Clinical manifestations of influenza in HIV-infected individuals

Although influenza vaccination is recommended for individuals with HIV infe ction, there are no data indicating an increased incidence or severity of i nfluenza in this population. We sought to describe the clinical manifestati ons and morbidity of influenza in HIV-infected patients. All cases of influ enza occurring in HIV-infected individuals over 3 years at a large county h ospital were reviewed. Forty-three cases of influenza were diagnosed. Most patients presented with typical signs and symptoms of influenza, including cough (90%), myalgias (64%), and fever (52%). Sore throat and headache occu rred in less than half of patients. The mean CD4 cell count and HIV viral l oad in patients with influenza was 340 cells/mm(3) and 3.34 log copies/ml, respectively. No significant differences in CD4 counts or viral loads were noted in patients with pneumonia (n=7) compared with patients without pneum onia (n=36), P > 0.5. Six patients were hospitalized. One patient each had encephalitis and renal failure, although the relationship to influenza was not clear. No new or unusual clinical manifestations were observed. The rat e of pulmonary complications was similar to other studies in HIV-negative p atients; however, the hospitalization rate was higher than commonly seen in HIV-negative individuals.