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GPs are wrongly being alerted to take HIV patients off antivirals

GPs and practice nurses are wrongfully being told to advise patients with HIV to stop taking their medication after receiving the flu jab.

EMIS Health said it was is urgently working to update systems after users highlighted the problem, which came about due to ‘ambiguity’ in available clinical guidance.

The EMIS Web alert suggests patients should not be taking antiviral medication for two weeks around receiving the flu vaccine.

The clinical desicion support alert, based on guidance from the British National Formulary, says: ‘Avoid antivirals for at least two weeks after immunisation; avoid immunisation for at least 48 hours after stopping the antiviral.’

An EMIS update said that ‘upon further investigation it has been noted that the interaction relates only to antivirals used for influenza treatment’.

It went on to advise that ‘in all cases, if there is any doubt over the use of vaccines in patients requiring antiviral treatment, then advice should be sought from the communicable disease consultant’.

An EMIS Health spokesperson told Pulse: ‘Like all GP clinical systems in the UK, EMIS Web’s decision support tools use guidance from BNF drug monographs. We implemented guidance from the BNF on antivirals and influenza vaccines in a recent drug alert.

‘Last week, some of our users identified that the BNF guidance was ambiguous. We contacted the BNF to inform them, and took immediate steps to remove the BNF alert and advise our customers via our online support platform.We are urgently rolling out the update to our customers this week.’

Dr Melanie Rosenvinge, consultant in HIV medicine at Lewisham Hospital, said she was alerted to the issue by a patient and a GP colleague. 

She told Pulse: ‘We had one patient who was told by her GP to stop her medicines, but she is quite an assertive, intelligent sort of patient so she smelled a rat and rang us. We said no, no, no, don’t change your medicines. 

‘While she didn’t stop her antiretroviral she could have done. A number of our patients would trust what their doctor told them in their GP surgery, and they would just do that. We were fortunate.’

According to Dr Rosenvinge, if the same advice has been given to more patients the ‘ramifications could be huge’.

She said: ‘If you stop antiretroviral drugs for two weeks, you could get resistance to your medicines. You could get very ill.’

A spokesperson for SystmOne, the most commonly used GP IT system provider alongside EMIS, said: ‘I can confirm SystmOne is not affected by this issue as our decision support tools use data from FDB Multilex, not the BNF.’


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