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Scenario: Hayfever and HIV

Counter assistant Melissa, who has been talking to a customer, hands Parveen a piece of paper. It lists two drugs – Combivir and efavirenz...

The man at the counter is asking for a hayfever product,” Melissa explains. “My hand was hovering over the steroid sprays after he’d described his symptoms but then I asked if he takes any other medication and he handed me this.” “OK,” says Parveen. “Can you ask him to take a seat – in the consultation room if he’d prefer – and I’ll be out to talk to him in a minute. And can you get me the iPad please?”

Answer

The drug names on the piece of paper Melissa has handed to Parveen reveal that the customer asking for hayfever products has the human immunodeficiency virus (HIV). The antiretroviral drugs used to manage the condition interact with a lot of medicines, including those OTC remedies used to treat hayfever.

Parveen needs to find out exactly what the patient is on and then check for interactions. The easiest way to do this is by using the website set up and maintained by the University of Liverpool at hiv-druginteractions.org/checker.

The bigger picture

When HIV and AIDS first became widely known in the 1980s, matters were helped by a hard-hitting awareness campaign that featured gravestones and the tagline, “Don’t die of ignorance”. The advertisements had a profound effect, causing a significant decrease in the number of all sexually transmitted infections, but their rather severe nature also resulted in many people developing a deep rooted belief that HIV is a death sentence.

In fact, many people with HIV live long and healthy lives, thanks to early diagnoses and careful management using antiretroviral drugs that stop the virus replicating and allow the immune system to stay strong.

However, many of these medicines have a large number of interactions, with OTC, prescribed and recreational drugs, so it is important to check before issuing or recommending any medicine to anyone in this patient group.

Extend your learning

• An overview of the principles of treatment and the drug classes used in HIV is given in the British National Formulary. The relevant section is available online at medicinescomplete.com/mc/bnf/current/PHP78275-hiv-infection.htm
• Patients with HIV may refer to their medication by shape or colour rather than name, so print off the sheet at aidsmap.com/flipbook/file/1213110/drug_chart_Sep_2016_WEB_ready.pdf
so you have a prompt to help you during consultations
• The over-50s are now the fastest-growing group of people living with HIV, but are also likely to experience problems such as loneliness, social care issues and financial struggles. Find out more about this by clicking on the links at: tht.org.uk/myhiv/Staying-Healthy/Health-Wealth-and-Happiness.

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