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Published on: April 25, 2025

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Hepatic Manifestations in Common Variable Immunodeficiency Associated With Mortality and Worse Hospital Outcomes in

Ahmed Elmoursi1, Daniel V DiGiacomo2, Jocelyn R Farmer3

  • 1Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Mass; Harvard Medical School, Boston, Mass.

The Journal of Allergy and Clinical Immunology. in Practice
|September 25, 2025
PubMed

Insights

Liver disease significantly impacts hospitalizations for common variable immunodeficiency (CVID) patients, leading to longer stays, higher costs, and increased mortality. Early detection and improved management are crucial for better outcomes in CVID with liver complications.

Area of Science:

  • Hepatology
  • Immunology
  • Public Health

Background:

  • Liver disease is a known risk factor for increased mortality in patients with common variable immunodeficiency (CVID).
  • Population-level data on the impact of liver disease on CVID-associated hospitalizations in the U.S. is limited.

Purpose of the Study:

  • To analyze the prevalence, spectrum, clinical factors, and outcomes of liver complications in hospitalized adults with CVID nationwide.
  • To identify predictors of hepatic manifestations and assess survival rates in CVID patients with liver disease.

Main Methods:

  • Retrospective cross-sectional analysis of the National Readmission Database (NRD).
  • Utilized International Classification of Diseases, Tenth Revision (ICD-10) codes to identify CVID admissions with hepatic complications.
  • Assessed comorbidities, risk factors, and in-hospital outcomes.

Main Results:

  • 10% of 181,288 CVID hospitalizations involved hepatic complications, including hepatic steatosis, cirrhosis, NAFLD, portal hypertension, and nodular regenerative hyperplasia.
  • CVID admissions with liver disease experienced longer stays (7 vs. 5 days), higher mortality (11% vs. 4%), and greater charges ($68,114 vs. $44,757).
  • Hypertension, CKD, diabetes, obesity, autoimmune cytopenia, alcohol use, and viral hepatitis were associated with hepatic manifestations; nodular regenerative hyperplasia and portal hypertension predicted lower survival.

Conclusions:

  • CVID admissions with liver disease, especially nodular regenerative hyperplasia and portal hypertension, are linked to worse clinical and economic outcomes.
  • Further research is essential for enhancing early detection and improving long-term survival for CVID patients with liver disease.
Abstract

Keywords:
Common variable immunodeficiencyHepatic manifestationsHospital readmissionIn-hospital mortalityLiver diseaseNationwide Readmissions DatabaseNodular regenerative hyperplasiaPortal hypertensionPrimary immunodeficiency

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