title: Health policy for common variable immunodeficiency: burden of the disease.
abstract: BACKGROUND
  Common variable immunodeficiency (CVID) is a primary immunodeficiency disease characterized by recurrent infections and increased susceptibility to autoimmunity and malignancy.
  
  
  OBJECTIVE
  This study was performed to estimate the burden of CVID in Iran during 1985-2008 based on incidence, mortality, and disability-adjusted life-years (DALY).
  
  
  METHODS
  The methods developed by the World Health Organization for national burden of disease studies were applied to estimate the incidence of disease and thus calculate the years of life lost due to premature mortality (YLL), years living with disability (YLD), and DALYs.
  
  
  RESULTS
  The average age-adjusted incidence of CVID was 1 case per 200 000 per year; the average age-adjusted prevalence was 1 case per 91 000 per year. The burden of CVID (DALYs) was 25.21 years per 100000 individuals (17.86 for YLL and 7.35 for YLD). DALYs increased significantly in patients aged 5-14 years and in those with polyclonal lymphocytic infiltration phenotypes (P < .001).
  
  
  CONCLUSIONS
  Based on the measurement of DALY in patients with CVID, reducing the rate of premature death in the polyclonal lymphocytic infiltration phenotype and the rate of infectious episodes in patients with the infectious only phenotype and appropriate management with regular intravenous immunoglobulin represent the best approach to decreasing the burden of CVID.
authors: Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: H
authors: H
authors: Abolhassani
authors: A
authors: A
authors: Aghamohammadi
authors: F
authors: F
authors: Abolhassani
authors: H
authors: H
authors: Eftekhar
authors: M
authors: M
authors: Heidarnia
authors: N
authors: N
authors: Rezaei
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D017074:Common Variable Immunodeficiency / Q000453:epidemiology*; D017281:Cost of Illness; D005260:Female; D006291:Health Policy; D006801:Humans; D015994:Incidence; D007492:Iran / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D055815:Young Adult