Patients with HIV consult their GP on a similar scale to the wider population, a large retrospective cohort study has found.

The study used data from the UK General Practice Research Database (GPRD), which involved 348 practices, yielding 5,504 person-years of follow up for known HIV-positive individuals.

Using the data that were available for a total of 1,438 men and 751 women recorded as HIV positive, the following were estimated: GP and nurse consultation rates for HIV patients compared with rates for the GP-registered population; the cost of GP and nurse consultations; consultation rates for selected morbidities and the proportion of prescriptions in 2005 that included a medication considered to present potential for serious adverse interactions with HIV medications.

Consultation rates started to decline in the late 1990s with the introduction of highly active antiretroviral therapy (HAART) from 5.0 and 7.3 consultations per person-year in men and women respectively in 1995 to 4.2 and 5.2 respectively in 2005. The rates appeared to converge to those similar to the wider population.

The cost of consultation decreased from £212 in 1995 to £117 in 2005 for female HIV patients. For male HIV patients, the cost decreased from £147 in 1995 to £86 in 2001 but increased to £100 in 2005.

HIV patients consulted GPs for a range of conditions; most commonly for respiratory problems (average 240 per 1,000 person-years. In this sample, 37% of men and 27% of women in 2005 had symptoms or diagnoses of mental health problems recorded.

In all, 17% of prescriptions given to HIV-positive individuals in 2005 were considered to have a major potential to interact with HIV medications. 

The authors conclude that HIV-positive individuals who are known to their GPs consult primary care at a similar rate to the general population. They also suggest that GPs could play a major role in maintaining the health of such individuals. At the same time, there is considerable potential for interactions between prescriptions given in primary care and HAART.

This is yet another paper that demonstrates that HIV patients do consult their GPs.

GPs should feel confident that they can manage the primary care of HIV patients especially if the disease is well controlled, and they have up-to-date information on the disease markers such as CD4 count and viral load, as well as current HAART medications; as long as this information is available, potential serious drug interactions can be kept to a minimum.

Dr Richard Ma