What is Common Variable Immunodeficiency?

Did you know that about one in 25,000 people live with common variable immunodeficiency (CVID), a disorder that makes it harder for the body to produce its protective antibodies?

Common variable immunodeficiency (CVID) is a primary immunodeficiency disorder that makes it harder for the body to produce enough antibodies to fight off bacteria and viruses. People with CVID often develop struggles like chronic lung disease, digestive issues, and other health challenges that can affect their daily life. Symptoms usually show up in teens or young adults, but they can appear at any age.

While living with CVID comes with real challenges, proper medical care and treatment can help people manage symptoms, prevent complications, and stay active.

Common Variable Immunodeficiency 101

Common variable immunodeficiency (CVID) is one of the most frequently diagnosed primary immunodeficiency disorders in adults. It affects the immune system’s ability to make enough antibodies, leaving people more vulnerable to repeated infections and other health challenges.

California Specialty Pharmacy (CSP), an Acelpa Health company, works with patients and providers to coordinate care, ensuring timely access to treatments and support for managing this condition.

How the Immune System Is Affected

Your immune system relies on specialized cells to protect your body from bacteria, viruses, and other pathogens. B cells normally develop into plasma cells that produce antibodies, which are proteins that help fight infections. In CVID, these B cells don’t mature properly or don’t produce enough antibodies.

Memory B cells—which help your body “remember” past infections—are often reduced or not fully functional. While T cells usually keep working normally, the lack of adequate antibodies means your body can’t defend itself as effectively, making you more likely to develop recurrent infections.

Causes and Risk Factors

The exact cause of CVID isn’t fully understood, but several factors can play a role:

Genetic factors: About 10–20% of cases involve mutations that affect B cell development or function. These can occur spontaneously or occasionally run in families.
Environmental triggers: Infections or other immune stressors may activate the condition in people with underlying genetic susceptibility.
Age of onset: CVID can appear at any age, though most people are diagnosed between 20 and 40 years old.

These factors together can disrupt normal antibody production, making it harder for the immune system to defend against infections.

Common Symptoms of CVID

If you’re able to recognize the signs of CVID early, it can make a real difference in getting the right care and improving long-term outcomes. People with CVID often experience symptoms that affect multiple parts of the body.

Recurrent Bacterial Infections

Frequent bacterial infections are a hallmark of CVID. These infections tend to come back even after treatment and can affect different parts of the body:

Respiratory infections: Sinus infections, ear infections, bronchitis, and pneumonia occur more often than in healthy individuals. Repeated pneumonia can sometimes cause lasting lung damage.
Gastrointestinal infections: Persistent diarrhea, poor nutrient or fluid absorption, or other digestive issues can develop in the gastrointestinal tract.
Skin and soft tissue infections: Cuts, rashes, or other skin infections may heal slowly or need longer courses of antibiotics.

Patients often notice they’re constantly battling infections that others seem to recover from quickly. Early recognition and ongoing management can help reduce the frequency and severity of these infections.

Autoimmune Issues

About one in four people with CVID experience autoimmune issues, where the immune system mistakenly attacks healthy tissue. These can include:

Blood disorders: Autoimmune hemolytic anemia or immune thrombocytopenia.
Joint and connective tissue problems: Pain or inflammation similar to rheumatoid arthritis.
Thyroid conditions: Overactive or underactive thyroid function.
Skin issues: Conditions such as vitiligo or alopecia.

Autoimmune disorders often need targeted treatment in addition to managing infections. Working with a knowledgeable medical team can help ensure both infections and autoimmune symptoms are addressed safely and effectively.

Diagnosis and Tests

Getting a CVID diagnosis usually involves a careful, step-by-step process guided by immunology specialists. The goal is to confirm CVID while ruling out other conditions that could cause similar symptoms.

Measuring Antibody Levels

Blood tests that measure antibody levels are the first and most important step in diagnosing CVID. Doctors look at IgG, IgA, and IgM levels:

IgG is often significantly low, usually below 500 mg/dL (normal ranges in adults are 700–1600 mg/dL).
IgA levels are frequently reduced.
IgM may be normal or slightly low.

These tests are usually repeated to confirm persistent low antibody levels because temporary drops can happen with other illnesses. Timing matters, too—testing is ideally done when the patient isn’t actively fighting an infection. In some cases, additional tests examine B cell numbers and subtypes to better understand the immune system’s behavior.

Functional Antibody Testing

Measuring antibody levels tells part of the story, but providers also need to know how well the immune system works. Functional antibody testing shows whether the body can produce protective antibodies after being challenged.

Patients may receive vaccines like pneumococcal or tetanus shots and then have blood tests several weeks later to see if their body responded appropriately. Low or absent responses to vaccines support a CVID diagnosis. Providers may also check natural antibodies against common bacteria to get a fuller picture of immune function.

Some patients undergo more detailed immunological testing, which can include T cell function and other immune components. While genetic testing can sometimes reveal mutations affecting immune function, most CVID cases don’t have a clearly identifiable genetic cause.

Treatment For CVID

Managing common variable immunodeficiency today focuses on replacing missing antibodies and preventing complications, so patients can live active, healthy lives. People with CVID need personalized treatment plans tailored to their needs.

The cornerstone of CVID treatment is immunoglobulin replacement therapy, which provides the antibodies your body can’t make enough of on its own. This therapy can be delivered intravenously (IVIG) or under the skin (SCIG), depending on what works best for each patient.

IVIG infusions typically happen every 3 to 4 weeks at infusion centers or at home with nursing support. Common brands include:

Gammagard Liquid (Takeda)
Privigen (CSL Behring)
Gamunex-C (Grifols)

Subcutaneous options allow for weekly or biweekly self-administration at home. Leading SCIG products include:

Hizentra (CSL Behring)
Cuvitru (Takeda)
Xembify (Grifols)

California Specialty Pharmacy helps coordinate these treatments, including:

Personalized care plans
Infusion sites or support for home infusions
Insurance assistance
Medication delivery
Nursing support for both IVIG and SCIG

Patient support programs can also help patients manage costs and make therapy more accessible.

Dosing is individualized based on a patient’s weight, antibody levels, and response to treatment. Regular monitoring ensures patients maintain protective antibody levels while minimizing side effects and treatment burden.

Living with Common Variable Immunodeficiency

Living with CVID requires some adjustments, but with proper care and support, many people lead active, fulfilling lives.

Establishing Healthy Daily Habits

Managing CVID means creating routines that protect health while keeping life as normal as possible. Simple habits make a big difference:

Regular hand washing
Avoiding contact with sick people
Tracking symptoms daily for early intervention

Staying on Track with Medication

Consistent medication schedules are key to maintaining protective antibody levels between infusions.

California Specialty Pharmacy offers 24/7 support for treatment or symptom questions, helping patients feel confident and supported.

Nutrition and Lifestyle

Nutrition plays an important role in overall health. Many people with CVID benefit from:

Vitamin D supplementation
Monitoring for other nutrient deficiencies

Exercise is also encouraged for general well-being, though intensity may need adjustment depending on treatment schedules.

Routine Medical Monitoring

Regular appointments with healthcare providers help keep CVID under control and catch potential complications early. Common monitoring includes:

Lung function tests
Liver health checks
Immunoglobulin level testing every 3–6 months

Vaccinations require careful planning, as live vaccines aren’t safe for CVID patients.

Home Infusions and Emergency Planning

Home infusion services through accredited providers like CSP make it easier to fit therapy around work, school, and family life. CSP supports patients with nursing guidance, medication delivery, and troubleshooting, ensuring infusions are safe, convenient, and consistent.

Patients and families should also work with their healthcare team to create emergency plans, ensuring quick responses to serious infections and giving extra peace of mind.

Thriving with Common Variable Immunodeficiency

Common variable immunodeficiency presents challenges, but with the right care, patients can lead full, active lives. Early recognition of symptoms like recurrent infections or autoimmune complications helps ensure faster diagnosis and better outcomes.

Immunoglobulin replacement therapy, delivered through IVIG or SCIG, provides the antibodies your body needs to fight infections. Combined with preventive antibiotics, monitoring, and healthy routines, these treatments can significantly improve quality of life.

California Specialty Pharmacy (CSP) supports patients with home infusions, medication delivery, and nursing guidance, helping families manage CVID confidently and effectively. With proper care and support, patients can focus on living life to the fullest.

Frequently Asked Questions (FAQ):

What are the main symptoms of Common Variable Immunodeficiency (CVID)?

CVID often shows up as recurrent bacterial infections, especially in the sinuses, ears, and respiratory tract. Many patients experience chronic infections like bronchitis or pneumonia. Gastrointestinal issues, including chronic diarrhea, poor nutrient and fluid absorption, and abdominal pain, are also common. Some individuals may develop autoimmune complications or notice enlarged lymph nodes or spleen.

How is CVID diagnosed, and what tests are involved?

Diagnosis involves comprehensive blood tests to measure immunoglobulin levels—IgG, IgA, and IgM—which are typically below normal. Doctors also assess how well immune cells function, including B cells, and test antibody responses to vaccines. Diagnosis usually occurs after age 4 and requires ruling out other primary immunodeficiency disorders. Additional tests may include lymphocyte subset analysis and genetic testing.

What treatment options are available for CVID patients?

The main treatment is immunoglobulin replacement therapy, given intravenously (IVIG) or subcutaneously (SCIG) every 3 to 4 weeks. This therapy provides antibodies your body can’t make on its own. Some patients also take prophylactic antibiotics to reduce infection risk, and acute infections are treated promptly. Treatment may be adjusted if autoimmune complications or organ-specific issues arise.

Where can families find support and reliable information for CVID?

Organizations like the Immune Deficiency Foundation provide valuable resources, including support groups, educational materials, and guidance for navigating daily life with CVID. CSP also helps coordinate care, from home infusions to nursing support, giving families the assistance they need to manage this condition confidently.

References:

Cleveland Clinic, 2025. Common variable immunodeficiency (CVID).
https://my.clevelandclinic.org/health/diseases/21143-common-variable-immunodeficiency-cvid
Mayo Clinic, 2025. Common variable immunodeficiency: Symptoms and causes.
https://www.mayoclinic.org/diseases-conditions/common-variable-immunodeficiency/symptoms-causes/syc-20355821
MedlinePlus, 2025. Common variable immunodeficiency.
https://medlineplus.gov/ency/article/007447.htm
NCBI PMC, 2014.
https://pmc.ncbi.nlm.nih.gov/articles/PMC3901442/
Primary Immunodeficiency Foundation, 2025. Common variable immune deficiency (CVID).
https://primaryimmune.org/understanding-primary-immunodeficiency/types-of-pi/common-variable-immune-deficiency-cvid

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