This page has information about the flu (H1N1 and seasonal) for those who are living with HIV and AIDS. The following is general advice and should not replace the advice of your doctor. We strongly encourage you to consult your doctor about your particular case

What is the flu?

Are people with HIV more likely to get the flu?

Who is at highest risk from complications of the flu?

What are the symptoms?

How to protect yourself and your family?

I'm HIV+ and I think I have the flu. What do I do? Do I seek medical attention?

What is the flu?

Influenza, commonly referred to as 'the flu', is caused by a virus. There are 3 main kinds of flu viruses: A, B, and C. Both Influenza B and Influenza C viruses have been infecting humans for centuries. Type C is the mildest (often expereienced as a minor cold), Type B is the most common cause of classic "seasonal" or "winter" flu. Type A is the most dangerous -- it remains essentially a bird virus, but every now and then it acquires the ability to cross into humans (either via pigs or directly). When it does this it can cause a pandemic such as we are seeing now with Influenza A (H1N1).


Because the vast majority of humans have never been exposed to this virus and there is no prior immunity or partial immunity. Our common understanding of the illness we know as 'flu' is that it is unpleasant, but mild. But this is in part due to the fact that we already have partial immunity to many of the strains circulating (mostly Influenza B) --- so the course of disease tends to be milder. With no previous exposure to H1N1 (influenza A), the disease can be more severe and there can be a higher risk for complications.

It is important to keep in mind that:

 Most people who get the flu (either seasonal or 2009 H1N1) will have mild illness, will not need medical care or antiviral drugs, and will recover in less than two weeks.


Some people, however, are more likely to get flu complications that can result in being hospitalized and occasionally can result in death. Pneumonia, bronchitis, sinus infections and ear infections are examples of flu-related complications. The flu can also make chronic health problems worse. For example, people with asthma may experience asthma attacks while they have the flu, and people with chronic congestive heart failure may have worsening of this condition that is triggered by the flu.

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Who is at highest risk for complications from the flu?

  • Children younger than 5, but especially children younger than 2 years old
  • Adults 65 years of age and older
  • Pregnant women
  • People who have:
    • Cancer
    • Blood disorders (including sickle cell disease)
    • Chronic lung disease [such as asthma or chronic obstructive pulmonary disease  (COPD)]
    • Diabetes
    • Heart disease
    • Kidney disorders
    • Liver disorders
    • Neurological disorders (such as epilepsy, cerebral palsy, brain or spinal cord injuries,  moderate to profound intellectual disability [mental retardation] or developmental delay)
    • Neuromuscular disorders (such as muscular dystrophy and multiple sclerosis)
    • Weakened immune systems (such as people with HIV or AIDS or who are on medications that weaken the immune system )

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Are people living with HIV more likely to get the flu?

No, they are not more likely to get the flu. They are, however, at higher risk for getting the complications of the flu (listed above)

Research on the flu -- including H1N1 flu -- shows that people who get severely ill from the flu tend to have one or more "underlying health conditions," a general term used to describe any of a number of diseases or states of being (listed above).  But the bottom line is that they include having a "weakened immune system" -- a state that all PHAs are lumped into, even if they have a CD4 count over 500. Though it is more likely that those who have low CD4 counts (<200) will be more succeptible to experiencing complications of the flu

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What are the symptoms of the flu?

Symptoms of the classic flu and symptoms of H1N1 are generally the same (with some exceptions):

*fever, chills, sore thorat, stuffed up or runny nose, coughing, aches, tiredness, (in children: vomiting and diarrhea)

*H1N1 seems more likely to cause vomiting and diarrhea in adults than the seasonal/winter flu

*not everyone will experience a fever

Both the flu and the common cold are viruses with similar symptoms, though flu symptoms tend to last greater than a week while cold symptoms are usually gone after a week. And people with just a common cold are much less likely to have a fever if a common cold is all they have.

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How to protect yourself and your family from the flu

Be sure your vaccinations are up to date:

  • we recommend both the seasonal and H1N1 flu vaccinations for all people living with HIV (dates and times of local clinics in Guelph/Wellington and Grey-Bruce )
  • be sure your Pneumovax vaccination is current; every 5 years (Not only are persons with HIV more susceptible to this infection that can cause pneumonia, but this is a form of bacterial pneumonia that also commonly complicates the course of influenza, and persons who have suffered influenza are predisposed to getting pneumococcal disease. People with HIV are at a higher risk for developing pneumococcal pneumonia, especially if they have a CD4 count under 200.Check with your HIV treating physician to see if you are up to date for Pneumovax!

Wash your hands frequently (soap and water, hand sanitizer)

Cover your mouth/nose when coughing or sneezing using a tissue (and discarding the tissue immediately). If a tissue is not available, sneezing or coughining into the crook of the arm (elbow area) is MUCH better than doing so into your hands!

Try not to touch your mouth, nose, or eyes (that's how germs get in!)

Try to avoid close contact with people who are sick

People living with HIV should maintain a healthy lifestyle; eat right, get enough sleep, and reduce stress as much as possible. Staying healthy reduces your risk of getting infected by influenza and other infections. Staying healthy also helps your immune system fight off a flu infection should it occur.

If you are currently taking antiretrovirals or antimicrobial prophylaxis against opportunistic infections you should adhere to your prescribed treatment and follow the advice of your health care provider in order to maximize the health of your immune system.

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I'm HIV+ and I think I have the flu. What do I do?

Inform your healthcare provider immediately (s/he will decide if testing or treatment are needed)

  • Tamiflu (oseltamivir) is an anti-viral medication that must be initiated as soon as possible after symptoms of the flu begin (best results are seen if it is taken within 48 hours of the appearance of symptoms). This drug can reduce the severeity of the symptoms and shorten the duration of the illness -- they may also prevent some flu complications.
  • Your doctor may be able to provide you with a prescription by phone and call in the prescription to your pharmacy to prevent you from having to go in to the doctor's office

Stay home and avoid contact with other people to avoid spreading it further

It is recommended that you stay home for 24 hours after fever disappears (does not count if you are using fever-reducing medicines like aspirin) or, ideally, until your cough is gone.

You should seek medical attention for any of the following warning signs:

In Children:

  • fast breathing or trouble breathing
  • bluish skin colour
  • not drinking enough fluids
  • not waking up or not interacting
  • being so irritable that the child does not want to be held
  • flu-like symptoms improve but then return with fever and worsening cough
  • severe or persistent vomiting

In Adults:

  • difficulty breathing or shortness of breath
  • pain or pressure in the chest or abdomen
  • sudden dizziness
  • Confusion
  • Severe or persistent vomiting
  • Flu-like symptoms improve, but then return with fever and worsening cough


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