Background: Up to one third of the patients diagnosed with common variable immunodeficiency (CVID) may develop gastrointestinal (GI) and hepatic manifestations. This study aimed to evaluate the prognostic significance of enteropathy and liver disease in patients with CVID. Methods: We conducted a retrospective study including all consecutive adult CVID patients followed in a tertiary care center in Spain from January 1990 to January 2023. A diagnosis of CVID-associated enteropathy (CVID-E) and CVID-associated liver involvement (CVID-L) was established when objective clinical, endoscopic, histologic, radiologic or hemodynamic findings were present. Relevant prognostic outcomes and their risk factors were studied, including survival, GI infections and GI cancer. Results: Eighty-nine patients with confirmed CVID were included, 26 of them (29.2%) had CVID-E and 23 (25.8%) had CVID-L. Nineteen (73.1%) of CVID-E patients suffered from GI infections, while 12 (46.2%) presented concurrent liver involvement. In comparison with the rest of the cohort, CVID-E patients had more frequently liver involvement, GI infections, and GI cancer. Multivariate analysis identified CVID-E as an independent risk factor for GI infections. Twelve (52,2%) of CVID-L patients concurrently exhibited CVID-E, and CVID-L patients presented more CVID-associated enteropathy, splenomegaly, and a trend towards more GI cancer and GI infections. CVID-L and age at CVID diagnosis emerged as independent risk factors for mortality. Conclusion: Gastrointestinal and hepatic involvements are common in patients with CVID, and frequently occur together. These manifestations significantly impact the disease course, increasing the risk of GI infections, GI malignancy, and, in the case of liver disease, mortality.
Martínez-Lozano et al. (2025) studied this question.