Novel H1N1 Flu and HIV-Infected Adults and Adolescents
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[Karen Hunter] The CDC, in coordination with state and local health departments and the World Health Organization, is working to understand the novel H1N1 flu and how it affects HIV-infected people.
Here to discuss CDC’s interim guidance for HIV-infected adults and adolescents regarding the novel H1N1 flu virus is Dr. John Brooks of the CDC’s HIV/AIDS Prevention Program. Welcome, Dr. Brooks.
[Dr. Brooks] Thank you for having me.
[Karen Hunter] Are adults and adolescents with HIV infection at higher risk for novel H1N1?
[Dr. Brooks] The information available so far this year doesn’t seem to indicate that people living with HIV infection are at greater risk of getting the novel H1N1 influenza. This is consistent with our prior experience with seasonal influenza, that is, that persons living with HIV are at about the same risk of catching seasonal influenza as anyone else. However, persons living with HIV, and especially persons with low CD4 cell counts or AIDS, can experience more severe complications of seasonal flu. Thus, HIV-infected individuals may be at higher risk for complications from H1N1 flu virus, as well.
[Karen Hunter] Now what are the signs and symptoms of novel H1N1 influenza?
[Dr. Brooks] They’re generally the same as for seasonal influenza: fever, cough, sore throat, runny or stuffy nose, headache, body aches, chills, and fatigue. Some people have reported diarrhea and vomiting.
[Karen Hunter] What should HIV-infected individuals do if they think they have the novel H1N1 flu?
[Dr. Brooks] If they think they’ve been infected or exposed to someone with influenza, either seasonal influenza or novel H1N1 influenza, they should consult with their healthcare provider to assess the need for evaluation and possibly the need for anti-influenza treatment or prophylaxis.
[Karen Hunter] What is the recommended treatment for novel H1N1 flu for people living with HIV/AIDS?
[Dr. Brooks] The H1N1 flu virus is sensitive to two antiviral drugs: zanamivir and oseltamivir. HIV-infected adults and adolescents who have novel H1N1 flu should get antiviral treatment. Antivirals are different from drugs called antiretrovirals which we use to treat HIV infection. Treatment for influenza is most effective if it is started within 48 hours of the onset of symptoms. Listeners can check the CDC website at www.cdc.gov/h1n1flu for updates in recommendations for antiviral treatment.
[Karen Hunter] Should people with HIV/AIDS take prescribed antiviral medications for the prevention of novel H1N1 flu?
[Dr. Brooks] HIV-infected adults and adolescents who are close contacts of persons with the novel H1N1 flu should take antiviral medications to reduce their risk of getting the flu.
[Karen Hunter] Are antiviral medications safe for people with HIV or AIDS?
[Dr. Brooks] No adverse effects have been reported among HIV-infected adults and adolescents who received oseltamivir or zanamivir, and there are no known major drug interactions between these drugs and antiretroviral medications used to treat HIV infection. Anyone taking oseltamivir or zanamivir who thinks they might be having a reaction to the drug, should contact their healthcare provider.
Also, healthcare providers should observe patients for possible adverse drug reactions to anti-influenza agents, especially patients who have neurologic problems or decreased kidney function.
[Karen Hunter] What steps can people take to reduce the risk for novel H1N1 flu infection?
[Dr. Brooks] There are things people can do to protect themselves from novel H1N1 influenza and other infectious diseases.
1.
Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it;
2.
Wash your hands often with soap and water, especially after you cough or sneeze. Use an alcohol-based hand sanitizer if soap and water aren’t available;
3.
Try to avoid close contact with sick people;
4.
If you get sick with influenza, stay home from work or school and limit your contact with others to keep from infecting them; and
5.
Avoid touching your eyes, nose, or mouth because germs can spread that way.
[Karen Hunter] What else can people living with HIV/AIDS do to reduce their risk of getting influenza?
[Dr. Brooks] Try to maintain a healthy lifestyle: eat right, get enough sleep, and reduce stress as much as possible. Staying healthy reduces the risk of getting influenza by keeping the immune system strong.
It’s also very important that persons who are taking medicine to treat their HIV infection continue to take their prescribed treatment and follow the advice of their healthcare provider in order to maximize the health of their immune system.
[Karen Hunter] How else should people with HIV/AIDS prepare?
[Dr. Brooks] People living with HIV and AIDS should make sure all of their vaccinations are up-to-date, including vaccination against the seasonal influenza and vaccination against bacterial pneumonia. Bacterial pneumonia can be a problem for people with HIV/AIDS and can cause complications for people who have the flu.
People with HIV should follow local public health advice regarding school closures, avoiding crowds, and other social distancing measures. HIV-infected adults and adolescents should keep their antiretroviral prescriptions and other prescriptions filled and up-to-date.
[Karen Hunter] What should people living with HIV/AIDS do if they think they have novel H1N1 flu?
[Dr. Brooks] HIV-infected people should do the same things as they would do for routine seasonal flu – contact their healthcare provider and follow his or her instructions. He or she will determine if laboratory testing or treatment is needed.
If you think you’re sick, stay home and away from others as much as possible. If you’re diagnosed with novel H1N1 flu, you should stay at home for at least 24 hours after your fever is gone except to get medical care or for other necessities. Your fever should be gone without the use of fever-reducing medicine.
If you need to go to a doctor’s office, emergency room, or other healthcare facility to be evaluated, cover your mouth and nose with a facemask, if available and tolerable. Let the office staff know you’re there because you think you might have novel H1N1 flu.
Lastly, if you develop influenza and are taking antiretrovirals for HIV infection, you should continue to take these medications, even while you’re sick. Your doctor will let you know if there’s some reason why you should stop taking your antiretrovirals.
[Karen Hunter] Thank you, Dr. Brooks, for talking with us today.
[Dr. Brooks] Thanks for having me.
[Karen Hunter] For more information about novel H1N1 flu, please visit www.cdc.gov/h1n1flu or call 1-800-CDC-INFO.
[Announcer]For the most accurate health information, visit www.cdc.gov or call 1-800-CDC-INFO, 24/7.