Systematic review: influenza A (H1N1) virus in patients with inflammatory bowel disease

Jean-Francois Rahier (1) , Yazdan Yazdanpanah (2) , Nathalie Viget (2) , Simon P L Travis (3) , Jean-Frédéric Colombel (4)

1 Service d'Hépato-gastroentérologie
2 Service Universitaire des Maladies Infectieuses et du Voyageur
3 Gastroenterology
4 Service d'Hépato-gastroentérologie

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. Aims: 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' . The ECDC, the CDC and the WHO 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 due to underlying disease or treatment are considered at higher risk of complications from influenza A (H1N1). They should be offered prevention (vaccination, post-exposure prophylaxis), or treatment with antiviral drugs if affected. Pneumococcal infection is a complication of influenza infection, so pneumococcal vaccination appears advisable. Seasonal influenza vaccination is also recommended. Withdrawal of immunosuppressive treatment appears advisable during severe active infection. Conclusions: Pragmatic advice is the best that can be offered in current circumstances, owing to the paucity of evidence. Investigation of the impact of influenza A (H1N1)v infection in young people with chronic conditions is needed.

Mots clés: Medicine

Jean-Francois Rahier, Yazdan Yazdanpanah, Nathalie Viget, Simon P L Travis, Jean-Frédéric Colombel. Systematic review: influenza A (H1N1) virus in patients with inflammatory bowel disease. Alimentary Pharmacology and Therapeutics, 2009, 31 (1), pp.5. ⟨10.1111/j.1365-2036.2009.04161.x⟩. ⟨hal-00524478⟩