Zorg voor mensen met hiv in de eerste lijn: samenvatting van een multidisciplinaire richtlijn

Abstract

The management of people living with HIV in primary care: summary of a multidisciplinary guideline HIV infection has evolved from a lethal to a chronic condition thanks to antiretroviral therapy (ART). General practitioners (GPs) provide care to patients with chronic conditions in collaboration with specialist care and are thus supposed to integrate, together with the HIV reference centre (HRC), certain aspects of the medical follow-up of patients living with HIV into their daily practice. This article is a summary of the recent guideline for the care of people living with HIV in primary care. It describes, besides the context and the conditions for the post-test counselling interview after the confirmation of the positive HIV diagnosis and during the follow-up consultations, the 3 main components in the care of patients with HIV: linkage to care, retention in care and adherence to ART, and how GPs can support patients in this. In addition, GPs have the task to monitor the overall health of patients living with HIV (basic vaccinations, comorbidities, risk factors, screening programmes, drug interactions with ART), as well as the HIV-specific aspects, such as vaccinations to prevent the risk of co-infections (hepatitis A virus, hepatitis B virus) and avoid infections (pneumococcal, influenza, COVID-19, HPV) where they are at a higher risk of complications. The sexual and reproductive health of patients with HIV can be monitored in primary or secondary care, according to the patient’s preference. The care of patients living with HIV is a joint responsibility of the GP and the HRC. The guideline clearly indicates when referral to the HRC is necessary.