文章基本信息

标题：Pandemic Influenza: Implications for Programs Controlling for HIV Infection, Tuberculosis, and Chronic Viral Hepatitis
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作者：James D. Heffelfinger ; Pragna Patel ; John T. Brooks 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2009
卷号：99
期号：Suppl 2
页码：S333-S339
DOI：10.2105/AJPH.2008.158170
语种：English
出版社：American Public Health Association
摘要：Among vulnerable populations during an influenza pandemic are persons with or at risk for HIV infection, tuberculosis, or chronic viral hepatitis. HIV-infected persons have higher rates of hospitalization, prolonged illness, and increased mortality from influenza compared with the general population. Persons with tuberculosis and chronic viral hepatitis may also be at increased risk of morbidity and mortality from influenza because of altered immunity and chronic illness. These populations also face social and structural barriers that will be exacerbated by a pandemic. Existing infrastructure should be expanded and pandemic planning should include preparations to reduce the risks for these populations. DURING AN INFLUENZA PAN demic, persons with or at risk for HIV infection, tuberculosis, or chronic hepatitis B or C will be particularly vulnerable,¹ not only to influenza^{2 – 7} but also to disruptions in treatment and prevention services. These groups share several vulnerabilities: (1) HIV, Mycobacterium tuberculosis , and hepatitis B and C viruses are transmissible, and disruption of prevention services during a pandemic could increase their transmission; (2) influenza and these illnesses may interact to increase morbidity and mortality; (3) interruptions in treatment of these infections may increase morbidity, mortality, and transmission; (4) these infections occur more frequently among persons challenged by substance abuse, homelessness, mental illness, incarceration, and reduced access to prevention and treatment services^{8 – 12}; and (5) specialty clinics, medical associations, community-based organizations (CBOs), and public health infrastructures that control these infections may be enlisted to address a pandemic, leaving each unable to fully serve their usual clients. In this article, we discuss steps that can be taken by public health programs and health care systems to reduce the risk of influenza illness among persons with or at risk for these conditions and to maintain continuity of care and prevention services for these conditions during a pandemic. The emergence of widespread infection with a novel influenza A(H1N1) virus and the recent pandemic declaration by the World Health Organization¹³ dramatically increase the urgency of considering these issues. We summarize data from the literature and discussions of a panel of experts in influenza, HIV, tuberculosis, and viral hepatitis, convened on May 5, 2008, in Atlanta, Georgia.