However, all cases of leishmaniasis in patients with autoimmunerheumatic diseases were reported after 1998, the year of introduction of anti-TNFagents, and most (9/15) of the reported leishmaniasis cases occurred during the past5 years (2004–2008), mainly among patients receiving anti-TNF agents (6of the 9 patients with leishmaniasis; 66.6%). This evidence concerns the gene TNF and leishmaniasis.