HIV-seropositive individuals should receive IAV vaccination each year.

IAV treatment may reduce secondary transmission in HIV-seropositive individuals, regardless of symptoms and treatment of index cases may be considered as a preventative measure

Antiviral prophylaxis is not routinely required in HIV-seropositive individuals exposed to IAV. For individuals who are (1) significantly immunosuppressed (CD4 T-cell count <200 cells/mL), (2) have not received vaccination or are believed to be at significant risk of vaccine non-response due to either immunosuppression or recent administration and (3) have been exposed within the last 48 h, antiviral prophylaxis may be considered.

Prophylaxis regimens

  • Oseltamivir 75 mg od for 10 days
  • Inhaled zanamivir 10 mg od for 10 days may be considered in more significantly immunosuppressed individuals or in the presence of oseltamivir-resistance

Some authorities recommend doubling the dose of these agents to treatment doses for 10 days in more severely immunocompromised individuals.

This area, like treatment recommendations discussed above, changes from year to year therefore practitioners are referred to national guidance on IAV management. In the UK these guidelines are provided by Public Health England