Feb. 12, 2016

Early Treatment is Key to Minimize Infections in People with Lupus

For some time, we have known that people with lupus are at increased risk for many different kinds of infections. There are two main reasons for this higher risk. First, lupus itself can make infections occur more often. The way lupus affects the immune system can sometimes limit the body’s ability to fight off foreign invaders, such as bacteria and viruses. Second, people with lupus often take immunosupressants (medications that suppress the immune system). These drugs limit the ability of the body’s immune system to respond, and can leave a person more open to infectious agents. 

The most common infections seen with lupus involve the respiratory system (lungs and heart), the skin and the urinary tract. People with lupus are also at an unusually high risk for developing Candida (yeast) infections and shingles (the same viral infection as chicken pox).  The key, however, to minimizing these infections, is early recognition of symptoms and early treatment.

A team led by Michael M. Ward, MD, MPH, senior investigator at the Intramural Research Program at the National Institute of Arthritis and Musculoskeletal and Skin Diseases published a new study in Arthritis Care & Research looking specifically to see if the rates of hospitalization for serious infections have increased over recent years among people with lupus. The study’s researchers also compared changes in these rates over time to the same changes in rates among people without lupus. This is the first study to look at such a comparison. 

The main finding in the study was that hospitalizations for the five serious infections the researchers studied have increased over time in people with lupus, and increased faster among these individuals compared to the general population.  However, the study found that the risk of death from these serious infections is not increased among patients with lupus compared to patients without lupus.  One exception was a slightly higher risk of death among people with lupus due to opportunistic infections, a special set of infections that occur more frequently and are more severe in individuals with weakened immune systems.

What do these findings mean for people with lupus?  According to Dr. Ward, if you have lupus, you should be aware that you are at higher risk of serious infections than people without lupus. Effective treatments exist for almost all types of serious infections. The key is early treatment. If you have lupus, you should know the signs and symptoms of possible infection.  Talk to your healthcare provider about what to look for and establish a plan with them to access care promptly should you suspect a developing infection.

More information about lupus and tips for preventing infections can be found at lupus.org.