Treatment for common variable immunodeficiency may include immunoglobulin replacement therapy, antimicrobial therapy, and B12 injections.
The treatment of common variable immunodeficiency (CVID) is individualized depending upon various factors such as the person’s age, symptoms, and general health.
Various specialists, including hematologists, pulmonologists, gastroenterologists, and immunologists, work as a team to decide the best management approach for the patient.
Treatment may of CVID include:
- Immunoglobulin replacement therapy:
- The primary treatment choice for CVID.
- Immunoglobulins (antibodies) may be administered through intravenous (IV) or subcutaneous infusions.
- Subcutaneous immunoglobulin infusions are preferred in individuals who develop side effects to IV infusions.
- Medications such as antihistamines, nonsteroidal anti-inflammatory drugs, and, rarely, corticosteroids (hydrocortisone) may be given to control allergic reactions.
- Immunoglobulin replacement therapy strengthens the immunity, thereby preventing recurrent infections.
- Antimicrobial therapy:
- Includes medications, such as antibiotics and antifungal medications, for treatment of infections. These medications are generally started at the first sign of an infection.
- Antimicrobials may be given prophylactically (before obvious signs of infection) in individuals susceptible to frequent infections or those with lung diseases.
- The choice and duration of antibiotics largely depend on the type, site, and severity of the infection.
- B12 injections:
- B12 shots may be given to individuals who have B12 malabsorption due to gut abnormalities.
Other medications may be given depending upon the symptoms and specific organ involvement.
The patient and their family are also advised to practice measures to prevent infections. The affected person must avoid getting certain live-viral vaccines, such as:
- oral polio,
- shingles,
- smallpox,
- live-attenuated influenza vaccine,
- yellow fever, or
- live oral typhoid vaccines.
Their caregivers and family members, however, can take these vaccines. In case of a confirmed or suspected genetic cause of CVID, genetic counseling is also provided to the affected individual and their family.
Regular follow-up and investigations are needed including blood counts, cancer screening, thyroid examination (including thyroid function tests), lung function tests, and other investigations as required.
Some individuals may require surgical care as well. These include surgeries for chronic sinus infections, biopsies to exclude malignancies, and spleen removal surgery (splenectomy) in individuals with certain blood disorders (autoimmune thrombocytopenia or hemolytic anemia).
What is common variable immunodeficiency?
Common variable immunodeficiency or CVID (also called late-onset immunoglobulin deficiency or acquired hypogammaglobulinemia) is a health condition characterized by immune system dysfunction.
- The condition occurs due to a defect or mutation in one or more genes.
- In most people with CVID, there is no family history of the disease.
- CVID affects about one in 30,000 people with no gender preference.
A healthy immune system is essential for protecting the body against various diseases including infections.
In people with CVID, the defective immune system cannot form enough antibodies or immunoglobulins. Immunoglobulins are specific proteins produced by a type of immune cells called the B cells. A low immunoglobulin level in the blood hampers the body’s ability to fight infections and neutralize toxins and other potentially harmful substances.
What are the symptoms of common variable immunodeficiency?
The symptoms of common variable immunodeficiency may vary from person to person.
Most patients present with recurrent infections affecting various parts of the body, such as sinusitis, ear infections, pneumonia, skin infections, and gut infections.
They may have symptoms such as:
- Difficulty breathing
- Persistent or recurrent cough
- Diarrhea
- Abdominal pain and bloating
- Nausea and vomiting
- Joint pain and swelling
- Earache and/or discharge
- Headache
- Runny or stuffy nose
- Fever
- Loss of weight
- Enlarged glands (lymph nodes)