Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Immunoglobulins (specifically intravenous immunoglobulin, or IVIG) have been used as adjunctive therapy in patients with Acquired Immune Deficiency Syndrome (AIDS), particularly in the early years of the HIV epidemic. The rationale is that patients with advanced HIV infection often have hypogammaglobulinemia and are at increased risk for recurrent bacterial infections, especially encapsulated organisms such as Streptococcus pneumoniae and Haemophilus influenzae. IVIG provides passive immunity by supplying pooled antibodies from healthy donors, thereby helping to prevent or reduce the frequency and severity of these infections.

Several studies from the late 1980s and early 1990s demonstrated that regular IVIG administration reduced the incidence of serious bacterial infections in HIV-infected children. For example, a double-blind, placebo-controlled trial published in the New England Journal of Medicine (1991) showed a significant reduction in bacterial infections among children receiving IVIG. However, in adults, the evidence is less robust, and the use of IVIG is generally reserved for specific complications such as immune thrombocytopenic purpura (ITP) or in cases of recurrent, severe bacterial infections unresponsive to antibiotic prophylaxis.

With the advent of highly active antiretroviral therapy (HAART), the incidence of severe infections and the need for adjunctive IVIG have decreased significantly. Current guidelines do not recommend routine use of IVIG for all HIV/AIDS patients but acknowledge its potential benefit in select situations. Thus, while there is scientific evidence supporting its use, the level of evidence is moderate and largely limited to pediatric populations and specific complications.

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