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VIRAL LOAD, FLU, and FLU SHOTS
Oct 20, 2006

Hey Dr. BOB

I know it's probably not a good thing to get the flu if we've already got HIV, right? But I just heard that getting a flu shot will make my HIV viral load sky-rocket! That scares me. Should we aviod the flu shot or not? I'm so confused. You are the only one who seems to explain things to us. Help!!!! Love, Zorba

Response from Dr. Frascino

Hey Zorba,

Here's the scoop. When flu or any germ for that matter gains access to your body, your body's frontline soldiers and defense mechanisms the infection-fighting immune cells get turned on (activated) to battle the unwanted invader. Activated CD4 cells, as it turns out, are more prone to HIV infection than "resting" CD4 cells. Once a CD4 cell becomes infected it acts like a viral factory and produces loads and loads of new HIV. Consequently, your viral load goes up. However, it's important to note many studies have demonstrated this rise in viral load is transient and returns to baseline within four weeks or so. If you are on HAART (highly active antiretroviral therapy), there's a good chance your viral load won't bump at all.

As for the flu shot, well it's a vaccine an inactivated version of the flu virus itself. It works by giving your immune system a test run, a training exercise if you will, for fighting the real flu virus. Once this training exercise is complete, your immune system is primed to recognize and defeat the actual thing (flu virus) when and if you are exposed to it. Vaccination specifically activates your immune system, including the CD4 cells, but at a significantly lower level than a full-fledged infection. Consequently the viral load bump associated with vaccines is considerably less than that seen with the real deal. The take-home message is: get vaxed! And now is an ideal time for flu vaccination, by the way. So roll up that sleeve; it's time to feel a little prick.

Stay well.

Dr. Bob


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