Common Variable Immunodeficiency (CVID) Explained

Medically Reviewed By Meredith Goodwin, MD, FAAFP
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In some people, their immune system does not secrete enough antibodies to fight infections. This could be a result of genetic factors or acquired causes. People with some genetic predispositions may not produce enough antibodies. This medical condition is known as common variable immunodeficiency (CVID).

People with CVID are typically prone to recurrent infections and some autoimmune disorders.

Read on to learn more about common variable immunodeficiency, causes, treatment, and outlook.

What are the symptoms of CVID?

a woman has her hand on her ear
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People with CVID have a genetic defect in B cells. These are immune cells that produce antibodies.

This means that they are vulnerable to recurrent bacteria and viral infections. They may experience infections more often.

Here are some recurrent infections in people with CVID:

There is also a risk of developing other complications, such as lymphomas and gastric cancers.

A few people with common variable immunodeficiency may develop the following autoimmune disorders:

Learn about other immune deficiency conditions here.

Is CVID rare?

CVID typically affects 1 in 25,000 people. Its overall prevalence rate may differ between countries.

It affects young people, particularly those between 20–40 years.

What can cause CVID?

The exact cause of CVID is unknown in most clinical cases.

However, in a few clinical cases, inheriting a mutated immunoregulatory gene is possibly responsible.

Scientists have discovered the presence of mutations in the regulatory genes that control B cell maturation and function. B cells with this mutated gene do not mature properly. They are not capable of secreting antibodies.

Inheriting the mutated genes alone is not enough for a person to develop CVID.

There is no scientific evidence yet to identify the specific environmental factors.

Learn more about how the immune system works here.

How do doctors diagnose CVID?

Your doctor will typically carry out a clinical history, physical examination, and lab investigations before diagnosing CVID.

After taking a clinical history, your doctor will conduct a physical exam to check for signs of target organ damage. Here are some possible signs of target organ infection:

  • Nasal congestion suggests chronic sinusitis.
  • Scars in the tympanic membranes in the ears can be a sign of recurrent ear infections.
  • Breathlessness and atypical breath sounds can indicate a chronic pulmonary disease.
  • Enlarged lymph nodes and spleen may suggest lymphoma.

Symptoms and signs vary from person to person. Some people with CVID may not have any signs of chronic infection.

Testing for common variable immunodeficiency

Your doctor will conduct a few investigations after a clinical evaluation to confirm the diagnosis. Here are common tests used:

  • Serum immunoglobulin level test: Low serum immunoglobulin IgG level of less than 450 milligrams per deciliter (mg/dL) typically indicates CVID. Also, IgA and IgM levels are typically low.
  • Blood count: Doctors take a blood test to assess the degree of infection.
  • Bone marrow biopsy: This can show signs of suspected lymphomas.
  • Lung function tests: Clinicians may need to assess pulmonary functions.
  • Lymph node biopsy: A biopsy can help clinicians look for suspected malignancies.
  • Genetic testing: If there is a history of a similar condition in first-degree relatives, doctors may order genetic testing.

How do doctors treat CVID?

The treatment of CVID involves administering antibody replacement therapy and medications to relieve other symptoms.

Immunoglobulin replacement therapy

Immunoglobulin replacement therapy is the main treatment option for CVID. It involves the injection of antibodies to boost the recipient’s serum level of antibodies.

Generally, doctors obtain administered antibodies from healthy people who are blood donors.

Here are some possible side effects of therapeutic immunoglobulin:

  • pain and swelling at the injection site
  • headache
  • acute kidney injury
  • hemolytic anemia
  • thrombocytopenia

Learn about hypogammaglobulinemia here.

Medications

Your doctor may prescribe medications to manage specific symptoms. For example, antibiotics will help treat infections.

Also, your doctor may recommend corticosteroids if you have autoimmune conditions, such as immune thrombocytopenia.

Vaccinations

Doctors may prescribe inactivated vaccines for people with severe antibody deficiency. Your doctor may vaccinate you against common diseases such as:

These vaccines provide additional protection against disease-causing organisms.

Is CVID considered a disability?

The Social Security Administration for Disability classifies primary immunodeficiencies such as CVID as a disability. This is because some people with the condition may experience severe multi-organ dysfunctions that may affect their ability to function normally.

Early diagnosis and prompt intervention are critical to prevent the progression and complication of common variable immunodeficiency.

If you have a family history of this condition, consult your doctor for clinical evaluation.

What is the outlook for CVID?

The severity and frequency of infection usually affect the future outlook or prognosis of CVID.

People who start immunoglobulin replacement therapy early typically have a good prognosis. This is because there is a lower risk of disease progression, severe infection, and life threatening complications.

It is important to remember your own outlook will depend on your own circumstances. Talk with your healthcare team for a more accurate assessment.

Summary

Common variable immunodeficiency (CVID) is a medical condition that causes a low serum level of antibodies. This makes people with this disorder immunodeficient. So, people with CVID are prone to infections and autoimmune diseases.

Immunoglobulin replacement therapy is the primary treatment method for this disorder. This therapy helps to boost the serum level of circulating antibodies, but it can cause severe reactions.

Also, your doctor may prescribe antimicrobial medications to fight infections and administer corticosteroids for autoimmune conditions.

Consult your doctor if you have a family history or symptoms that suggest common variable immunodeficiency disorder.

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Medical Reviewer: Meredith Goodwin, MD, FAAFP
Last Review Date: 2022 Sep 24
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