Question about immunity

[nitty]

Hi everyone!

Can anyone tell me about the differences in how Azathioprine and other meds (biologics) affect the immune system.

This is because I have had to stop taking Azathioprine because it has allowed cytomegalovirus (CMV) to take a hold in my colon during a flare due to the immunosuppression. I am currently taking antivirals, but I may have to start something different after that, and the consultant mentioned biologics.

What I don't understand is, if these also suppress the immune system, won't I then be susceptible to a resurgeonce of the CMV again?

 

[Clash]

Immunosuppressive meds like imuran, 6mp or mtx suppress the entire immune system whereas biologics are more selective and aren't suppressing the entire immune system. Remicade and humira work by suppression of tnf, in most simple terms.

That said I wouldn't know if it would make you susceptible to a resurgeonce of CMV.

In the remicade pamphlet or humira it may state that caution, worth looking into.

 

[nitty]

Thanks Clash,

I'm trying to read around about it and I think there is still the potential for CMV to be problematic, but maybe to a lesser degree?

It's annoying because perhaps if I'd not had the flare then the CMV would have stayed dormant, as it does in healthy people. I think it took advantage of the combination of low immunity and damaged tissue. However, it was my own choice to try reducing some of my meds so it's not anyone's fault.

I'm grateful that my GI had the insight to test for CMV at a relatively early stage, rather than faffing around with umpteen treatments that would never have worked while the CMV is active anyway. He said that most doctors don't test for CMV in relatively 'healthy' outpatients and their disease gets categorised as unresponsive to treatment, where actually some people could get back on track after antiviral therapy if diagnosed positive for CMV.