Table 5: Overview of the Infectious Complications of Rituximab

  Risk Impact on Prophylaxis Impact on Laboratory Monitoring
Bacterial Infections No increased risk (69) None None
BK Virus   No increased risk (69) N/A Standard monitoring (if indicated)
CMV   No increased risk compared to other regimens (69, 46) Standard prophylaxis or preemptive therapy is required None
EBV / PTLD   No increased risk, potentially protective (70) None None
Fungal Infections Traditionally, no increased risk (69) though recent data somewhat conflicts (39) None None
HCV/HBV   Increased risk for HBV reactivation (68), lack of data regarding HCV Consider HBV prophylaxis if evidence of chronic HBV infection (including core antibody positive) Monitor for HBV reactivation if not taking prophylaxis and evidence of chronic HBV
HSV/HZV No increased risk None None
Miscellaneous Infections Increased risk for JC virus infection (cause of PML); No association with TB (53) N/A N/A
Pneumocystis No increased risk (No impact on T cells) Prophylaxis only if other high risk agents administered None

  When rituximab is combined with ATG there appears to be an increased risk for infection related mortality.