Common Variable Immunodeficiency (CVID)

Common Variable Immunodeficiency (CVID) is a primary immunodeficiency disorder characterized by low levels of serum immunoglobulins (antibodies) and an increased susceptibility to infections. It is a heterogeneous disorder, meaning that it can manifest differently in each affected individual.

In CVID, the immune system fails to produce adequate amounts of immunoglobulins, specifically immunoglobulin G (IgG), which plays a crucial role in fighting off bacterial and viral infections. This deficiency in immunoglobulins leads to a weakened immune response, making individuals with CVID more susceptible to recurrent and severe infections, particularly in the respiratory system (sinus, lungs) and gastrointestinal tract.

The exact cause of CVID is often unknown, but it is believed to be a combination of genetic and environmental factors. It can be inherited in an autosomal dominant or autosomal recessive manner, or it can arise spontaneously without any family history.

Symptoms of CVID

Symptoms of CVID can vary widely among individuals, but common signs include:
Frequent bacterial infections, such as sinusitis, bronchitis, and pneumonia.
Chronic diarrhea or gastrointestinal infections.
Recurrent ear infections.
Autoimmune disorders, such as rheumatoid arthritis or lupus.
Enlarged spleen or lymph nodes.
Poor response to vaccinations.

Laboratory tests for CVID

Diagnosis of CVID involves assessing the levels of immunoglobulins in the blood, particularly IgG, IgA, and IgM. Additionally, other tests may be performed to rule out secondary causes of immunodeficiency and to evaluate the functioning of the immune system.

Immunoglobulin Levels: Measurement of immunoglobulin levels, including immunoglobulin G (IgG), immunoglobulin A (IgA), and immunoglobulin M (IgM), is a key diagnostic test for CVID. Low levels of these immunoglobulins are indicative of an immunodeficiency. Typically, IgG levels are the most affected in CVID.
Antibody Response: Evaluation of antibody response to vaccinations can help assess the immune system's ability to generate specific antibodies. Vaccinations such as tetanus and pneumococcal vaccines may be given, and blood samples are taken before and after vaccination to measure antibody production.
Vaccine-Specific Antibodies: Testing for specific antibodies against certain infections, such as measles, mumps, rubella, and varicella-zoster, can help identify deficiencies in antibody production.
Lymphocyte Subset Analysis: Flow cytometry analysis of lymphocyte subsets can provide insights into the distribution and functioning of different immune cell populations, including T cells, B cells, and natural killer (NK) cells.
Functional Immune Testing: Functional assays can be performed to evaluate the immune system's response to stimulation. Examples include tests like lymphocyte proliferation assays, mitogen stimulation assays, and assessments of T-cell and B-cell responses.
Genetic Testing: In some cases, genetic testing may be conducted to identify specific gene mutations associated with CVID. This can help determine the genetic basis of the condition, particularly in familial cases.

Diagnosing CVID often requires a comprehensive evaluation that includes clinical history, physical examination, and multiple laboratory tests to assess the immune system's functioning.

The main treatment for CVID is immunoglobulin replacement therapy, where intravenous or subcutaneous immunoglobulins are administered to boost the immune system and prevent infections. Antibiotics may be prescribed to treat and prevent infections. Other supportive measures, such as vaccinations, managing autoimmune disorders, and maintaining a healthy lifestyle, are also important. CVID is a complex condition, and the management and treatment may vary depending on the individual.

Certain lifestyle practices can support overall health and well-being in individuals with CVID. These practices include:

Good Hygiene: Practicing good hygiene habits, such as regular handwashing with soap and water, can help reduce the risk of infections. It is important to avoid close contact with individuals who have contagious illnesses.
Balanced Diet: Maintaining a balanced and nutritious diet is crucial for overall health and supporting the immune system. Focus on consuming a variety of fruits, vegetables, whole grains, lean proteins, and healthy fats.
Adequate Sleep: Getting sufficient restorative sleep is essential for supporting immune function. Aim for 7-8 hours of sleep per night and establish a regular sleep routine.
Stress Management: Chronic stress can affect immune function. Engage in stress-reducing activities such as meditation, deep breathing exercises, yoga, or engaging in hobbies that bring joy and relaxation.
Regular Exercise: Moderate exercise can help boost overall health and immune function. Consult with a healthcare professional to determine an appropriate exercise routine based on individual capabilities and limitations.
Avoid Smoking and Limit Alcohol: Smoking and excessive alcohol consumption can weaken the immune system. If you smoke, consider quitting, and if you drink alcohol, do so in moderation.
Stay Updated on Vaccinations: Ensure that you are up to date on all recommended vaccinations, as they can help prevent certain infections.

Vasilis J. Sideris
Biologist
Medical Doctor, Biopathologist (Microbiologist)
Certified Functional Medicine Practitioner, CFMP®