Swine flu information for people living with HIV.

The dreaded flu season is upon us and you’re probably aware that flu vaccines are available, and offered for free to certain groups on the NHS.  Here’s some information, relative to people who are living with HIV.

!! IMPORTANT. The following information should not be interpreted as medical advice.  We are simply presenting facts and you should always speak with your doctor or medical team when discussing a change or supplementing your health care.

While a bad cold can include aching limbs, headaches and general exhaustion too, the difference with flu is it’s more severe, you’ll probably struggle to get out of bed and there’s often a fever as well.

How Serious is the flu when you’re HIV positive?

If you’re in overall good health, you’ll usually recover naturally from flu after a week or so and some sensible rest; pain-killers, plenty of fluids and keeping warm all help. However, flu can be very serious for those less able to fight off or cope with the virus.

Complications can arise, including a worsening of any pre-existing health conditions such as asthma and diabetes, and flu also leads to a number of deaths each year, particularly in the elderly. HIV infection reduces CD4 levels and function which means the bodies of individuals with a low CD4 count have to work harder to fight the flu. However, even with HIV, the human immune system can still fight the swine flu virus to a degree. Data so far does not show that people living with HIV are at a higher risk of catching swine flu virus than the rest of the population.

That being said, if you are infected (with the flu), Swine flu illness may develop at a higher rate amongst people living with HIV with a CD4 count of less than 250 cells/mm3 and not on antiretroviral therapy. Patients with CD4 count of less than 250 cells/mm3 need to contact their HIV department to start anti HIV treatment as soon as possible.

Should People Living with HIV receive the Swine flu (H1N1) vaccination ?

“No one likes getting the flu, but while most people (including people living with HIV) are able to shake it off, people living with HIV are considered to be an at-risk group and are eligible for a free annual flu vaccination.

The influenza vaccine (flu jab) protects against different strains of flu. Unlike a cold, flu can have serious symptoms such as fever and painful limbs. It can lead to complications These can include chest infections such as bronchitis or pneumonia.

It is recommended that people Living with HIV receive the flu vaccination, as they may be at higher risk of developing serious flu and related complications. Flu vaccination should be repeated every year, as the strain of seasonal influenza infecting people changes every year.

People living with with HIV should receive the flu shot rather than the nasal spray. The shot does not contain live flu virus whereas the nasal spray contains flu virus that is alive but weakened. It is not recommended that HIV-infected people (particularly those with CD4 (T-cell) counts <250 cells/mm3) receive the nasal spray, since people with vulnerable immune systems may have a higher risk of complications from the nasal spray. You cannot get the flu from the flu shot.

You should tell your doctor if you are allergic to eggs or have had a bad reaction to other vaccinations in the past before you receive the flu shot.

Pneumococcal vaccination

People living with HIV are also recommended to have a pneumococcal vaccination (known as a ‘pneumo jab’). This will protect you against infections such as pneumonia, meningitis and septicaemia.

You may only need one vaccination or it might need to be repeated after five years. You will be able to get the vaccination from your GP, so you could have it at the same time as your flu jab.  If your GP doesn’t know about your HIV status please speak to someone at your HIV clinic about where to get vaccinated.

I had a vaccination last year, do I really need another one?

Yes – because flu viruses are constantly mutating, so new vaccines are developed each season.  With many illnesses, one jab will keep you immunised for the rest of your life.  Unfortunately, just like HIV, the flu virus is very clever and constantly changes to build up a resistance to the vaccines we produce.

That’s why you need to have a new flu jab every year and stay one step ahead.

It’s also important to be aware that there are lots of flu viruses, and while the vaccines are the best form of protection currently available, they won’t provide 100% protection against flu, so you’d still need to seek medical advice if you experienced symptoms at any point.

It’s best to try at get it done at the start of the season if possible.

Can I catch flu from a flu jab?

No – technically, this isn’t possible, as there are no ‘active viruses’ in the vaccine when administered intravenously.  The NHS points out that you may experience some mild aches and a mild fever for a couple of days afterwards, but serious side-effects are deemed very rare. As with everything we come into contact with, allergic reactions can occur. If you did experience any warning signs, seek urgent medical advice.

What about interactions/side effects between antiretroviral agents & anti-novel H1N1 drugs?

There are two agents active against novel H1N1 virus; tamiflu® (taken as tablets) and relenza® (administered via inhalers). There is little data available on the interaction between anti HIV treatment and these agents. It is likely that protease inhibitors (kaletra, atazanavir, darunavir) may interact with tamiflu® and increase the rate of side effects associated with tamiflu®.

The current advice is to take the drugs and inform your doctor if you developed any side effects. The most significant side effects include neurological and those reducing kidney function. Relenza® is believed to be safe with anti HIV treatment regimes.

What should I do before receiving my vaccination?

The information presented here is not medical advice nor should it be interpreted as medical advice.  You should always speak with your doctor or medical team when discussing a change or supplementing your health care.

What can I do to protect myself from Swine Flu?

Make good hygiene a habit for yourself and your children by following the information below:

  • If you are not currently on HIV treatment, speak with your doctor, particularly if your CD4 count is low (around 250 cells/mm3)
  • Wash your hands frequently with soap and water (Especially after using public transport or being in public spaces).
  • Use a paper towel to dry your hands and if you use cloth towels, wash them daily
  • Avoid touching your eyes, nose or mouth with your hands. Virus spread this way
  • Cover your mouth and nose with tissue when coughing or sneezing
  • Dispose of used tissue in the bin
  • Cough or sneeze into your upper sleeve if you don’t have a tissue
  • Wash your hands after coughing or sneezing
  • Clean hard surfaces, like door handles frequently using normal cleaning products
  • Stay at home if you are sick
  • Stop smoking, smoking suppresses the natural immunity in your lungs
  • Eat a balanced diet; including plenty of vegetables, fruits and whole grain products. Also include low fat diary products, lean meats, poultry, fish and beans
  • Drink lots of water
  • Reduce your salt, sugar and alcohol intake
  • Avoid contact with sick people
  • Take your anti-retroviral drugs fully and regularly

In addition to providing this information when ‘flu season’ hits, we ask our staff and volunteers to receive a vaccination.  We do this to prevent ourselves from catching the flu, so there is less chance for our clients and service users to catch it from us.

Want more information?

Visit the NHS choices page on the Flu Jab for more infomration: http://www.nhs.uk/conditions/vaccinations/pages/flu-influenza-vaccine.aspx

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