Venom immunotherapy

Allergen immunotherapy (AIT) in patients with moderate and severe allergic symptoms to insect venom (Hymenoptera venom allergy – HVA) significantly reduces the risk of severe reactions to subsequent sting and improves the patient’s quality of life. Allergen immunotherapy in HVA is also advantageous for pharmacoeconomic reasons. Allergen immunotherapy is recommended for HVA patients with life threatening reactions to sting. The therapy can be recommended for subjects with non-life threatening reactions in cases such as: high-risk exposure to sting (e.g. beekeepers), concomitance of diseases increasing the risk of severe reactions to subsequent stings, and/or limited access to specialized medical care. Qualification for VIT is based on clinical criteria and diagnostic tests confirming the presence of sIgE to insect venom. Molecular diagnosis can be helphul in HVA diagnosis. Venom immunotherapy is absolutely contraindicated in uncontrolled asthma, active phases of autoimmunological and neoplastic diseases, AIDS, and in children under two years of age. Venom immunotherapy must not be started in pregnancy. In patients with severe HVA reactions, baseline serum tryptase (bsT) test should be performed. It is recommended that bsT test should be performed again before the planned completion of VIT. Patients qualified for VIT should undergo a general medical examination. Complications in the course of VIT are more frequent in the induction than the maintenance phase and their frequency is similar to that of the occurrence of complications in inhalant allergen immunotherapy.