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Richard J. Whitley, MD; John W. Gnann Jr, MD

JAMA. 2009;301(7):774-775.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Drugs that inhibit tumor necrosis factor (TNF-) are now widely used for management of a variety of inflammatory processes (eg, rheumatologic disorders, inflammatory bowel diseases) proven refractory to conventional therapy. As with many medical advances, benefit comes with a price, and an important consequence of anti–TNF- therapy is increased risk of infection, especially tuberculosis.¹ Other studies have linked anti–TNF- therapy with increased risk of serious bacterial² and fungal³ infections. Associations between TNF- antagonists and viral infections have not been as clearly defined, though case reports of severe episodes of herpes zoster in patients receiving these drugs have appeared in the literature.⁴ Prior analyses of large databases have yielded conflicting results regarding a causal association between treatment with biologic agents and herpes zoster.^5-6

In this issue of JAMA, Strangfeld and colleagues⁷ further explore possible associations between anti-TNF- therapy and viral . . . [Full Text of this Article]

Author Affiliations: Departments of Pediatrics, Microbiology, Medicine, and Neurosurgery, The University of Alabama at Birmingham (Dr Whitley); and Departments of Medicine, Pediatrics, and Microbiology, The University of Alabama at Birmingham and Birmingham VA Medical Center (Dr Gnann).

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