Safety considerations in IGIV utilization

One of the primary patient concerns about IGIV infusions is safety. Patients and physicians are both concerned about transmission of infectious agents and product tolerability. Since the documented transmission of hepatitis C virus in 1994, the manufacturers of IGIV products have added additional steps to remove and/or deactivate viruses. There are numerous different methods employed to accomplish this goal. It is desirable to utilize methods that are separate and additive to decrease the likelihood of viral or prion transmission with the infusion of IGIV products. This article describes the different methods and the impact on enveloped and non-enveloped viruses and prions. IGIV tolerability is impacted by the pharmaceutical differences in these products. Different stabilizers such as sugars, amino acids and sodium chloride affect the osmolality of the products and their potential for adverse events. Patients with co-morbid conditions including age and impaired renal status could require a change in product, concentration and rate of administration.