Influenza in Patients with Human Immunodeficiency Virus Infection

In: Influenza

18 Nov 2012

Influenza in Patients with Human Immunodeficiency Virus Infection The incidence of pulmonary complications following influenza infection is known to be increased in patients with certain underlying conditions, particularly cardiac or pulmonary disease. In view of the likelihood of increased susceptibility to severe infection, yearly immunization of human immunodeficiency virus (HlV)-infected persons against influenza is recommended by the Immunization Practices Advisory Committee of the Centers for Disease Control, Atlanta. However, the effect of HIV infection on the course of influenza illness has not been well studied. We therefore reviewed the clinical features of virolo-gically confirmed influenza infection in HIV-infected subjects during the 1988-1989 winter season.
Methods
At San Francisco General Hospital (SFGH), all induced sputum and bronchoalveolar lavage (BAL) specimens from patients suspected of having the diagnosis of Pneumocystis carinii pneumonia are routinely submitted for viral culture. Specimens are inoculated onto three cell lines: human embryonic lung, human foreskin fibroblasts, and primary cynomolgus monkey kidney. Monkey kidney cells are hemadsorbed with washed guinea pig red blood cells five and ten days after inoculation. Hemadsorption-positive cultures are then stained with fluorescent monoclonal antibodies (Boots-Celltech Diagnostics, Plainview, NY) against influenza A and B, as well as against parainfluenza 1-3. Subtyping of influenza A isolates was performed by the Virus Laboratory of the San Francisco Department of Health.
Clinical and laboratory data of patients from whom influenza was isolated were extracted from review of the patient s medical record; all records were reviewed by a single physician (S.S.). Chest roentgenograms were reviewed by both S.S. and a staff radiologist.


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