TY - JOUR T1 - Prevalence and Risk Factors for Major Infections In Patients with Anca-associated Vasculitis. Influence on The Disease Outcome JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.190065 SP - jrheum.190065 AU - Eloi Garcia-Vives AU - Alfons Segarra-Medrano AU - Ferran Martinez-Valle AU - Irene Agraz AU - Roser Solans-Laque Y1 - 2019/06/15 UR - http://www.jrheum.org/content/early/2019/06/11/jrheum.190065.abstract N2 - Objective to analyse the role that infections play on the ANCA-associated vasculitis outcome. Methods retrospective study of adult patients with AAV diagnosed in a tertiary centre. Clinical features, laboratory findings, treatment, relapses, major infections and outcome were evaluated. Results 132 patients (51 MPA, 52 GPA, 29 EGPA) with a mean follow-up of 140 (96- 228) months were included. ANCAs were positive in 85% of cases. A total of 300 major infections, mainly bacterial (87%), occurred in 60% patients during the followup. Lower respiratory tract (64%) and urinary tract infections (11%) were the most frequent, followed by bacteraemia (9%). A total of 7.4% opportunistic infections were observed, most due to systemic mycosis. Up to 46% of all opportunistic infections took place in the first year of diagnosis, and 55% of them under CYC treatment. Bacterial infections were associated with BVASv.3>15 at the disease onset (OR 2.35, 95%CI 1.14-4.76, p=0.021), a total cumulative CYC dose >8.65gr (OR 2.67, 95%CI 1.15-4.82, p=0.008), dialysis (OR3.07, 95%CI 1.07-8.79, p=0.04) and development of leukopenia during the follow-up (OR 2.63, 95%CI 1.23-5.64, p=0.016). Leukopenia was the only factor independently related to opportunistic infections (OR 4.31, 95%CI 1.43-12.98, p=0.006). Forty-four patients died: 25 with MPA, 11 with GPA and 8 with EGPA. Death was due to infection in 50% of cases, directly (34%) or associated to active disease (16%). Patients who suffered from major infections had an increased mortality from any cause. Conclusion Our results confirm that major infections are the main cause of death in patients with AAV. ER -