Duration: 3min 41 sec

KHOPOTSO: Influenza is a viral infection that can be prevented by vaccination. Until recently there has been controversy over the efficacy of the flu vaccine in persons living with HIV. Professor Barry Schoub is the Director of the National Institute for Communicable Diseases, in Johannesburg.

PROF. BARRY SCHOUB: There was an observation that immediately after vaccination that the viral load increased. The reason for that is that when you get the vaccine you stimulate the immune response. That’€™s the whole purpose of the vaccine. And in doing so, you stimulate the CD 4 cells, which are the kind-of pilot cells of the immune system. At the same time those are the cells that the HI virus infects, and because of that there’€™s an increase in the amount of the HIV virus, which is produced in the blood-stream. That’€™s why the viral load goes up. It’€™s a very temporary phenomenon and it’€™s not related at all to the progression of the disease. So, that has really been laid to rest.

KHOPOTSO: Dr Dave Johnson is a Johannesburg-based family physician who specialises in HIV treatment.

Dr DAVE JOHNSON: Vaccines are very effective, although in HIV they may have slightly less effectivity because of the decrease in immunity and you need a good immune response to be able to get a good response to a vaccine’€¦ As the immune system deteriorates to certain levels there is a less effective response to any vaccine, whether it be the flu vaccine or another vaccine. And so, we may not get as adequate a response. But if we give the vaccine and we don’€™t get a stronger response as if their immune system were normal it may however, not prevent flu, but if they were to get flu it would be a less severe illness.

KHOPOTSO: Dr Johnson adds that even though it doesn’€™t offer a fool proof guard against the flu, vaccination is a medically sound option.

Dr DAVE JOHNSON: If we don’€™t vaccinate and they do get the flu, it’€™s a more protracted illness with a more severe impact on the immune system and therefore, a more severe loss of CD 4 cells and a more rapid progression of disease versus just the vaccine itself.

KHOPOTSO: It’€™s advisable that if someone is HIV-positive, with a CD 4 count less than 500 they should consider having a flu vaccine.

As Prof. Barry Schoub of the National Institute for Communicable Diseases explains, vaccination could spare them from certain flu-related complications.

PROF. BARRY SCHOUB: The Influenza virus itself can cause ‘€“ the most important one – pneumonia, which is an infection of the lung. Now, the virus itself can cause pneumonia without any other opportunistic infections. Or alternatively, it damages the lining of the lung and that makes a person susceptible to other infections and particularly, bacterial infections. So, what often happens is that one starts off with an Influenza infection and therefore, be subsequently complicated by a bacterial pneumonia. We can have one of two scenarios: Either a direct viral infection or viruses followed by a bacterial pneumonia. And that’€™s the most common important complication of Influenza.

KHOPOTSO: At risk of the flu are also people with diabetes, the elderly and the very young or those on immuno-suppressive therapy after undergoing a renal transplant. The benefits of vaccination are currently limited to a section of the South African population as the service is not available freely in the public health sector. Even though a flu shot is not prohibitively expensive at about R50 once a year, not everyone is able to afford it.

If you have R50 to spare, right about now is the time to head off to your pharmacist or doctor to ask for that prick that could save you from the coughs and the sneezes or even worse. In addition to vaccination and curative treatments doctors recommend good nutrition and plenty of exercise to keep at bay the flu bug this winter.  

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