Fever and respiratory tract symptoms, very common clinical problems in HIV patients, are frequently caused by influenza virus infection, Canadian researchers report in the July 15th issue of Clinical Infectious Diseases.
"HIV infected persons," lead investigator Dr. Marina B. Klein told Reuters Health, "despite having well-controlled HIV infection and receiving influenza vaccination, seem particularly at risk for influenza virus infection."
To establish the prevalence of such infection, Dr. Klein of Montreal Chest Institute and colleagues studied 50 consecutive patients with HIV who had a temperature greater than 38 degrees C and had respiratory symptoms. Of the group, 45 were receiving HAART and 39 had received influenza vaccine.
A causative pathogen was identified in 25 patients while 25 other patients had undiagnosed infections. Among the 21 viral infections, 10 patients had influenza A, 10 had influenza B and 1 patient had parainfluenza virus type 3 infection.
Overall, 70% of the patients received antibiotics. No patients with influenza had radiography-confirmed pneumonia or required hospitalization.
Although illness was mild, say the investigators, influenza accounted for a large proportion of unscheduled visits to a health care provider for respiratory illness and was associated with unnecessary antibiotic prescriptions that may contribute to antimicrobial resistance.
Moreover, continued Dr. Klein, care providers "frequently did not recognize influenza and missed opportunities to treat it. Thus HIV-infected persons may serve as an important reservoir of infection."
"We hope that this study will raise awareness about the importance of influenza infection in HIV infected persons," she concluded, "and lead to future research into ways to better prevent influenza in this population."
Clin Infect Dis 2007;45:234-240.
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