Being Alive/Los Angeles; Being Alive Newsletter - November 1993
Walt Senterfitt

Researchers have hypothesized for several years that various factors can stimulate HIV replication in the body. Particularly suspect are events or treatments which normally stimulate the immune system, for instance, acute infections or vaccinations. It is generally believed, though in practice it has been difficult to prove precisely, that other acute infections like influenza, herpes, and sexually transmitted diseases may indirectly cause HIV replication by stimulating the normal defensive functioning of the immune system. This, in fact, is part of the underlying logic behind the search for infectious "co-factors," i.e., things other than HIV which may account for the disease progressing more rapidly in some people.

Vaccines have been studied largely to make sure that their protective or immune-boosting effects are not outweighed by the potential dangers of stimulating HIV growth. Dr. William O'Brien of the West LA Veterans Administration Medical Center and the UCLA Medical School conducted laboratory studies of the effect of flu vaccines on HIV viral load in test tube cultures of blood taken from HIV+ individuals. In his statement below, he notes that he did find an increase in viral load of half of the samples tested. This increase, however, was in almost every case short-lived, i.e., it had returned to the prior level in a month or less. It is unclear to Dr. O'Brien and others whether this transient increase has any clinical significance. Further studies are necessary to answer that question.

Physicians and researchers do agree that a serious case of the flu can be very deleterious to anyone whose body is compromised by HIV infection. They believe that, in addition to the directly negative physical effects of the flu, the flu infection quite possibly can be an even greater (perhaps much greater) stimulant to HIV replication than the vaccine. For these reasons, and because Dr. O'Brien's study needs to be replicated and extended to see if it has any real-life implications before becoming the basis for a change in practice, everyone we consulted believes it is appropriate to follow the CDC recommendations and continue to offer the flu vaccine to everyone who agrees with their doctor that it is indicated.
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