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This review looks at the available evidence on viral infections in patients with B cell alymphocytosis, in particular those with X-linked agammaglobulinemia (XLA), Good\u2019s syndrome, post monoclonal-antibody therapy and certain patients with Common Variable Immune Deficiency (CVID). Viral infections are not as infrequent as previously thought in these conditions and individuals with very low circulating B cells seem to be predisposed to an adverse outcome. Particularly in the case of SARS-CoV2 infection, mounting evidence suggests that peripheral B cell alymphocytosis is linked to a poor prognosis.<\/jats:p>","DOI":"10.3389\/fimmu.2021.731643","type":"journal-article","created":{"date-parts":[[2021,9,3]],"date-time":"2021-09-03T15:00:14Z","timestamp":1630681214000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":35,"title":["Peripheral B Cell Deficiency and Predisposition to Viral Infections: The Paradigm of Immune Deficiencies"],"prefix":"10.3389","volume":"12","author":[{"given":"Alexandros","family":"Grammatikos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Donati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah L.","family":"Johnston","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark M.","family":"Gompels","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,8,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2013.27.3899","article-title":"Common Variable Immunodeficiency","volume":"27","author":"Tam","year":"2013","journal-title":"Am J Rhinol Allergy"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-02-380105","article-title":"How I Treat Severe Combined Immunodeficiency","volume":"122","author":"Gaspar","year":"2013","journal-title":"Blood"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1128\/9781555817411.ch2","article-title":"Functions of Antibodies","volume":"2","author":"Forthal","year":"2014","journal-title":"Microbiol Spectr"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(88)80030-1","article-title":"The IgA Mucosal Immune System","volume":"12","author":"Lamm","year":"1988","journal-title":"Am J Kidney Dis"},{"key":"B5","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1016\/B978-012374410-4.00591-4","article-title":"Immune Response to Viruses: Antibody-Mediated Immunity","author":"Neurath","year":"2008","journal-title":"Encycl Virol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2018.00276","article-title":"Features of Effective T Cell-Inducing Vaccines Against Chronic Viral Infections","volume":"9","author":"Panagioti","year":"2018","journal-title":"Front Immunol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.01920","article-title":"Update on Transplacental Transfer of IgG Subclasses: Impact of Maternal and Fetal Factors","volume":"11","author":"Clements","year":"2020","journal-title":"Front Immunol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2020.03.001","article-title":"Long-Term Follow-Up of 168 Patients With X-Linked Agammaglobulinemia Reveals Increased Morbidity and Mortality","volume":"146","author":"Lougaris","year":"2020","journal-title":"J Allergy Clin Immunol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/9.2.334","article-title":"Chronic Enteroviral Meningoencephalitis in Agammaglobulinemic Patients","volume":"9","author":"McKinney","year":"1987","journal-title":"Rev Infect Dis"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197706302962601","article-title":"Persistent and Fatal Central-Nervous-System ECHOvirus Infections in Patients With Agammaglobulinemia","volume":"296","author":"Wilfert","year":"1977","journal-title":"N Engl J Med"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-198505000-00001","article-title":"Winkelstein JA. 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