General Practitioners play a vital role in supporting the health and wellbeing of people living with HIV. With advances in treatment, individuals diagnosed with HIV can lead long, healthy lives and primary care is increasingly central to their ongoing wellbeing. This leaflet covers vaccinations, cardiovascular disease prevention, cervical screening and drug-drug interactions.

Vaccinations:

• Annual flu vaccination is recommended for all people living with HIV (PLWH).
• Pneumococcal vaccine:
  • A single dose of PCV-13 (Prevenar-13) is recommended, regardless of CD4 count.
  • Patients meeting additional national pneumococcal vaccination criteria should also receive a single dose of PPV-23.
  • Ensure a minimum three-month interval between PCV-13 and PPV-23.
• Shingles vaccine:
  • If indicated, use Shingrix (recombinant vaccine) instead of Zostavax (live attenuated vaccine).
• Covid-19 vaccine:
  • Offer to all PLWH as per BHIVA guidance:
    • Those with CD4 <350 cells/mm³ or detectable viral load may have lower responses; additional 3rd and 4th doses are strongly recommended.
    • Spring boosters should be administered six months after the previous dose.

Cardiovascular disease (CVD) prevention: BHIVA recommends all PLWH aged 40 or above be offered atorvastatin 20 mg once daily for primary CVD prevention, regardless of lipid profile or estimated CVD risk.

Cervical cytology: Invite all HIV-positive female patients for annual cervical screening.

Drug-drug interactions: Many medications interact with ART, sometimes significantly.

• Notable interactions (non-exhaustive):
  • Statins, especially simvastatin
  • Corticosteroids (inhaled, intranasal, injectable, oral)
  • Oral contraceptives
  • Macrolide antibiotics
  • Acid suppressants (PPIs and H2-antagonists)
• To reduce risks:
  • Include the patient's HIV medication history in all referrals and on the Summary Care Record.
  • Consult the HIV Specialist Pharmacist Team for advice:
    • kchft.sh-pharmacy@nhs.net
    • kchft.pharmacycloverstreet@nhs.net
    • www.hiv-druginteractions.org

Find out more about the person-centred treatment and care we offer to people living with HIV in Medway, East Sussex and east Kent and more information on living well with HIV at our Living with HIV page.