Intravenous immunoglobulin (IVIg) for refractory and difficult-to-treat infections

Am J Med. 2012 Oct;125(10):1036.e1-8. doi: 10.1016/j.amjmed.2012.01.023. Epub 2012 May 16.


Traditionally, intravenous immunoglobulin (IVIg) has been used as replacement therapy for patients with primary or secondary immunoglobulin deficiencies. Increasingly, IVIg is being used (in doses higher than for replacement therapy) in certain bacterial or viral infectious diseases. A variety of modes of action have been attributed to the beneficial effects of IVIg, including its interaction with T-cell function, antigen-presenting cell maturation/presentation, combined with a general "tune down" effect on inflammatory reactions. More often, IVIg is being evaluated in clinical trials for the treatment of refractory and difficult-to-treat chronic infections. The evidence, molecular mechanisms, and rationale for the use of adjunct IVIg therapy in infectious diseases are reviewed, and its potential use in the adjunct treatment of difficult-to-treat drug-resistant tuberculosis discussed.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Bacterial Infections / drug therapy*
  • Bacterial Infections / immunology
  • Bacterial Infections / prevention & control
  • Chronic Disease
  • Humans
  • Immunoglobulins, Intravenous / immunology
  • Immunoglobulins, Intravenous / therapeutic use*
  • Immunologic Deficiency Syndromes / complications
  • Immunologic Deficiency Syndromes / drug therapy
  • Tuberculosis, Multidrug-Resistant / drug therapy
  • Tuberculosis, Multidrug-Resistant / immunology
  • Virus Diseases / drug therapy*
  • Virus Diseases / immunology
  • Virus Diseases / prevention & control


  • Immunoglobulins, Intravenous