Does intravenous immune globulin have a role in HIV-infected patients?

The main immunological abnormality in human immunodeficiency virus (HIV)-infected patients, and particularly those with the acquired immune deficiency syndrome (AIDS), is a deficiency in cellular immunity. However, symptomatic HIV-infected children also have evidence of deficiency of specific antibody synthesis, and intravenous immune globulin (IVIG) preparations in doses of 0.2-0.4 g/kg every 2-4 weeks have been shown to reduce the incidence of respiratory infections. IVIG therapy may also reduce the mortality and incidence of bacterial infections in adults but further studies are required. In addition, high-dose IVIG therapy (1-2 g/kg over 2-5 days) produces increased platelet counts in patients with idiopathic thrombocytopenic purpura (ITP) associated with HIV infection. Finally, IVIG therapy may have a role in HIV-infected patients suffering from severe parvovirus B19 or measles infection, or in patients suffering from autoimmune disorders where high-dose IVIG therapy has been shown to be efficacious.