Intravenous immunoglobulin treatment of immunodeficiency disorders

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 firstline 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.