Zainaldain Hamed, Rizvi Fatema Sadaat, Rafiemanesh Hosein, Alizadeh Mahla, Jamee Mahnaz, Mohammadi Sara, Kiaee Fatemeh, Mohammadi Hamed, Babaie Farhad, Yazdani Reza, Abolhassani Hassan, Aghamohammadi Asghar, Azizi Gholamreza
Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Student Research Committee, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Oman Med J. 2020 Jul 30;35(4):e157. doi: 10.5001/omj.2020.64. eCollection 2020 Jul.
Common variable immunodeficiency (CVID) is a heterogeneous disorder characterized by hypogammaglobulinemia and increased susceptibility to recurrent infections.
We searched PubMed, Web of Science, and Scopus databases to find eligible studies from the earliest available date to January 2018 with standard keywords. Pooled estimates of the infection prevalence and the corresponding 95% confidence intervals were calculated using random-effects models.
We found that pneumonia (67.7%) was the most prevalent infection followed by upper respiratory tract (59.0%) and gastrointestinal infections (36.3%). Furthermore, bacterial complications (41.7%) were higher in CVID patients compared to viral (25.4%), parasitic (18.8%), or fungal (3.4%) infections. Patients with longer age at diagnosis presented with fewer disease comorbidities. There was an inverse correlation between T lymphocyte count and viral infections. Moreover, we found that immunoglobulin M (IgM) serum level was inversely correlated with hepatitis C and gastrointestinal infections, and IgG serum level was inversely correlated with infectious arthritis. Higher numbers of CD4 and CD8 T cells were associated with the lower frequencies of otitis media. CVID patients with infections had significantly lower percentages of CD3 T cells. In contrast, higher percentages of CD19 lymphocytes were found in CVID patients who had a history of infections.
Our findings demonstrated that in addition to hypogammaglobulinemia, patients with CVID have an imbalance in the frequency of T lymphocytes, which is in parallel with the higher frequency of infectious complications.
普通可变免疫缺陷（CVID）是一种异质性疾病，其特征为低丙种球蛋白血症和反复感染易感性增加。
我们检索了PubMed、科学网和Scopus数据库，以标准关键词查找从最早可用日期至2018年1月的符合条件的研究。使用随机效应模型计算感染患病率的合并估计值及相应的95%置信区间。
我们发现肺炎（67.7%）是最常见的感染，其次是上呼吸道感染（59.0%）和胃肠道感染（36.3%）。此外，与病毒感染（25.4%）、寄生虫感染（18.8%）或真菌感染（3.4%）相比，CVID患者的细菌并发症（41.7%）更高。诊断时年龄较大的患者疾病合并症较少。T淋巴细胞计数与病毒感染呈负相关。此外，我们发现免疫球蛋白M（IgM）血清水平与丙型肝炎和胃肠道感染呈负相关，免疫球蛋白G（IgG）血清水平与感染性关节炎呈负相关。较高数量的CD4和CD8 T细胞与中耳炎较低的发生率相关。有感染的CVID患者CD3 T细胞百分比显著降低。相反，有感染史的CVID患者中CD19淋巴细胞百分比更高。
我们的研究结果表明，除低丙种球蛋白血症外，CVID患者的T淋巴细胞频率失衡，这与感染并发症的较高发生率平行。
