Swine flu: A deadly cocktail of Human Influenza A and HIV?

Syed Akbar
Hyderabad, June 17: With swine flu gradually turning deadly in many parts of the world, health experts and scientists fear that a mix of swine flu virus with human immunodeficiency virus (HIV) may lead to a cocktail of a severely potent viral strain that could wreak havoc.

The HIV-H1N1 co-infection risk is more in Andhra Pradesh as it has a large number of people living with HIV. The State has 5.4 lakh HIV positive cases, the highest number for any State in India. Since half of the 31 swine flu cases reported in the country are from Hyderabad and other parts of the State, any lax on the part
of health and quarantine authorities may spell a doom.

Since people with HIV have suppressed immunity, it takes quite a long period for swine flu virus to subside. The virus may develop into a potent viral strain by being a co-pathogen with the human immunodeficiency virus.

"People suffering from HIV, particularly those with low CD4 cell counts in their blood, are at higher risk of contacting swine flu. While swine flu may not develop pneumonia in ordinary people, chances are higher among people living with HIV," warns senior researcher Dr MN Khaja, who formed part of the team that
sequenced Hepatitis C virus.

Moreover, the swine flu or novel influenza A (H1N1) virus may emerge into a more potent viral strain in PLWH as in the case of tuberculosis bacteria. The TB bacteria has turned more potent in people with TB and HIV co-infection, causing resistance to available drugs.

"Though we do not have sufficient research data on H1N1 and HIV co-infection and how severe the human influenza virus would behave in people with low or compromised immunity, the World Health Organisation and the Centers for Disease Control and Prevention, USA, have preliminary data that suggests the severity of the problem. The virus may turn more lethal and a new strain may emerge in HIV hosts," Dr Khaja told this correspondent.

Health officials point out that adults and adolescents with HIV infection are known to be at higher risk for viral and bacterial lower respiratory tract infections and for different types of recurrent pneumonia. Evidence that influenza can be more severe for HIV-infected adults and adolescents comes from studies among HIV-infected persons who had seasonal influenza.

The novel influenza A virus has been found to be sensitive to the neuraminidase inhibitor anti viral medications zanamivir and oseltamivir. But whether it works in people living with HIV is not yet clear.