**Author details**

Yldz Camcoğlu\* *Istanbul University Cerrahpasa Medical School, Department of Pediatrics Infectious Diseases, Clinical Immunology and Allergy Division, Cerrahpasa, Istanbul* 

#### **15. References**

[1] Stiehm ER, Vaerman JP, Fudenberg HH. Plasma infusions in immunologic deficiency states: metabolic and therapeutic studies. *Blood*, 1966. 28(6): p. 918-937.

<sup>\*</sup> Corresponding Author

[2] Fischer A. Primary immune deficiencies of B-lymphocytes. *Rev Prat*, 1991. 41(9): p. 790- 794.

106 Immunodeficiency

immunodeficiency [69].

**14. Conclusion** 

established.

immunodeficiencies.

**Author details** 

Yldz Camcoğlu\*

**15. References** 

Corresponding Author

 \*

patients with antibody deficiencies receive SCIg [3].

reactions are more frequent but the systemic side effect profile is low. Local tissue reactions are often mild and tend to improve over time. Adults switching therapy reported improved vitality, mental health, and social functioning. Treatment satisfaction (TS) scores and healthrelated quality of life (HRQOL) was improved in adults and children with

According to ESID registry (http://www.esid.org), 4462 of 10,039 patients with PID receive IgG replacement (74% intravenous, 26% subcutaneous, <0.5% intramuscular). There is a wide variety of frequency of subcutaneous IgG replacement therapy in European countries. Sweden was the first country to deliver IgG via the SC route, therefore more than 80% of all

Replacement therapy with immunoglobulin either via intravenous or via subcutaneous is in patients with immunodeficiencies are associated with reduced infection frequency and organ damage and increased life expectancy. IVIG has been widely used in US and Europe for many years. Monthly IVIG treatment offered steady-state IgG level throughout the dosing cycle, dedicated viral inactivation steps improved safety concerns, pooled analyses confirmed the efficacy and safety, benefits of therapy and adverse events has been welll

Recent advances in the basic science of immunoglobulins and meta-analyses of patient data have provided new approaches in using polyclonal IgG to treat patients with primary immunodeficiencies. The old fashion subcutaneuos IG infusion reintroduced to treat patients with immunodeficiencies. The subcutaneous-IG therapy was reported to be effective, safe and well tolerated in children and adults. In addition, the SCIG home therapy high treatment satisfaction (TS) scores and health-related quality of life (HRQOL) was advantages of SCIG. Subcutaneous infusions are recommended to patients who are small children or reactive to IVIG or have problem with vascular access. Practicing immunologists can use new concepts in tailoring their approach to treat patients with primary

*Istanbul University Cerrahpasa Medical School, Department of Pediatrics* 

*Infectious Diseases, Clinical Immunology and Allergy Division, Cerrahpasa, Istanbul* 

states: metabolic and therapeutic studies. *Blood*, 1966. 28(6): p. 918-937.

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Immunoglobulin Treatment of Immunodeficient Patients 109

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**Section 2** 

**Immunodeficiency –** 

**Mechanisms and Pathophysiology** 

**Immunodeficiency – Mechanisms and Pathophysiology** 

112 Immunodeficiency

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therapy. *Clin Immunol*, 2008. 126(1): p. 81-88.

**Chapter 5** 

© 2012 Anastassopoulou, licensee InTech. This is an open access chapter distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2012 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution,

**Chemokine Receptors** 

Additional information is available at the end of the chapter

Cleo G. Anastassopoulou

http://dx.doi.org/10.5772/51588

**1. Introduction** 

**as Therapeutic Targets in HIV Infection** 

Acquired immunodeficiency syndrome (AIDS) evolved into a pandemic in less than a decade since the first reports of a new set of symptoms that included severe opportunistic infections and unusual neoplasms, particularly Kaposi's sarcoma, in homosexual men [1]. Nearly 30 years since the discovery of the causative agent [2, 3], human immunodeficiency virus (HIV) cannot still be eradicated, nor is there sight of a safe and effective prophylactic vaccine in the horizon. Infection with either virus type invariably leads to AIDS; however, the less pathogenic HIV-2 stains have been geographically restricted mainly to West Africa, whilst the more virulent HIV-1 strains have spread around the globe causing the AIDS pandemic [4]. The worst afflicted region is sub-Saharan Africa, where in a few countries more than one in five adults is infected with the virus; at the same time, the epidemic is spreading most rapidly in Eastern Europe and Central Asia, where the number of people living with HIV increased by 250% between 2001 and 2010 [5]. Worldwide, an estimated 34 million people, including 3.4 million children, were living with HIV at the end of 2010,

while the related deaths and new infections were 1.8 and 2.7 million, respectively [5].

Despite these frightening numbers, which are indicative of a growing epidemic far from the UNAIDS vision of zero AIDS-related deaths and zero new infections, considerable progress has undoubtedly been noted in basic and clinical research in the field of HIV/AIDS [6]; we now understand most aspects of HIV pathogenesis and have identified targets suitable for therapeutic intervention. The introduction of combination antiretroviral therapy (ART) in 1996 revolutionized patient care and brought about a significant reduction in AIDS-related morbidity and mortality; HIV infection has been transformed into a chronic condition that is generally controllable with lifelong treatment, at least in the developed world where treatment is available. At the forefront of current anti-HIV research, CCR5 inhibitors represent a novel drug class that broadens the therapeutic options of patients, which are

and reproduction in any medium, provided the original work is properly cited.
