Infectious complications of immune modulatory agents

Immune modulatory agents used in solid organ transplantation and other disciplines have various mechanisms of action and differences in the duration and intensity of immunosuppression. While newer agents have improved patient outcomes, an important result of these immune modulatory agents is associated infections, caused by organisms such as cytomegalovirus, BK polyomavirus, Epstein-Barr virus and tuberculosis. Herein, we review the infectious complications of several newer immune modulatory drugs - belatacept, alemtuzumab, and rituximab - and focus on their use in solid organ transplantation. New immune modulatory agents can potentially modify the landscape of allograft rejection and noninfectious and infectious complications. Health-care practitioners should remain familiar with these agents and their potential infectious complications to help ensure optimal patient outcomes.