Introduction

Systemic lupus erythematosus (SLE) is an autoimmune disorder that affects almost every organ system and it is treated with immunomodulation and immunosuppression. SLE patients have an intrinsically dysfunctional immune system which is exacerbated by disease activity and leaves them vulnerable to infection. Treatment with immunosuppression increases susceptibility to infection, while hydroxychloroquine use decreases this risk. Infectious diseases are a leading cause of hospitalization and death.

Areas covered

This narrative review provides an overview of recent epidemiology and predictors of infections in SLE, delineates the risk of infection by therapeutic agent, and provides suggestions for risk mitigation. Articles were selected from Pubmed searches conducted between September 2019 and January 2020.

Expert opinion

Despite the large burden of infection, effective and safe preventative care such as universal hydroxychloroquine use and vaccination are underutilized. Future efforts should be directed to quality improvement, glucocorticoid reduction, and validation of risk indices that identify patients at the highest risk of infection.

中文翻译：

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系统性红斑狼疮和感染风险。

简介

系统性红斑狼疮 (SLE) 是一种自身免疫性疾病，几乎影响每个器官系统，可通过免疫调节和免疫抑制进行治疗。SLE 患者的免疫系统本质上功能失调，疾病活动会加剧这种情况，并使他们容易受到感染。免疫抑制治疗会增加感染的易感性，而羟氯喹的使用会降低这种风险。传染病是住院和死亡的主要原因。

覆盖区域

这篇叙述性综述概述了 SLE 感染的近期流行病学和预测因素，描述了治疗剂感染的风险，并提供了降低风险的建议。文章选自 2019 年 9 月至 2020 年 1 月期间进行的 Pubmed 搜索。

专家意见

尽管感染负担沉重，但有效和安全的预防性护理（例如普遍使用羟氯喹和接种疫苗）并未得到充分利用。未来的努力应针对质量改进、糖皮质激素减少和风险指数的验证，以识别感染风险最高的患者。