Pathogens and/or presentations of specific pathogens to be considered as opportunistic (or ‘indicator’) infections in the setting of biologic therapy (level of evidence I–V)
| Definite*† | Probable‡ |
|---|---|
| Pneumocystis jirovecii (II) | Paracoccidioides infections (V) |
| BK virus disease including PVAN (V) | Penicillium marneffei (V) |
| Cytomegalovirus disease (V) | Sporothrix schenckii (V) |
| Post-transplant lymphoproliferative disorder (EBV) (V) | Cryptosporidium species (chronic disease only) (IV) |
| Progressive multifocal leucoencephalopathy (IV) | Microsporidiosis (IV) |
| Bartonellosis (disseminated disease only) (V) | Leishmaniasis (Visceral only) (IV) |
| Blastomycosis (IV) | Trypanosoma cruzi infection (Chagas’ disease) (disseminated disease only) (V) |
| Toxoplasmosis (IV) | Campylobacteriosis (invasive disease only) (V) |
| Coccidioidomycosis. (II) | Shigellosis (invasive disease only) (V) |
| Histoplasmosis (II) | Vibriosis (invasive disease due to Vibrio vulnificus) (V) |
| Aspergillosis (invasive disease only) (II) | HCV progression (V) |
| Candidiasis (invasive disease or pharyngeal) (II) | |
| Cryptococcosis (II) | |
| Other invasive fungi: Mucormycosis (zygomycosis) (Rhizopus, Mucor and Lichtheimia), Scedosporium/Pseudallescheria boydii, Fusarium (II) | |
| Legionellosis (II) | |
| Listeria monocytogenes (invasive disease only) (II) | |
| Tuberculosis (I) | |
| Nocardiosis (II) | |
| Non-tuberculous mycobacterium disease (II) | |
| Salmonellosis (invasive disease only) (II) | |
| HBV reactivation (IV) | |
| Herpes simplex (invasive disease only) (IV) | |
| Herpes zoster (any form) (II) | |
| Strongyloides (hyperinfection syndrome and disseminated forms only) (IV) |
*Generally does not occur in the absence of immunosuppression and whose presence suggests a severe alteration in host immunity.
†Can occur in patients without recognised forms of immunosuppression, but whose presence indicates a potential or likely alteration in host immunity.
‡Published data is currently lacking, but expert opinion believes that risk is likely elevated in the setting of biologic therapy.
EBV, Epstein-Barr virus; HBV, hepatitis B virus; HCV, hepatitis C virus; PVAN, polyomavirus-associated nephropathy.