Intravenous immunoglobulin treatment of immunodeficiency disorders

Abstract

ADDs can occur as primary genetic disorders or may develop secondary to various other conditions, including infections, trauma, malnutrition, and protein-losing states. Although antibiotics are the first-line therapy for acute infection, using them prophylactically can select for resistant organisms. IM ISG and fresh frozen plasma were the principal agents for antibody-replacement therapy until the advent of IVIG 2 decades ago. IVIG is now the definitive product for antibody-replacement therapy. Although IVIG has a long history of safety regarding the infectious pathogens, the identification of more than 100 patients with non-A, non-B hepatitis apparently acquired from a single product prompted additional modifications, improving the safety profile of IVIG. Despite the excellent safety record of IVIG, the unexpected occurrence of hepatitis in some recipients served as a reminder that IVIG is a biologic product derived from human plasma. Newer products are being developed that may supplement polyvalent IVIG including humanized MAbs and hyperimmune IVIG preparations to address specific clinical requirements.