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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.
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.
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 both the administration
of flu shots and antiviral medications in people with HIV/AIDS. 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.
These can be found at
http://www.cdc.gov/flu/professionals/treatment/
0405antiviralguide.htm.)
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.
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. 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. These can be found at http://www.cdc.gov/flu/professionals/treatment/
0405antiviralguide.htm.)
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.
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)” at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5306a1.htm. 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). For
more information, visit www.cdc.gov/flu or
call CDC at (800) CDC-INFO (English), (888) 246-2857 (Español),
or (866) 874-2646 (TTY). |
