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Q&A on H1N1 for people with HIV/AIDS
Drug-drug reactions not clear, should be reported
The Centers for Disease Control and Prevention has posted the following answers to common questions about novel H1N1 influenza A and adults with HIV/AIDS:
Are people with HIV/AIDS at greater risk than other people of infection with novel H1N1 flu?
At the present time, we have no information about the risk of the novel H1N1 flu in people with HIV/AIDS. In the past, people with HIV/AIDS have not appeared to be at any greater risk than the general population for infection with routine seasonal influenza. However, HIV-infected adults and adolescents, and especially persons with low CD4 cell counts or AIDS, can experience more severe complications of seasonal influenza. It is therefore possible that HIV-infected adults and adolescents are also at higher risk for complications from infection with the H1N1 flu virus.
What can people with HIV/AIDS do to protect themselves from novel H1N1 flu?
HIV-infected patients should take precautions to protect themselves from novel H1N1 flu.
1. Wash your hands often (or using an alcohol-based hand sanitizer if soap and water aren't available)
2. Avoid touching your eyes, nose or mouth with your hands – germs spread this way
3. Try to avoid close contact with sick people
HIV-infected persons should maintain a healthy lifestyle; eat right, get enough sleep, and reduce stress as much as possible. Staying healthy reduces your risk of getting infected by influenza and other infections. Staying health also helps your immune system fight off a flu infection should it occur.
If you are currently taking antiretrovirals or antimicrobial prophylaxis against opportunistic infections you should adhere to your prescribed treatment and follow the advice of your health care provider in order to maximize the health of your immune system.
What are the signs and symptoms of HN1 influenza?
Signs and symptoms of infection with the novel H1N1 influenza are generally the same as for seasonal influenza: fever, cough, sore throat, runny or stuffy nose, headache, body aches (muscle aches or joint pain), chills and fatigue. Some people have reported diarrhea and vomiting associated with novel H1N1 flu.
What should people with HIV/AIDS do if they think they may have novel H1N1 flu?
HIV-infected people should do the same things as they would do for routine seasonal flu – contact your health care provider and follow his or her instructions. He or she will determine if laboratory testing or treatment is needed.
If you are sick, stay home. If you have novel H1N1 flu, you should stay at home for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer. Staying at home will help prevent others from catching your illness.
If you need to go to a doctor's office, to an emergency room, or to any other healthcare facility to be evaluated, cover your mouth and nose with a facemask (or ask for one at the healthcare facility) and tell them that you are there because you think you might have novel H1N1 flu.
Is there a vaccine against this the H1N1 flu virus?
No. There is currently no vaccine for the novel H1N1 flu. The vaccine given for seasonal flu does not protect against the novel H1N1 flu. If a vaccine against novel H1N1 flu becomes available, CDC will make recommendations for people with HIV/AIDS. Researchers are presently working to develop a vaccination against novel H1N1 flu.
Is there treatment against novel H1N1 flu for people with HIV/AIDS?
Yes. The novel H1N1 flu virus is sensitive to two antiviral drugs: zanamivir and oseltamivir. HIV-infected adults and adolescents who meet current case-definitions for confirmed, probable or suspected infection with novel H1N1 flu should receive antiviral treatment. Treatment is most effective if started within 48 hours of symptom onset. Please check the CDC website frequently for updates in recommendations for antiviral treatment.
When should people with HIV/AIDS be prescribed antiviral medications for the prevention (also called "chemoprophylaxis") of novel H1N1 flu?
HIV-infected adults and adolescents who are close contacts of persons with novel H1N1 flu should receive antiviral chemoprophylaxis. Please check the CDC website frequently for updates in recommendations for antiviral chemoprophylaxis.
Are the medicines used to treat and prevent infection with the novel H1N1 flu virus safe for people with HIV/AIDS?
There is not a lot of information on the interaction between anti-flu medications and HIV antiretrovirals. No adverse effects have been reported among HIV-infected adults and adolescents who received oseltamivir or zanamivir. There are no known major drug interactions between oseltamivir or zanamivir with currently available antiretroviral medications used to treat HIV infection. If you are prescribed oseltamivir or zanamivir and think you might be having a reaction to the drug, contact your health care provider. Healthcare providers should observe patients for possible adverse drug reactions to anti-influenza agents, especially patients with neurologic problems or decreased kidney function.
How else should people with HIV/AIDS prepare?
Stay informed. Health officials will provide additional information as it becomes available on the CDC website. Consult your doctor and make sure all your vaccinations are up-to-date, including vaccination against seasonal influenza and vaccination against bacterial pneumonia caused by the Streptococcus pneumoniae. Bacterial pneumonia from Streptococcus pneumoniae can be a problem for people with HIV/AIDS and can also cause complications for people who have the flu. The vaccine against Streptococcus pneumoniae is different than the vaccine from the influenza vaccine.
Follow local public health advice regarding school closures, avoiding crowds and other social distancing measures based on illness in specific communities.
If you haven't developed a family emergency plan yet, consider developing one now as a precaution. In particular, make sure to keep your antiretroviral prescriptions and other prescriptions filled and up-to-date and to take all of your antiretrovirals as prescribed.
What is CDC doing about H1N1 flu for people with HIV/AIDS?
CDC, in coordination with state and local health departments and with WHO is working aggressively to understand the epidemiology of this novel H1N1 flu and determine if it affects HIV-infected people and people with other immunocompromising conditions differently. As additional information about the situation become available, the CDC's recommendations may change. Please check the CDC H1N1 Flu website frequently at: http://www.cdc.gov/h1n1flu/index.htm.