Serious infections in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) represent a contributor to morbidity and mortality. Patients are susceptible to both typical and opportunistic infections due to immunocompromise resulting from immunosuppressive treatments and disease activity. Over the past decade, studies predominantly in retrospective cohorts have outlined the incidence and nature of serious infections, including organ involvement and pathogens, as well as various risk factors for serious infections. This review summarises the recent literature on serious infections and discusses risk factors for these infections; we have categorised them into baseline characteristics, laboratory values, end-organ damage, and immunosuppressive treatments. It discusses emerging data on the role of reduced glucocorticoid regimens and trimethoprim-sulfamethoxazole prophylaxis in preventing serious infections. Finally, implications on clinical practice and important avenues for future research are discussed. • Serious infections in patients with ANCA-associated vasculitis are a leading cause of mortality. • The highest risk of serious infection occurs during the early phase of induction treatment. • Risk factors for serious infections include disease activity, co-morbidities and immunosuppression. • Trimethoprim-sulfamethoxazole prophylaxis and reduced glucocorticoid regimens may lower the risk of serious infections.
Chang et al. (Fri,) studied this question.