The TNFalpha antagonists have become a standard treatment for many severe chronic inflammatory diseases. After a few years of practical use in individual patient's setting adverse effects, especially infectious have been recorded and a practical attitude can be proposed for prevention and follow-up. TNFalpha antagonists increase the risk of infection by intracellular pathogens. A latent tuberculosis infection must be looked for prior to the initiation of the treatment. A prophylaxis is started in case of positive result. The global infectious risk can also be minimized by an optimal vaccination coverage and a regular screening for leucopenia.
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