Journal of Acquired Immune Deficiency Syndromes (11.01.03) Vol. 34: P. 304-307 - Monday, December 29, 2003
Kathleen M. Neuzil, MD, MPH; Christopher S. Coffey, PhD; Ed F. Mitchel, Jr., MS; Marie R. Griffin, MD, MPH

The researchers defined the influenza season based on local virus surveillance, and they measured hospitalizations for acute cardiopulmonary causes and deaths from any cause throughout the year. Over the four-year period, cardiopulmonary hospitalization rates in HIV/AIDS patients declined by 53 percent and death rates declined by 77 percent.

Hospitalization attributed to influenza was 48 per 1,000 persons in 1995 and 5 per 1,000 persons per year from 1996- 1999, after the introduction of HAART. "We could detect no effect of influenza on mortality;" the researchers wrote, "the estimated influenza- attributable rate was 0.5 deaths per 1,000 enrollees." The scientists noted that as the overall health of HIV patients improved, so did their study outcomes. Nevertheless, they noted, patients tended to experience higher hospitalization rates during influenza season.

The authors pointed out that a growing body of evidence supports the benefit of influenza vaccine for HIV patients. "Despite early reports of transient increases in viral load after influenza immunization, sustained adverse effects on HIV viral load or disease progression have not been demonstrated," they noted.

"In summary," the investigators concluded, "as compared with studies in the pre-HAART era, our current study demonstrates a more modest effect of influenza season on hospitalizations in a population of patients with HIV infection in the HAART era. Studies that better define the risk of influenza morbidity based on immunologic and virologic status of HIV-infected patients are needed to direct preventive efforts and vaccination policy."
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