While there is currently no cure for CVID, various treatments may help relieve symptoms and infections associated with the disease. Immunoglobulin concentrates are used most often to treat CVID patients.

Immunoglobulin concentrates: Immunoglobulin concentrates (like Gamimune®, Gammar-P®, Sandoglobulin® or Gammagard S/D®) may be administered intravenously (injected into the vein) or subcutaneously (injected below the skin). Solutions of 3-12% intravenous immunoglobulin (IVIG) have been used on a regular basis to maintain a trough level of 400-500mg/dL in adults. A dose of 400-600mg/kg every two to four weeks is usually required. In patients with structural lung damage, a trough level of 700-800mg/dL is generally required.

Most patients respond well to immunoglobulin therapy, according to research. The therapy has been shown to reduce the recurrence of infections, arthritic symptoms, and the severity of CVID. However, gastrointestinal disease shows little improvement with immunoglobulin concentrates. In some patients who have a severe autoimmune disease, the concurrent use of steroids or other immunosuppressive drugs may be needed.

The patient should be monitored during therapy for side effects. The most common reactions include backache, nausea, vomiting, chills, low-grade fever, myalgia (muscle pain) and fatigue. Side effects typically occur 30 minutes after the infusion and usually last for several hours. Slowing the rate of infusion or interrupting the infusion for a few minutes may help prevent side effects. Antipyretics, diphenhydramine or corticosteroids are often used to treat side effects such as flushing (reddening of the cheeks), headache, chills, dizziness, increased sweating, leg cramps, pain and tenderness at the injection site. Although anaphylactic reactions to immunoglobulin concentrates are rare, patients who have IgA deficiency have an increased risk for these effects.

There have been reports in the past of transmitted infectious diseases through infusion. While no cases of HIV infection have been linked to immunoglobulin therapy, the transmission of hepatitis C virus has been reported with blood transfusions. However, current methods of viral inactivation help prevent transmission. These methods include treatment with organic solvents and detergents, pasteurization and storage at a low pH. In the United States, immunoglobulin products are derived from donated human plasma, which undergoes a manufacturing process that includes cold ethanol fractionation and viral inactivation steps.

Antibiotics: Patients who have chronic sinusitis or lung disease may need long-term treatment with broad spectrum antibiotics like tetracycline, cephalosporin, trimethoprim/sulfmethoxazole (Bactrim® or Septra®), ciprofloxacin (Cipro®) or others.

Surgery: Surgery may be required to treat the complications of CVID. For instance, chronic sinusitis may require endoscopic sinus surgery to drain the sinus cavities. Severe autoimmune thrombocytopenia or hemolytic anemia can be treated with splenectomy (surgical removal of the spleen). Biopsy should be considered to exclude infection or malignancy in enlarging lymph nodes.

Probiotics: Antibiotics are the main treatment to eradicate Helicobacter pylori, the cause of most stomach ulcers. Side effects commonly include bloating, diarrhea and taste disturbances. Probiotics reduce these side effects and generally help people tolerate the treatment. They may also reduce levels of H. pylori in children and adults. Yogurt containing probiotics suppresses H. pylori infection and may lead to more complete eradication during antibiotic treatment.

Probiotics are generally considered safe and well tolerated. Avoid if allergic or hypersensitive to probiotics. Lactose-sensitive people may develop abdominal discomfort from dairy products containing probiotics.

Probiotics: Limited evidence with daycare children suggests supplementation with Lactobacillus GG may reduce number of sick days, frequency of respiratory tract infections and frequency of related antibiotic treatments.

Fermented milk (with yogurt cultures and L. casei DN-114001) may reduce the duration of winter infections (gastrointestinal and respiratory), as well as average body temperature, in elderly people.

Probiotics are generally considered safe and well tolerated. Avoid if allergic or hypersensitive to probiotics. Lactose-sensitive people may develop abdominal discomfort from dairy products containing probiotics.

Blessed thistle: Laboratory studies report that blessed thistle (and chemicals in blessed thistle such as cnicin and polyacetylene) has activity against several types of bacteria and no effects on some types. Reliable human study is lacking. Further evidence is necessary in this area before a firm conclusion can be drawn.

Cranberry: Study results of cranberry as an antibacterial in other conditions show conflicting results. Further study is needed before a conclusion can be drawn.

Probiotics: As a bacterial reservoir, the nose may harbor many varieties of potentially disease-causing bacteria. There is limited evidence that probiotic supplementation may reduce the presence of harmful bacteria in the upper respiratory tract. More studies are needed to establish this relationship and its implications for health.

Results are mixed regarding the ability of probiotics to reduce infective complications of medical treatment. Reduced incidence of infection has been seen in patients treated for brain injury, abdominal surgery and liver transplantation. Other studies have shown no such reduction in elective abdominal surgery and critical care patients.

Propolis: Animal and laboratory studies suggest activity of propolis in the treatment of various types of infections. Initial human studies suggest possible benefits against oral/dental bacteria, genital herpes, urine bacteria, intestinal giardia infections or H. pylori. Additional research is needed before a recommendation can be made.

Seaweed, kelp and bladderwrack: Laboratory study suggests antifungal and antibacterial activity of bladderwrack. However, there are no reliable human studies to support use as an antibacterial or antifungal agent.

Selenium: Preliminary research reports that selenium can be beneficial in the prevention of several types of infection, including recurrence of erysipelas (bacterial skin infection associated with lymphedema) or Mycoplasma pneumonia. Further research is needed to confirm these results before a clear recommendation can be made.

Sorrel: There are no well-conducted published studies that demonstrate sorrel to possess activity against viruses or bacteria that are important human pathogens. In an in vitro study, sorrel did not demonstrate activity against herpes simplex virus-1, herpes simplex virus-2, HIV, B. subtilis, E. coli, Proteus morganii, Pseudomonas aeruginosa, P. vulgaris, Serratia marcescens or Staphylococcus aureus.

There is currently no known method of prevention.