hepatitis. Because of these risks, screening for TB and hepatitis B before starting DMARDs II and considering antiviral prevention when indicated are essential. While other infections can occur with immunosuppression, TB reactivation and HBV reactivation are the infections most specifically associated with this class.