{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T15:58:37Z","timestamp":1777737517752,"version":"3.51.4"},"reference-count":55,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2022,11,27]],"date-time":"2022-11-27T00:00:00Z","timestamp":1669507200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Palex Medical S.A."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Common variable immunodeficiency (CVID) is an antibody immunodeficiency with a wide variety of clinical and immunological manifestations, and whose genetic cause is found in about 25% of diagnosed cases. Giardia lamblia is one of the main causes of gastrointestinal infections in CVID. 5-Nitroimidazoles are the most used first-line treatment, but nitroimidazole-refractory giardiasis is increasing. Nevertheless, only a few cases of refractory giardiasis in CVID have been reported. This study aimed to determine the incidence of Giardia infection in our CVID cohort, shows our management experience and describes patients\u2019 phenotypic features. Clinical data collection, immunological, immunogenetics and microbiology assays were performed, and previous cases of giardiasis in CVID were reviewed. The incidence of symptomatic giardiasis was 12.9%. The main immunological features were undetectable or decreased IgA levels and reduced switched memory B cells. A probable PTEN pathogenic variant was detected in one. Three patients responded to metronidazole but suffered reinfections, and one was a refractory giardiasis eradicated with innovative quinacrine plus paromomycin combination. This work could contribute to the decision-making and therapeutic management of future patients with CVID and giardiasis, highlighting the importance of the early detection and treatment of infections in patients with CVID to ensure a good quality of life.<\/jats:p>","DOI":"10.3390\/jcm11237007","type":"journal-article","created":{"date-parts":[[2022,11,28]],"date-time":"2022-11-28T06:04:36Z","timestamp":1669615476000},"page":"7007","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Incidence, Management Experience and Characteristics of Patients with Giardiasis and Common Variable Immunodeficiency"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8458-612X","authenticated-orcid":false,"given":"Irene","family":"D\u00edaz-Alberola","sequence":"first","affiliation":[{"name":"Servicio de An\u00e1lisis Cl\u00ednicos e Inmunolog\u00eda, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain"},{"name":"Programa de Doctorado en Biomedicina, University of Granada, 10816 Granada, Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria de Granada (ibs.GRANADA), 18012 Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Francisco","family":"Guti\u00e9rrez-Bautista","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Biosanitaria de Granada (ibs.GRANADA), 18012 Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9013-3621","authenticated-orcid":false,"given":"Andrea","family":"Espuch-Oliver","sequence":"additional","affiliation":[{"name":"Servicio de Reproducci\u00f3n Asistida, Hospital Universitario de Torrec\u00e1rdenas, 04009 Almer\u00eda, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5225-6823","authenticated-orcid":false,"given":"Jos\u00e9 Mar\u00eda","family":"Garc\u00eda-Aznar","sequence":"additional","affiliation":[{"name":"Health in Code S.L., 15008 A Coru\u00f1a, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Per","family":"Anderson","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Biosanitaria de Granada (ibs.GRANADA), 18012 Granada, Spain"},{"name":"Departamento Bioqu\u00edmica, Biolog\u00eda Molecular e Inmunolog\u00eda III, University of Granada, 18071 Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pilar","family":"Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Servicio de An\u00e1lisis Cl\u00ednicos e Inmunolog\u00eda, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria de Granada (ibs.GRANADA), 18012 Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6394-5728","authenticated-orcid":false,"given":"Carmen","family":"Hidalgo-Tenorio","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Biosanitaria de Granada (ibs.GRANADA), 18012 Granada, Spain"},{"name":"Unidad de Enfermedades Infecciosas, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel \u00c1ngel","family":"L\u00f3pez-Nevot","sequence":"additional","affiliation":[{"name":"Servicio de An\u00e1lisis Cl\u00ednicos e Inmunolog\u00eda, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria de Granada (ibs.GRANADA), 18012 Granada, Spain"},{"name":"Departamento Bioqu\u00edmica, Biolog\u00eda Molecular e Inmunolog\u00eda III, University of Granada, 18071 Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/j.iac.2020.03.001","article-title":"Defining Common Variable Immunodeficiency Disorders in 2020","volume":"40","author":"Ameratunga","year":"2020","journal-title":"Immunol. 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