interim guidelines of the CDC for adults and adolescents infected with HIV: considerations for clinicians on the "new influenza A (H1N1) Background Virus infections of the "new influenza A (H1N1) virus transmissible between humans, were identified originally in April of 2009 cases in the U.S. and Mexico.
The epidemiology and clinical presentations of these infections are currently under investigation.
The current data are insufficient to determine who is at increased risk for complications from infection by "new influence." In any case, adults and adolescents infected with HIV, especially people with low CD4 counts are known to be subject to greater risk of lower respiratory infections of viral and bacterial, and recurrent pneumonia.
evidence that influenza may be more severe in persons infected with HIV comes from studies among HIV-infected patients infected with seasonal flu, although these data are limited. Nevertheless, several studies have reported higher rates of hospitalization, prolonged disease and increased mortality, especially among people in full-blown AIDS. Therefore, immunocompromised persons, including the HIV infected persons, especially those with low CD4 count or full-blown AIDS may face more serious complications of seasonal influenza, and it is possible that these people are also at increased risk for complications of the "new Flu. "
Clinical Presentation
In HIV-infected persons against "influenza A (H1N1) infection may present with a typical acute respiratory illness (eg cough, burning throat, cold) and fever or fever, headache, muscle aches.
In some people with HIV, especially those with low CD4 cell counts, the disease may progress rapidly and may be complicated by secondary bacterial infections, including pneumonia.
People with HIV who are suspected infected with the virus "influenza A" should be monitored, and samples from people with HIV who have no influence "under tipabile" (?) Should be sent to state laboratories for the identification of new influence.
People with HIV should remain alert to the signs and symptoms of influenza, as identified above. People with HIV who were concerned about possible signs or symptoms of influenza, or to have been exposed to a confirmed case, probable or suspected influenza, both seasonal and "influenza A", should consult their physician to assess the need for evaluation and possible treatment or prophylaxis of influenza.
treatment and chemoprophylaxis
The virus currently circulating in the "influenza A" is sensitive to the antiviral neuraminidase inhibitors zanamivir and oseltamivir, but is resistant to the antiviral drug, amantadine and rimantadine.
People with HIV who are the current definitions for infection confirmed, probable or suspected to be "influenza A" should receive antiviral treatment on an empirical basis. Individuals with HIV infection next to people with probable or confirmed by the "new influenza A should receive chemoprophylaxis.
antiviral prophylaxis with oseltamivir or zanamivir may be considered in people with HIV who report a household with suspected cases of "influenza A".
These recommendations for treatment and chemoprophylaxis are the same as for those at high risk of flu complications.
As recommended for other persons treated, treatment with oseltamivir or zanamivir should be initiated as soon as possible to the onset of flu symptoms, with greater benefit if started within 48 hours after the onset of symptoms, as is clear from the studies on seasonal influenza. In any case, some data from the studies on seasonal influenza show that the benefit to hospitalized patients even if treatment is started after 48 hours of onset of symptoms.
The recommended duration of treatment is five days.
Treatment with zanamivir or oseltamivir chemoprophylaxis and the schemes recommended for people infected with HIV are the same for adults with seasonal flu. The doctors should monitor patients closely and consider the possible need to extend the therapy based on disease course. The recommendations on the use
of antivirals for influenza in people with HIV may change as more data are available on the risk-benefit of antiviral therapy in these people.
There are no reported adverse side effects in patients with HIV treated with zanamivir or oseltamivir. There are no absolute contraindications known for co-administration of zanamivir or oseltamivir in constant high activity antiretroviral treatment (HAART).
Other means to reduce risk in people with HIV There is still no preventive vaccine for the "new influenza A (
this is a document dated June 5, 2009 ). The risk of infection may be reduced by adopting some measures to limit possible exposure to subjects with respiratory infections.
These actions include:
- frequent washing of hands
- the cover when you cough (with a handkerchief "disposable")
- the convalescent home for sick people, except to go to the doctor and provide for other unshakeable need
- minimizing contact with those who may be infected with "influenza A" and lives with us. Further measures that would place
limit the transmission of germs of the "new flu" may include the reduction of social contacts is not necessary, avoid frequenting crowded places in communities where the "new flu is in circulation.
If used properly, facial masks and respirators may help reduce the risk of contracting the flu, but should be used along with other preventive measures such as avoiding close contacts and maintain good hand hygiene.
Patients should be advised regarding the importance of staying healthy, as a means to reduce the risk of infection with the "new influence," and in order to improve the ability of their immune system to fight the infection should it arise. In particular, patients currently being treated with antiretroviral or antimicrobial against opportunistic infections should be reminded of the importance of full adherence to therapy.
http://www.cdc.gov/h1n1flu/guidance_hiv.htm c1cc10l0fr1tt0@nirvana.admins.ws
