Can immune suppression be treated?
It all depends on the cause. In some cases it can be treated, in others it is managed. For example:
- HIV infection and AIDS are treated with specific anti-HIV medication. See separate leaflet called HIV and AIDS.
- Many cancers can be successfully treated, or at least their progression delayed, with chemotherapy.
- Stem cell (or bone marrow) transplants are used in some situations. Damaged cells are replaced with normal ones. This is used in some forms of cancer, as well as some genetic immunosuppression conditions.
- Immune suppression caused by medication should reverse if the medication is stopped. If the immune suppression is causing harm then sometimes an alternative can be used, or the dose dropped. In other cases, infection is quickly managed as and when it occurs, while the medication is continued. It depends on the condition being treated how long the medication is used for.
- If you have had a splenectomy, the effect is lifelong, but there are ways of reducing the risk of infection (see section below).
- In some conditions, such as genetic immune disorders, injections of antibody proteins (immunoglobulins) can be given to help the body fight infection.
Treating infections early is crucial if you are immunosuppressed. You will be given treatment for the infection. If you are unwell, or if it doesn't seem to be working, you may be admitted to hospital.
Do I need any specific treatments to prevent problems if I am immunosuppressed?
If your immune system is suppressed, the important thing is to take steps to avoid infection. This can be done in a number of ways:
- Take general steps to avoid infection. For example, avoid eating food which puts you at risk of food poisoning. Handle raw meat safely. Use general hygiene measures to keep your home, etc, clean and germ-free.
- Avoid close contact with people with infectious conditions where possible.
- Ensure all routine vaccinations are up to date. (Specific recommendations are made for immunosuppressed children having their childhood vaccinations.)
- Extra vaccinations for higher-risk people, such as an annual flu jab, and vaccination against pneumonia and shingles.
- Some live vaccinations (those which contain live germs) are not given to some people who have a suppressed immune system.
- Some people who have had a splenectomy and are at particular risk of infection are advised to take a regular antibiotic, such as penicillin, on a daily basis.
Are there any special precautions to take when I travel?
Because you are at particular risk of infection, it is wise to plan very carefully for travel. Have all travel vaccinations advised for your destination. (Depending on the reason for your immune suppression, you may be advised against certain live vaccines. Be wary of travelling to countries with high risk of diseases you cannot be vaccinated against.) Avoid going to places where you wouldn't have access to good medical care if you became ill. Travel with information about your condition and medication in case you need the help of a health professional while away from your usual doctor(s). Check your travel insurance covers you if you become ill. Discuss with your doctor and consider taking some "in-case" antibiotics and instructions for when to take them if you are at risk of specific infections. Take the usual precautions to avoid food poisoning/traveller's diarrhoea if visiting somewhere this might be a risk.
And finally, if travelling somewhere hot, use plenty of high-factor sun cream to protect your skin.
Further reading and references
Immunisation against infectious disease - the Green Book (latest edition); Public Health England
Immunosuppression; Travel Health Pro Fact Sheet
Splenectomy; Public Health England, January 2015
Wilsdon TD, Hill CL; Managing the drug treatment of rheumatoid arthritis. Aust Prescr. 2017 Apr40(2):51-58. doi: 10.18773/austprescr.2017.012. Epub 2017 Apr 3.
Yu SH, Bordeaux JS, Baron ED; The immune system and skin cancer. Adv Exp Med Biol. 2014810:182-91.
Skin cancer in transplant recipients; DermNet NZ
Renal transplantation - immunosuppressive regimens for children and adolescents; NICE Technology Appraisal Guidance (2006)
Moini M, Schilsky ML, Tichy EM; Review on immunosuppression in liver transplantation. World J Hepatol. 2015 Jun 87(10):1355-68. doi: 10.4254/wjh.v7.i10.1355.
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