i-Base Q&A: swine flu and HIV
1 July 2009. Related: Special reports.
Caution: The swine flu pandemic is new. Some of the advice in this Q&A is likely to become outdated soon as scientists learn more about this virus.
What is swine flu?
Swine flu is a new strain of flu (influenza). The medical name for this strain is H1N1v. It has been called a ‘pandemic’ because of the speed with which it spread to many different countries in a short time.
Are HIV-positive people more at risk of catching swine flu?
No. Generally, as with other strains of flu, having HIV does not increase your risk of catching swine flu.
Are HIV-positive people at risk of becoming more ill from swine flu?
Not generally. It may be more serious if you have a low CD4 count (less than 200 cells/mm3). This is mainly because symptoms of other serious infections could be mistaken for flu. If you have flu symptoms and either a low CD4 count, other health complications or are pregnant, please call your HIV clinic.
Are pregnant women at risk of becoming more ill from swine flu?
Pregnant women are at greater risk of becoming ill with severe symptoms, especially in the third trimester of pregnancy. Complications can develop rapidly. If you are pregnant and develop flu-like symptoms (fever, muscle pain, sore throat, dry cough), you need urgent treatment with oseltamivir (Tamiflu). You must not wait for any laboratory test results,
How is swine flu different from regular seasonal flu?
Because this is a new strain of flu virus, people do not have immunity against it. People older than 65 appear to be less affected by it than people aged 10 to 45. Researchers are already working to produce a vaccine, and this may, or may not, be ready in time for the next flu season.
Is swine flu very dangerous?
The vast majority of people with swine flu, both HIV-positive and HIV-negative, make a full recovery, even without special treatment. Nevertheless, if you have symptoms of swine flu and you are HIV-positive, especially if you have a low CD4 count or other health complications, including being pregnant, you should take the steps recommended in this fact sheet.
How is swine flu spread?
Swine flu is spread by person-to-person contact, just like regular flu – specifically through not covering your mouth when sneezing and not washing your hands. Washing your hands regularly and trying to avoid unnecessarily touching your nose, mouth and eyes with your hands might help reduce the risk of you spreading or contracting flu. Remember to wash your hands after touching other people’s hands.
Will flu medicines work in people who are HIV-positive?
Antiviral medications used to treat flu, such as oseltamivir (Tamiflu), will work against swine flu, but do not have a big impact on most people’s symptoms. The National Institute of Communicable Diseases (NICD) recommends oseltamivir for people with HIV within the first 48 hours of flu symptoms. After 48 hours it is a choice you will have to make with your doctor.
Will flu medicines interact with antiretrovirals?
There is a potential for interactions between oseltamivir, boosted PIs and some nucleoside reverse transcriptase inhibitors (3TC, FTC and tenofovir) but the benefits outweigh this small risk. Your doctor, nurse or pharmacist should advise you on this.
What do I do if I think I have symptoms?
If you have HIV or are pregnant or both, you should contact your doctor or clinic (preferably first phone if possible). The NICD considers people with HIV possibly to be at higher risk of more severe illness (though scientists are unsure) and should be prioritised for receiving flu medicines. Testing is not always necessary and oseltamivir should be given on the basis of symptoms and before any swine flu test results are received.
When does seasonal flu occur?
Most people get seasonal flu during late autumn and winter, from April through to August. Almost all cases of flu are now swine flu.
Should I have the flu vaccine?
Yes, especially if you are HIV-positive or likely to become pregnant. Children and people living in institutions should also get vaccinated. The vaccine is seldom available in the public health system, but most pharmacies and private doctors can vaccinate you. The vaccine reduces the risk of you getting seasonal flu. Currently there is no vaccine that works against swine flu. Vaccination should ideally be given in April each year for seasonal flu,. A new vaccine is given each year because the flu virus changes from year to year.
Where can I find out more information?
There is a swine flu helpline: 0861-364-232.
Also look online at the NICD website