Immune Deficiency Disorders: Treatment

Reviewed by Ann Mullen, RN, CNS, AE-C, CDE, TTS
People living with immune deficiency can lead active and full lives. The goal of treating an immune deficiency is to help you regain or maintain control of your life.

For many people this may include:

  • Participating in work, school, family and social activities

  • Decreasing the number and severity of infections

  • Having few, if any, side effects from medications and other treatments

  • Feeling good about yourself and your treatment program 

Your doctor may prescribe medications or other treatments to make you feel better and to protect you from foreign invaders. Medications and treatments must be chosen for your individual needs and may be adjusted as your needs change.

 

Medications and treatments for immune deficiencies include:

 

Antimicrobial Therapy

Antimicrobials, such as antibiotics and antifungals, are medications that fight bacterial or fungal infections. They are used when signs of infection are present. It is often difficult to determine whether a pulmonary or sinus infection is caused by bacteria, as viral infections can present with similar signs and symptoms. In these cases, your doctor may perform additional testing, such as imaging (X-ray or CT scan), or obtain cultures of secretions from the infected area to determine the nature of the infectious agent. Cultures can also provide sensitivities of that particular organism to determine the most effective antimicrobial agent.
Antimicrobial therapy may also be used to prevent infections, and may be added as a routine medication that is taken as prophylaxis. Talk with your doctor about the potential side effects of antimicrobials.  

 

Replacement Therapy 

People who are unable to produce adequate amounts or functional immunoglobulins or antibodies may benefit from replacement therapy with gamma globulins. There are a number of immunoglobulins: IgG, IgA, IgM and IgE. Antibody replacement with gamma globulin replaces IgG in the blood. This can be given both intravenously (IVIG) or under the skin, called subcutaneously (SCIG.)
Gamma globulin is made of pooled antibodies from the blood of healthy people. Antibodies from at least 1,000 donors in each treatment provide protection against a wide variety of foreign invaders. The blood is carefully tested, and discarded if there is evidence of contagious diseases such as hepatitis or HIV. Talk with your doctor if you have any questions or concerns.
Because supplemental IgG therapy (IVIG or SCIG) does not contain IgA or IgM, their protective functions are not replaced. People with immune deficiencies may continue to have trouble with certain types of infections despite supplemental IgG therapy. However, treatment with supplemental IgG and early treatment of infections help many people with immune deficiencies lead active and full lives. 

 

Specific Immune Globulins

Pathogen-specific immune globulins may be used in some immunocompromised people for prophylaxis against potentially life-threatening infection from the offending pathogen. Monoclonal antibody treatment against respiratory syncytial virus (RSV) is used to prevent RSV infection in high-risk populations. Specific immune globulins are also used to prevent or treat varicella infections and cytomegalovirus infections. 

 

Other Treatments

Other treatments are available for some types of immune deficiencies. Bone marrow transplants, hematopoietic cell transplantation, thymus transplantation, gene therapy, enzyme replacement and biologic cytokine inhibitors are examples of other treatments. Researchers in immunology are experimenting with gene therapy and other treatments that will be available in the future. 

 

Helpful Hints for Remembering Medications

  • Plan to take your medications at the same time as a daily activity like waking up, brushing teeth, eating meals and going to bed.

  • Use a medication checklist or worksheet to record when medications are taken. Place the checklist someplace visible to use as a reminder.

  • Pack medications in pillboxes to help you remember to take them.

 

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