Immunoglobulin therapy is well established in the treatment of HIV-infected children with frequent
bacterial infections or recurrent severe
bacterial infections, and the beneficial effects are well demonstrated. Such clear recommendations regarding
intravenous immunoglobulin (
IVIG)
therapy are currently not available for adults. Several studies have been performed in adults to determine the effects of
IVIG therapy in different dosages on the frequency and severity of
infections, as well as on survival. Although most studies suffer from problems in design and low patient numbers, some conclusions can be drawn. The
therapy is well tolerated and does not seem to have adverse effects on patients' immune functions. Most studies demonstrate beneficial results of
IVIG treatment, especially on frequency and severity of
infections in patients with advanced HIV disease. However, overall survival is, if at all, only slightly prolonged. Despite the observed beneficial effects, it is unclear whether these benefits justify the high costs of continuous
IVIG therapy. The role of
IVIG therapy could be further altered by the recent improvements in
antiviral drug therapy. Taken together, the available data suggest an individualised usage of
IVIG as adjunctive
therapy in adults with advanced
HIV infection and severe or recurrent
bacterial infections.