Swine Flu and The HIV Positive Community

The threat of a swine flu epidemic in the United States has many people living with HIV concerned about their health and safety. POZ and AIDSmeds check in with WHO and the CDC for the latest. In short: While there are reasons to be cautious, there’s no reason to panic.

What is swine flu?

Swine flu is a respiratory disease common among pigs. Though people are not usually susceptible to swine flu, animal-to-human transmission has been documented, notably among farmers working closely with pigs. What’s unique about the particular strain now under surveillance—dubbed swine influenza type A/H1N1—is its ability to spread from person to person.

A possible reason for this is the fact that pigs can be infected with not only swine influenza, but also flu viruses that affect humans and birds. The genetic material from multiple influenza viruses can then mix. Swine influenza typeA/H1N1, for example, contains genes from two strains of swine flu, one strain of bird flu and one strain of human influenza.

Is swine flu deadly?

All types of influenza that cause disease in humans can be deadly—approximately 200,000 people are hospitalized and 36,000 people die from flu-related complications every year in the United States.

There is no reason to believe that the swine flu being reported is any more deadly than the regular seasonal flu. Of the 40 confirmed cases of swine flu in humans in the United States as of April 27, none have resulted in death. In fact, according to the Centers for Disease Control and Prevention (CDC), all cases reported in the United States thus far were associated with mild symptoms of illness, with only one patient requiring brief hospital care.

Is swine flu a threat to people living with HIV?

People living with HIV—as well as those with other chronic conditions, such as heart disease, asthma and diabetes—are believed to face an increased risk of serious influenza-related symptoms. According to the CDC, there is often a spike in the number of heart- and lung-related hospitalizations among people living with HIV during the winter influenza season as opposed to other times of the year. Studies also indicate that influenza symptoms might be prolonged and the risks of influenza-related complications—including death—are higher for certain HIV-positive people.

It is not clear that this strain of swine flu poses any more or less of a risk to people living with HIV. One theory: Given that, at least in Mexico, swine flu mimics what was seen during the 1918 influenza pandemic—it appears most serious among people between 18 and 35 years of age; those with healthy immune systems that become hyperactive in response to the virus and causes serious respiratory inflammation and disease—and may be less of a threat to those with compromised immune systems, such as people living with HIV. Unfortunately, it is not clear if this theory will hold up, given that many HIV-positive people are responding well to antiretroviral treatment, compounded by the possibility that a hyperactive immune response to HIV, not the virus itself, is responsible for HIV disease progression and a heightened risk of non-AIDS related health problems.

To help prevent seasonal flu, an annual vaccine is recommended for people with HIV to lower the risk of infection or serious disease if infection does occur. Unfortunately, a vaccine has not yet been developed against swine influenza A/H1N1. But people living with HIV can take steps to prevent infection.

How can I protect myself?

The CDC and other public health experts list fairly simple ways to prevent the spread of swine influenza A/H1N1. These include:

* Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
* Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
* Avoid touching your eyes, nose or mouth. Germs spread this way.
* Try to avoid close contact with sick people.
* Very little is known about the benefits of wearing face masks to help control the spread of flu. Whenever possible, instead of relying on face masks, try avoiding close contact and crowded conditions—particularly if swine flu reaches pandemic status.
* No evidence shows that swine flu can be transmitted through food. Eating properly handled pork—cooked to an internal temperature of 160 degrees—is safe.
* If you come down with influenza-like symptoms, contact your doctor’s office immediately and stay home from work or school.

It is possible to rapidly develop a vaccine—if it’s needed. “We’ve identified the virus,” Richard Besser, MD, acting director of the CDC said during a White House press briefing on Sunday. “Should we decide to manufacture a vaccine, we can work toward that goal very quickly.” Though it would likely take at least four months to develop and mass produce a vaccine against H1N1, it could be available in time for a possible second wave of swine flu this coming winter.

Crossposted via Mike Tidmus.