Digital illustration of a healthy blood vessel

Hydroxychloroquine and AAV: Unveiling the Potential for Infection Prevention

Theo Raines in Health & Wellness December 2025 • 4 min read.

"Exploring the Role of Hydroxychloroquine in Protecting Patients with Antineutrophil Cytoplasm Antibody-Associated Vasculitis"

Antineutrophil cytoplasm antibody-associated vasculitis (AAV) is a group of autoimmune diseases causing inflammation of small blood vessels. While treatments like rituximab have revolutionized AAV management, they also increase the risk of infections. This is where hydroxychloroquine, an antimalarial drug, comes into play, potentially offering a protective effect.

The current standard of care for AAV involves managing the disease itself and preventing infections, especially those caused by opportunistic pathogens. Historically, trimethoprim/sulfamethoxazole has been used to prevent Pneumocystis jirovecii pneumonia. However, this article explores the use of hydroxychloroquine as another method for infection prevention, along with its potential benefits beyond its protective effects.

This article aims to provide a comprehensive overview of the latest research on hydroxychloroquine in AAV treatment, highlighting its potential benefits, associated risks, and the future implications of this approach for patient care. We will be taking a deep dive into the current medical landscape to better understand the need for the medication.

Understanding AAV and the Risk of Infections

Digital illustration of a healthy blood vessel

AAV treatments, such as rituximab, effectively suppress the immune system to control the disease. However, this immunosuppression increases the risk of infections, especially respiratory tract infections. This is a significant concern, as infections can lead to serious complications and even be life-threatening for AAV patients. The medical community faces the challenge of balancing effective disease management with minimizing infection risks.

Current recommendations often include preventative measures like trimethoprim/sulfamethoxazole to combat certain infections. However, this article explores the potential of hydroxychloroquine as an alternative or complementary approach, particularly in light of emerging research. This includes its potential protective effects against infections and the possibility of additional benefits for patients.

Increased Infection Risk: AAV treatments can weaken the immune system, increasing the likelihood of infections.
Need for Prophylaxis: Prophylactic medications are often used to prevent infections like Pneumocystis pneumonia.
Emerging Alternatives: Hydroxychloroquine is being investigated as a potential alternative or addition to existing preventative strategies.

Recent studies have highlighted the potential of hydroxychloroquine to reduce infection risks. For example, research has shown that hydroxychloroquine users had a reduced risk of infection compared to non-users. In addition, the protective effect was observed in different patient cohorts. This, along with other findings, suggests a significant role for hydroxychloroquine in protecting against infections. These findings have led to increased interest in using it as a method for treatment. This is in line with doctors trying to balance the treatment of the disease with minimizing infection risks.

Looking Ahead: Hydroxychloroquine in AAV Treatment

Hydroxychloroquine shows promise in the prevention of infections in AAV patients. This approach may offer new possibilities for improving patient outcomes. Future research, including clinical trials, will be crucial to fully understand its role and to refine treatment strategies, ensuring patients with AAV receive the best possible care. The goal is to provide the most effective and safe treatment options.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1136/annrheumdis-2018-214508, Alternate LINK

Title: Prevention Of Infections In Patients With Antineutrophil Cytoplasm Antibody-Associated Vasculitis: Potential Role Of Hydroxychloroquine

Subject: General Biochemistry, Genetics and Molecular Biology

Journal: Annals of the Rheumatic Diseases

Publisher: BMJ

Authors: Pavel I Novikov, Nikolai M Bulanov, Anastasiia S Zykova, Sergey V Moiseev

Published: 2018-11-24

Everything You Need To Know

What is antineutrophil cytoplasm antibody-associated vasculitis (AAV), and why are those affected at a higher risk of infection?

Antineutrophil cytoplasm antibody-associated vasculitis, or AAV, refers to a group of autoimmune diseases characterized by inflammation of small blood vessels. Treatments for AAV, particularly rituximab, suppress the immune system to manage the disease. However, this immunosuppression unfortunately elevates the risk of infections, making patients more vulnerable, especially to respiratory tract infections. The need to balance effective AAV management with minimizing infection risks is a critical challenge.

How has AAV traditionally been managed to prevent infections, and what new approach is being explored?

Traditionally, the prevention of infections in AAV patients has included prophylactic medications like trimethoprim/sulfamethoxazole to prevent Pneumocystis jirovecii pneumonia. However, a new approach is being explored that involves the use of hydroxychloroquine. This medication is being investigated for its potential to protect against infections in AAV patients, either as an alternative to, or in conjunction with, existing preventative strategies.

What evidence supports the use of hydroxychloroquine in preventing infections for patients with AAV?

Recent studies suggest that hydroxychloroquine may reduce the risk of infections in AAV patients. Research indicates that hydroxychloroquine users experienced a lower risk of infection compared to non-users. These findings suggest a significant role for hydroxychloroquine in protecting AAV patients against infections, leading to increased interest in its use as a method for treatment and balancing disease management with minimizing infection risks. It remains crucial to conduct clinical trials to fully understand the role of Hydroxychloroquine and refine the treatment strategies.

What are the potential benefits and risks associated with using hydroxychloroquine as a preventative measure for infections in AAV patients, beyond its protective effects?

The benefits of hydroxychloroquine for infection prevention in AAV patients extend to the potential for improved patient outcomes. The main appeal is that it may offer protection in addition to AAV treatment. It's critical to balance these potential benefits with a clear understanding of the drug's associated risks, including those that need to be addressed and mitigated to ensure the best possible care. While the medication may have some potential beyond the treatment of AAV and prevention of infection, further studies need to be done.

What future research is planned to fully understand the role of hydroxychloroquine in AAV treatment and refine treatment strategies?

Future research, including clinical trials, is crucial to fully understand the role of hydroxychloroquine in AAV treatment and to refine treatment strategies. These trials aim to provide a more comprehensive understanding of its benefits, identify the patients who are most likely to benefit from this approach, and determine the optimal dosage and duration of treatment. Additionally, research will focus on identifying and managing any potential side effects or risks associated with hydroxychloroquine use in AAV patients, ultimately ensuring they receive the safest and most effective care.