Infections associated with immunosuppressants

Drug	Target	Effect	Infections
alemtuzumab	CD52	depletes T and B cells	herpesviruses, especially CMV and EBV, BK virus, PML, Pneumocystis, Cryptococcus, dimorphic fungi
rituximab	CD20	depletes B cells	HBV reactivation, PML, Pneumocystis
antithymocyte globulin	CD3	depletes T cells	herpesviruses, especially CMV and EBV, BK virus, Pneumocystis, Cryptococcus, dimorphic fungi
corticosteroids	multiple	multiple	LTBI reactivation, herpesviruses (especially HSV/VZV), Candida, Pneumocystis, dimorphic fungi, invasive fungal infection
adalimumab	TNF-α		intracellular organisms, including tuberculosis, non-tuberculous mycobacteria, Aspergillus, dimorphic fungi, Pneumocystis, Cryptococcus, Candida, hepatitis B, human herpesviruses (especially HSV and VZV), Strongyloides stercoralis, Legionella, Nocardia, Salmonella, Staphylococcus aureus septic arthritis, Leishmania, Plasmodium, Babesia, Strongyloides
infliximab
golimumab
etanercept
anakinra	IL-1	prevents cytokines from activating B and T cells	LTBI reactivation
canakinumab
rilonacept
basiliximab	CD-25	block IL-2 receptor, preventing activation of T, B, and NK cells	human herpesviruses
daclizumab
tocilizumab	IL-6	prevents cytokine production	LTBI reactivation, Candida, Aspergillus, Pneumocystis, dimorphic fungi, human herpesviruses
abatacept	CD28	blocks APCs from binding T cells	EBV, PML, CMV, Pneumocystis, LTBI reactivation, hepatitis B reactivation, malignancies (lymphoma, lung cancer, and skin cancer)
belatacept
natalizumab	integrin	inhibits T cell migration
vedolizumab
eculizumab	C5	inhibits terminal complement	severe Neisseria meningitidis infections, Streptococcus pneumoniae, Haemophilus influenzae
ustekinumab	IL-12 and IL-23	inhibits cytokines