Swine flu and the AIDS community

Posted on 30 Apr 2009 at 7:08pm
By Tammye Nash Senior Editor

Outbreak hasn’t made big impact on HIV-positive population — yet

At least 168 people are believed to have died of the swine flu in Mexico, where the outbreak appears to have originated. And as of Thursday, Dr. Richard Besser, acting head of the U.S. Centers for Disease Control, said the number of swine flu cases in this state has gone over 100.

An infant died of swine flu in Harris County earlier this week, and individual school campuses, and even some entire school districts — including Fort Worth Independent School District and Cleburne Independent School District in North Texas — have cancelled classes in an attempt to stem the spread of the disease.

It sounds like a nightmare scenario to people with HIV/AIDS, whose weakened immune systems often make them much more susceptible to such potentially deadly infections. But some North Texas officials said this week the swine flu outbreak does not appear to be having any significant effect on the HIV/AIDS community.

Bret Camp, associate executive director of health and medical services with the Resource Center of Dallas, said he considers the outbreak "cause for concern, but not cause for panic" among HIV-positive individuals.

Dr. John Carlo, medical director for Dallas County Health and Human Services, said Wednesday, April 29 that he knows of no swine flu cases associated with individuals living with HIV/AIDS. And Jesus Chairez, a former Dallas LGBT activist now living in Mexico City, said by e-mail this week that newspapers there, where the outbreak is at its worst so far, have reported only two cases of people with HIV having been diagnosed with swine flu.

Responding to questions via e-mail, Carlo said experts "don’t know at this time" whether the swine flu virus would be worse for people with HIV than would other influenza strains.

"The severity of a flu infection depends on both the strain of the virus and the person’s overall health, so it’s hard to say if it would be worse because we don’t know how virulent this [swine flu] strain is," Carlo said.

"Persons living with HIV/AIDS would be at an increased risk for severe flu infections. It is important for such individuals to see their doctor immediately if any flu symptoms develop," he added.

And Camp said Wednesday there is some indication the new strain of swine flu could be less of a threat to people with HIV than it is to non-HIV-infected individuals, referring to a "very interesting" article published Monday, April 27 in Poz Magazine.

According to the article, found online at www.poz.com/articles/hiv_swine_flu_401_16519.shtml: "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 cause serious respiratory inflammation and disease and may be less of a threat to those with compromised immune systems, such as people living with HIV."

But, the article goes on to warn, "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."

But even if it’s true that a suppressed immune system might lessen the impact of the swine flu, HIV-psoitive individuals should take no chances.

Carlo noted, "Any situation where there is a mass gathering or large groups of people, regardless of one’s immune status, increases the risk for flu transmission." That would include waiting rooms at clinics and AIDS service organizations where people with HIV/AIDS go frequently for treatment or other services.

He said those with HIV and anyone at risk for severe flu infections "should be aware of the current situation, take the necessary precautions and see their doctors promptly if symptoms develop."

But, he said, there are no specific extra precautions people with HIV really need to take.

Camp said the Resource Center, "as I am sure all of the other [HIV/AIDS organizations] have, has initiated some infection control procedures. We are wiping down the countertops and the phones and the doorknobs more frequently, just as we do during the regular flu season."

CDC recommendations for avoiding swine flu infections

• 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.

• If you come down with influenza-like symptoms, contact your doctor’s office immediately and stay home from work or school.

The CDC also noted that 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.

More information is available at www.cdc.gov/swineflu.

E-mail nash@dallasvoice.com

This article appeared in the Dallas Voice print edition May 1, 2009.

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