Review article: influenza A (H1N1) virus in patients with inflammatory bowel disease

• Published in: Alimentary pharmacology & therapeutics 2010-01, Vol.31 (1), p.5-10
• Main Authors: RAHIER, J.‐F., YAZDANPANAH, Y., VIGET, N., TRAVIS, S., COLOMBEL, J.‐F.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Digestive system; Disease Outbreaks; Gastroenterology. Liver. Pancreas. Abdomen; Human viral diseases; Humans; Immunization Programs; Immunocompromised Host - immunology; Infectious diseases; Inflammatory Bowel Diseases - complications; Inflammatory Bowel Diseases - drug therapy; Inflammatory Bowel Diseases - immunology; Influenza A Virus, H1N1 Subtype - immunology; Influenza Vaccines - therapeutic use; Influenza, Human - complications; Influenza, Human - drug therapy; Influenza, Human - immunology; Medical sciences; Other diseases. Semiology; Pharmacology. Drug treatments; Practice Guidelines as Topic; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Viral diseases; Viral diseases of the respiratory system and ent viral diseases
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/j.1365-2036.2009.04161.x

Summary Background  Infection with influenza A (H1N1)v (swine flu) has caused widespread anxiety, among patients who are potentially immunocompromised, such as those being treated for inflammatory bowel disease. Aim  To provide guidance for physicians and their patients on the risk, prevention and management of influenza A (H1N1)v infection. Methods  Medline was searched using the following key words: ‘swine flu’, ‘immunosuppression’, inflammatory bowel disease’, ‘recommendations’, ‘immunization’, ‘vaccination’. Organizations such as European Centre for Disease Prevention and Control, the Centers for Disease Control and Prevention and the World Health Organization were consulted for recent papers and recommendations regarding immunocompromised patients and influenza A (H1N1)v infection. Results  Pandemic influenza A (H1N1) virus predominantly affects young patients. Those who are immunocompromised because of underlying disease or treatment are considered at higher risk of complications from influenza A (H1N1). They should be offered prevention (vaccination, postexposure prophylaxis) or treatment with antiviral drugs, if affected. Pneumococcal infection is a complication of influenza infection; therefore, pneumococcal vaccination appears advisable. Seasonal influenza vaccination is also recommended. Withdrawal of immunosuppressive treatment appears advisable during severe active infection if possible. Conclusions  Pragmatic advice is the best that can be offered in the current circumstances because of paucity of evidence. Investigation into the impact of influenza A (H1N1)v infection in young people with chronic conditions is needed.