Evidence supporting the use of: Immunoglobulin
For the health condition: Infection (viral)

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Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Immunoglobulin (often administered as intravenous immunoglobulin, IVIG) is used to support or treat certain viral infections, and this practice has scientific validation, especially for specific clinical scenarios. Immunoglobulins are preparations of pooled antibodies derived from the plasma of thousands of healthy donors. The rationale for their use is to provide passive immunity by supplying antibodies that can neutralize specific pathogens, including certain viruses.

For example, hepatitis B immunoglobulin is used to prevent infection after exposure to the hepatitis B virus, and varicella-zoster immunoglobulin is used for post-exposure prophylaxis in high-risk individuals. In addition, IVIG has been used as adjunctive therapy for severe or complicated viral infections, such as in immunocompromised patients with cytomegalovirus (CMV) or enterovirus infections, and during outbreaks of emerging viruses (e.g., Ebola, SARS-CoV-2) when no specific antiviral therapy exists. However, its use in more common viral infections (such as influenza or uncomplicated respiratory viruses) is not generally supported by evidence.

Numerous randomized controlled trials and meta-analyses support the efficacy of specific immunoglobulin preparations for post-exposure prophylaxis or treatment of certain viral infections. However, the evidence is variable for off-label or broad-spectrum use, and recommendations are generally limited to specific scenarios. Side effects, limited availability, and high cost further restrict its routine use. Thus, while immunoglobulin therapy is scientifically validated for some viral infections, its utility is highly dependent on the clinical context.

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