Flu and People with HIV

Are People with HIV at High Risk for Serious Flu Illness?

Yes. People with HIV are at higher risk of developing serious flu-related complications, especially people who have a very low CD4 cell count (a weakened immune system) or those who are not taking medicine to treat HIV (called antiretroviral therapy or ART).

What Is Flu?

Influenza (flu) is caused by a virus. It can cause mild to severe illness, and at times can lead to death. Flu signs and symptoms usually come on suddenly. People who are sick with flu often feel some or all of these signs and symptoms:

• Fever*/feeling feverish or chills
• Cough
• Sore throat
• Runny or stuffy nose
• Muscle or body aches
• Headache
• Fatigue (tiredness)
• Some people may have vomiting and diarrhea, although this is more common in children than adults.

*It’s important to know that not everyone with flu will have a fever.

Flu is worse than the common cold, and can cause serious complications.

Flu is contagious, meaning it can spread from person to person when someone coughs, sneezes or talks. People can spread flu before they know they’re sick—and while they have flu.

What Is the Best Way to Prevent Flu?

If you have HIV, in addition to taking ART, the best way to prevent flu is to get a flu vaccine every year.

How flu vaccines work. Flu vaccines cause antibodies to develop in your body about two weeks after vaccination. These antibodies provide protection against flu illness

People with HIV should get a flu vaccine every year, if possible, by the end of October or before flu starts spreading in their community.

People with HIV should receive the flu shot rather than the nasal spray. The shot does not contain live flu virus whereas the nasal spray contains flu virus that is alive but weakened. People with weakened immune systems may have a higher risk of complications from the nasal spray.

You cannot get flu from the flu vaccine. You should tell your provider if you are allergic to eggs (since some vaccines are made with flu virus that is grown in eggs) or if you have had a bad reaction to other vaccines in the past.

Where to find a flu vaccine. Flu vaccines are offered in many doctor’s offices and clinics. Even if you don’t have a regular doctor or nurse, you can get a flu vaccine somewhere else like a health department, pharmacy, urgent care clinic, college health center, and even in some schools and workplaces. Find a flu vaccine near you.

What Else Can You Do to Prevent Getting or Spreading Flu?

In addition to getting a flu shot every year, people with HIV should use the same core prevention strategies CDC recommends for everyone:

• Stay up to date with other recommended immunizations for respiratory viruses
• Practice good hygiene (practices that improve cleanliness)
• Take steps for cleaner air

People with HIV should also be up to date with their pneumococcal vaccination to protect against pneumococcal diseases, such as pneumonia, meningitis, and bloodstream infections. Pneumococcal pneumonia is a serious flu complication that can cause death. If you’re age 50 or older, talk with a healthcare provider to make sure you’re up to date with pneumococcal vaccination.

What Should You Do if You Think You Have Flu?

If you have HIV and get sick with flu symptoms, contact your health care provider right away.

If you are experiencing difficulty breathing, shortness of breath, and other emergency warning signs, seek medical care right away.

CDC recommends prompt flu antiviral treatment for people with HIV who have flu or suspected flu. These drugs work best when started within 1-2 days after flu symptoms begin and can lessen symptoms and shorten the time you are sick by about a day. Starting antiviral treatment shortly after symptoms begin also can help reduce some flu complications. For adults hospitalized with flu, some studies have reported that early antiviral treatment can reduce their risk of death.

Until you know if you have flu, stay away from others as much as possible or wear a face mask, if you have one. Follow common preventive actions such as washing hands and covering coughs.

If you get a flu diagnosis, stay at home for at least 4-5 days after onset of symptoms. People with flu are most contagious during the first 3 days of illness.

Flu Symptoms vs. Early HIV Infection

Early HIV is the beginning stage of HIV, right after someone gets the virus. It is also called acute HIV. Within 2 to 4 weeks after infection with HIV, about two-thirds of people will have a flu-like illness. This is the body’s natural response to HIV infection. If you are not sure if you have flu or early HIV, ask yourself if you may have been exposed to HIV (such as by having vaginal or anal sex without a condom or medicine to prevent or treat HIV, or by sharing injection drug equipment) within the past few weeks. If so, talk to a healthcare provider.

Certain HIV tests available in healthcare settings can detect HIV as early as 10 days after an exposure took place. By talking with a health care provider about your symptoms and your recent possible exposure to HIV, he or she can make sure you get the proper tests to detect early HIV. Use the HIV.gov Locator to find a provider or HIV testing site near you.

Flu and COVID-19

Flu and COVID-19 are both contagious respiratory illnesses, but they are caused by different viruses. You can have flu and COVID-19 at the same time. Health experts are still studying how common this can be. You cannot tell the difference between flu and COVID-19 by the symptoms alone because they have some of the same signs and symptoms. Specific testing is needed to tell what the illness is and to confirm a diagnosis. Learn more.

According to CDC, you can get a flu vaccine and a COVID-19 vaccine at the same visit if you are due for both vaccines. Learn more.

Remember, getting vaccinated is the best way you can protect yourself against both flu and COVID-19.