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Bacterial Infections
Aug 16, 2008

Hi Dr. Frascino:

Are upper respiratory bacterial infections an indication that a persons CD4 count is droping? How is it possible for a person living with HIV who has received a flu and pneumonia vaccine and on antiviral drugs (Atripla) with <50 VL still able to get a bacterial/viral infection?

Response from Dr. Frascino

Hi,

Are upper respiratory bacterial infections an indication a person's CD4 count is dropping? No, not necessarily. Lots of folks with perfectly normal immune systems get upper respiratory infections, both bacterial and viral.

How is it possible that an HIVer who has received flu vaccine and pneumococcal vaccine (Pneumovax) and is also on antiretroviral drugs (VL <50) still acquires bacterial/viral infections? The reason is that vaccines are very specific. The flu vaccine protects you from influenza, one type of viral respiratory infection. There are many, many more viral respiratory infections that being vaccinated with Fluvax would not protect you from, the "common cold," for instance. The same holds true for the pneumococcal vaccine. It protects you from one type of bacterial infection (pneumococcal), but offers no protection against other types of bacterial infections.

Dr. Bob


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