HIV

Q: Is it safe to treat the flu when you are on HIV medications?

There are a number of medications that can be used to treat influenza. Currently, the CDC recommends oseltamivir (Tamiflu). There is very little Tamiflu resistance right now. Tamiflu can be taken safely with most medications, including HIV medications and prophylactic medications such as trimethoprim/sulfamethoxazole (Septra, Bactrim). Zanamivir (Relenza) is an alternative influenza treatment that may be used if Tamiflu resistance becomes a problem. Relenza is given as an inhaled medicine and may cause wheezing or breathing problems if you have asthma or other lung disease. Influenza treatment works best if started within 2 days of the onset of flu symptoms, and it may shorten the duration of symptoms and reduce the length of time you are infectious to others.

We don't know if the flu affects HIV-infected people more severely. We do know that HIV-infected people are hospitalized more often for influenza, even in the era of effective antiretroviral treatment. HIV-infected people may be more susceptible to complications from influenza, such as bacterial lung infections. People with well-controlled HIV, high CD4 cell counts, and mild flulike symptoms may not require treatment for influenza.

However, if you have lung disease, other illnesses, or advanced HIV disease, you should discuss any flulike symptoms with your provider, as you may have influenza or another illness requiring treatment. People with HIV infection and influenza are treated with the same flu medications as people with influenza who are not HIV infected.

If you think you have the flu and want to be evaluated for treatment, call your provider. Many providers will not want you to go to their clinic in person, in order to reduce the risk of spreading influenza to others. They may consider prescribing medications based on your symptoms. If you have trouble breathing, a high fever, or other signs of serious illness, you should seek medical care promptly. If you do go to a clinic or hospital to be seen, tell the staff right away that you have flulike symptoms, and they likely will ask you to put on a mask to reduce the risk of spreading disease.