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As flu season approaches, immunocompromised patients face unique challenges. Their weakened immune systems make them more susceptible to serious complications from the flu, so taking extra precautions is important. Let’s review a few strategies on how to help patients reduce their risk of infections. 

Prevention 

• Vaccination: Flu shots are crucial for immunocompromised patients to help prevent infection. While a full immune response to the flu vaccine may not occur, vaccination continues to have protective benefits. Flu shots, such as egg-based quadrivalent inactivated influenza vaccine (IIV4) and quadrivalent recombinant hemagglutinin influenza vaccine (RIV4) are recommended over the nasal spray, live attenuated influenza vaccine (LAIV) because the flu shot does not have a live flu virus while the nasal spray does, and as such, LAIVs are contraindicated in people living with HIV/AIDS. Ideally, getting patients vaccinated in September and October have shown success.  
• Personal Protection: Keep good hand hygiene and disinfect high-touch surfaces regularly. Limit contact with sick individuals and consider wearing a mask in highly populated settings.  

Vigilance 

• Signs and Symptoms: Checking one’s health by looking out for signs and symptoms of the flu, including fever, cough, body aches, and dehydration, is important to reduce the possibility of serious complications, like worsening HIV symptoms. Remind patients to seek medical attention immediately.  
• Monitoring: Look out for worsening and persistent symptoms, like fever, difficulty breathing, and dehydration. Sometimes flu infection can lead to secondary infections, like pneumonia, bronchitis, sinusitis, and ear infections, and seek medical care if new symptoms develop.  

Treatments and Self-Care 

• Medication: Prescription antivirals may help reduce the flu's severity if given within 48 hours of the onset of symptoms. Sometimes, fever may be self-limiting and may be managed with acetaminophen.  
• Self-Care: Boost your immunity by getting plenty of rest, eating nutritious foods, and staying hydrated. If you are sick, isolate, but continue to engage with activities that reduce stress and promote mental and physical well-being. 

In conclusion, patients with HIV/AIDS are at high risk of developing serious complications from the flu, so it’s important to take extra precautions during flu season. Flu vaccination, infection prevention, recognizing flu symptoms, antiviral medication, avoiding complications, and emotional support are all important considerations for patients with HIV/AIDS during flu season. By taking these steps, patients can help to prevent infection and avoid complications. 

REFERENCES  

Centers for Disease Control and Prevention, Infectious Disease Society of America. Considerations for Coadministering COVID, Flu and/or RSV Vaccines this Fall. Vaccines and Immunity. Published September 29, 2023. Accessed October 10, 2023. https://www.idsociety.org/covid-19-real-time-learning-network/vaccines/considerations-for-coadministering-covid-flu-andor-rsv-vaccines-this-fall/#/+/0/publishedDate_na_dt/desc/

Centers for Disease Control and Prevention. Flu and People Living with HIV. Published August 25, 2023. Accessed October 10, 2023. https://www.cdc.gov/flu/highrisk/hiv-flu.htm

HIV.gov. Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV. Published September 7, 2023. Accessed October 10, 2023. https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-opportunistic-infections/immunizations

Grohskopf LA, Blanton LH, Ferdinands JM, Chung JR, Broder KR, Talbot HK. Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2023–24 Influenza Season. MMWR Recomm Reports. 2023;72(2):1-25. doi:10.15585/mmwr.rr7202a1