Pandemic Influenza A (H1N1) Outbreak among 15 School‐Aged HIV‐1–Infected Children

Abstract

Patients infected with human immunodeficiency virus type 1 (HIV-1) are considered to be at increased risk for 2009 H1N1 influenza-related complications. We performed an observational study after an outbreak of 2009 H1N1 influenza virus infection among a group of 15 HIV-1-infected school-aged children in Germany in October 2009. Clinical course, kinetics of viral shedding, and antibody response among children with CD4 cell counts >350 cells/μL and 2009 H1N1 influenza virus coinfection did not appear to differ from that among healthy children. Oseltamivir shortened the duration of viral shedding.

Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children

“…In an outbreak of 2009 H1N1 influenza virus infection in Germany involving 15 HIV-infected schoolchildren receiving cART, the clinical course in HIV-infected children was similar to that in HIV-uninfected children. 15 A case series of 13 HIV-infected children with 2009 H1N1 in Barcelona also reported outcomes similar to those in HIV-uninfected groups. 16 In both reports, half of the children were aged <13 years, had CD4 counts >500 cells/mm 3 , and very low or undetectable HIV viral loads.…”

“…15–17 Loss of appetite was more common in HIV-infected patients than in HIV-uninfected patients in one study. 18 In a prospective cohort study conducted in South Africa from 1997 to 1999, prior to cART availability, hospitalized HIV-infected children with laboratory-confirmed influenza had more radiographic evidence of alveolar consolidation when compared with HIV-uninfected children.…”

“…Existing data suggest that HIV-infected children receiving cART who have natural influenza infection develop influenza-specific antibody levels similar to those seen in HIV-uninfected children. 15 Larger observational studies of HIV-infected children are needed to further substantiate these findings.…”

“…During the influenza pandemic of 2009, 2009 H1N1 viral RNA was detectable by RT-PCR for a median of 4 days (range 4–5) in 5 HIV-infected, oseltamivir-treated children, compared with a median of 8 days (range 8–13) in 10 HIV-infected, oseltamivir-untreated children. 15 …”

An Analysis of 332 Fatalities Infected with Pandemic 2009 Influenza A (H1N1) in Argentina

“…Although our study did not determine which fatalities had acquired immunodeficiency syndrome or were on antiretroviral therapy, we found a higher prevalence of influenza A H1N1pdm co-infection among HIV positive fatalities when compared to the general population. Such data are important because early reports suggested that HIV-infected individuals might experience more severe complications from influenza A H1N1pdm infection [20], [24], [25], [26], a finding not confirmed in later studies [27], [28], [29].…”