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Immune costimulatory checkpoints are crucial in regulating both lymphocyte activation and function. They also serve a major role in foreign antigen specificity and self-tolerance. The two major families of checkpoint inhibitors target the CTLA-4/B7s and the PD-1/PD-L1 axis. Inhibition of either of these two pathways intends to enhance the antitumor activity of lymphocytes. The risk of infections associated with checkpoint inhibition can be explained by two major mechanisms: the use of corticosteroids for the treatment of autoimmune inflammatory reactions and immune-mediated cytopenia. The overall risk of infections with immune checkpoint inhibitors is considered to be low, with bacterial infections being most frequent. For this reason, no prophylaxis is recommended with the use of checkpoint inhibitors. Recent research suggests that these drugs may be efficacious in treating specific infectious syndromes (such as sepsis, HIV infection, progressive multifocal leukoencephalopathy, hepatitis B, fungal infections, and COVID-19) but more data is needed to recommend its use.

DOI: 10.1007/978-3-031-11363-5_13