Influenza
What is it? Influenza is caused by a virus which may lead to mild flu-like symptoms or severe life-threatening pneumonia. In Hong Kong there are 2 influenza seasonal peaks per year during which extensive spread of the virus may occur. HIV infection may predispose to more severe diseases with influenza.
Treatment: Antivirals may be indicated.
Prophylaxis: Yearly vaccination advised.
COVID-19
What is it? COVID-19 is a respiratory infection caused by SARS-CoV-2, a virus similar to that causing SARS in 2003. Fever, pneumonia and tiredness are the common presenting symptoms. The virus is easily transmitted through droplets and close contacts with infected persons and contaminated environment. Progression to severe diseases may occur leading to death. People living with HIV have a higher risk of severe diseases.
Treatment: Antivirals and steroids may be used depending on the condition and indications.
Prophylaxis: Vaccination is strongly advised
Pneumococcal disease
What is it? Diseases caused by a bacteria called pneumococcus. HIV+ patients are more prone to pneumococcal diseases. Pneumonia is the common disease though the infection can also affect brain lining causing meningitis and septicaemia.
Treatment: Antibiotics.
Prophylaxis: Vaccination is advised. There are 2 forms of vaccine PCV13 and PPSV23. Unvaccinated persons should receive PCV13 followed by PPSV23 at least 8 weeks later.
Pneumocystis pneumonia (PCP)
What is it? Commonest opportunistic fungal infection caused by Pneumocystis jirovecci that often occurs as the first infection alerting HIV patient of the underlying immunodeficiency. Pneumonia is the common clinical presentation. The risk of infection is low when one’s CD4 improves after antiretroviral treatment.
Treatment: Anti-microbial medicine treatment; may need steroid.
Prophylaxis: Co-trimoxazole (Septrin) may be used for prophylaxis if the CD4 count is below 200/uL
Tuberculosis (TB)
What is it? A very common respiratory infection in Hong Kong. HIV patients may have atypical presentation because of the underlying immunodeficiency. Reactivation disease may occur because of the poor immune defence.
Treatment: Treatment involves the use of multiple antibiotics for extended duration.
Prophylaxis: To prevent reactivation, patient with latent infection requires a course of antibiotics for up to nine months. Latent TB is diagnosed by a skin test or a special blood test called IGRA.