Current concepts: Common Variable Immunodeficiency

doi:10.1016/j.anai.2025.11.009

Current concepts: Common Variable Immunodeficiency

2025-11-20

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Charlotte Cunningham‐Rundles *

DOI：10.1016/j.anai.2025.11.009

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Common variable immunodeficiency (CVID) is the most frequent symptomatic primary immunodeficiency disorder seen in clinical medicine. The immune defect occurs in males and females equally, and is characterized by reduced serum levels of immunoglobulin G (IgG) along with deficient immunoglobulin A (IgA) and/ or immunoglobulin M (IgM) levels, along with poor to absent specific antibody responses to infection or vaccinations. Although CVID is considered a primary immune defect, most subjects are diagnosed between the ages of 20 to 40. However, due to the heterogeneous clinical appearance, a diagnostic delay of 5 to 8 years after the first cardinal symptom is common in all countries where this has been investigated. As the genetics of this immune defect have been further clarified, it is clear that the name “CVID” is an umbrella diagnosis, useful clinically for arranging treatment, but it actually includes a very large number of immune defects, many of which are not yet discovered. Due to prevalence, common inflammatory complications, and numbers of medical encounters, the awareness of CVID is critical for pediatricians, internists, and primary care physicians, as well as pulmonologists, otolaryngologists, hematologists and physicians in many other specialties. Here we outline the early history of CVID, the diagnostic criteria and standard workup of subjects, the clinical manifestations, emerging genetic understandings and current treatment modalities for patients with this immune defect.

Current concepts: Common Variable Immunodeficiency

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