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HIV/AIDS
and the Flu
HIV
(human immunodeficiency virus) is the virus that causes AIDS
(Acquired Immune Deficiency Syndrome). HIV kills or damages
cells in the body’s immune system, gradually destroying
the body’s ability to fight infection and certain cancers.
An estimated 850,000 to 950,000 people are infected with HIV
in the United States.
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People
with HIV/AIDS are considered at increased risk from
serious influenza-related complications. Studies have
shown an increased risk for heart- and lung-related
hospitalizations in people infected with HIV during
influenza season as opposed to other times of the year,
and a higher risk of influenza-related death in HIV-infected
people. Other studies have indicated that influenza
symptoms might be prolonged and the risk of influenza-related
complications higher for certain HIV-infected people.
Vaccination with a flu shot has been shown to produce
an immune response against influenza viruses in certain
people infected with HIV.
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Because
influenza can result in serious illness, HIV-infected persons
are recommended for vaccination. During the setting of the
current vaccine shortage, people with HIV/AIDS are among the
priority groups that should get flu shots this season. This
fact sheet provides Questions & Answers to guide the administration
of both flu shots and antiviral medications to people with
HIV/AIDS.
This
fact sheet provides Questions & Answers to guide both
the administration of flu shots and antiviral medications
in people with HIV/AIDS.
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Should
people with HIV/AIDS receive the inactivated influenza vaccine?
People
with chronic underlying medical conditions, including HIV/AIDS,
should receive inactivated influenza vaccine (the flu shot)
during the 2004-05 influenza season. People with HIV/AIDS
are considered at increased risk from serious influenza-related
complications and should be vaccinated. Persons with advanced
HIV disease may have a poor response to immunization. Therefore,
chemoprophylaxis (use of antiviral medications for prevention)
should be considered for these patients if they are likely
to be exposed to people with influenza. (CDC has developed
interim recommendations on the use of antiviral medications
for the 2004-05 influenza season.
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Are
there people with HIV/AIDS who should NOT receive the inactivated
influenza vaccine?
Contraindications
to the use of inactivated influenza vaccine (the flu shot)
in persons with HIV/AIDS are the same as those for uninfected
persons ? a history of severe allergy (i.e., anaphylactic
allergic reaction) to hens’ eggs, or a history of onset
of Guillain-Barre syndrome during the 6 weeks after vaccination.
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Can
people with HIV/AIDS receive the live attenuated flu vaccine
(LAIV, sold commercially as FluMist)?
No.
Persons with HIV/AIDS and persons with other medical conditions
are not recommended to receive the live influenza vaccine.
LAIV contains a weakened form of the live influenza virus.
LAIV is approved for use only among healthy persons between
the ages of 5 and 49 years.
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When
should people with HIV/AIDS be prescribed antiviral medications
for chemoprophylaxis (prevention)?
Persons
at high risk of serious influenza-related complications should
be given antiviral medications if they are likely to be exposed
to other people with influenza. For example, when a family
or household member is diagnosed with influenza, the exposed
person with HIV/AIDS should be given chemoprophylaxis for
7 days. Vaccinated and unvaccinated HIV-infected persons who
are residents of institutions experiencing an influenza outbreak
should be given chemoprophylaxis for the duration of the outbreak
or until discharge. People with advanced HIV disease who are
not expected to mount an adequate antibody response to influenza
vaccination should consider chemoprophylaxis with antiviral
medications for the duration of influenza activity in the
community, if antiviral medications are available in adequate
supply locally. (CDC has developed interim recommendations
on the use of antiviral medications for the 2004-05 influenza
season.
There
are no published data on interactions between anti-influenza
agents such as amantidine and rimantidine and drugs used in
the management of HIV infected persons. Patients should be
observed for adverse drug reactions to anti-influenza chemoprophylaxis
agents, especially when neurologic conditions or renal insufficiency
is present.
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Should
health-care workers who have contact with HIV/AIDS patients
be vaccinated?
Influenza
vaccination is recommended for health-care workers who are
involved in direct care of HIV- infected patients. More information
about vaccination of health-care workers can be found in “Prevention
and Control of Influenza Recommendations of the Advisory Committee
on Immunization Practices (ACIP)”. Health-care workers
who are healthy, less than 50 years of age, and are not pregnant
may receive the nasal-spray flu vaccine (LAIV/FluMist).
Source:
Centers for Disease Control and Prevention, www.cdc.gov
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