Serologic evidence of seasonal influenza A and B in HIV patients on combined antiretroviral therapy in Lagos, Nigeria

Abstract

Background Influenza and HIV are endemic in Nigeria but there is no epidemiological data on the co-infection of influenza A and B among HIV patients. Objective We investigated seasonal influenza A and B, and co-infection among HIV patients on combined antiretroviral therapy (cART) in Lagos, Nigeria. Methods In a prospective cross-sectional study, clear sera collected from 174 HIV-positive patients between August and September 2018 were analysed for immunoglobulin M-specific antibodies to seasonal influenza A subtypes H1N1 and H3N2, and influenza B by enzyme immunoassay. Results A total of 39.7% (69/174) of HIV patients were seropositive for influenza A or B viruses with 84.1% (58/69) being positive for influenza A, 13.04% (9/69) seropositive for both influenza A and B, and only 2.9% (2/69) positive for influenza B mono-infection. Median age was 44 (mean 45, mode 40, range 18–74) years. The 41–50 years age group had the highest seroprevalence (39.1%; 27/69). Seropositivity was highest among women (65.2%; 45/69). A total of 88.4% (61/69) of HIV patients seropositive for influenza A or B were on fixed dose cART, while 73.9% (51/69) were virologically suppressed. Furthermore, 27.5% (19/69) were immunocompromised, of which 21.1% (4/19) were severely immunosuppressed (cluster of differentiation 4 < 200 cells/mm >3 ). Conclusion Influenza A and B was prevalent among HIV patients on cART, which may predispose them to life-threatening complications. We recommend strong advocacy on the need to reduce the risk of exposure to influenza and for the provision of an influenza vaccine in Nigeria.