Rifampin: potent CYP3A4 inducer — contraindicated with most boosted PIs and cobicistat
Use with InSTI requires DTG 50 mg twice daily dose doubling
Methadone: minimal interaction with InSTI-based regimens
Patient Discharge Instructions
copy discharge instructions
What is HIV and what happens now
HIV (Human Immunodeficiency Virus) attacks your immune system over time
With medication (ART — antiretroviral therapy), most people with HIV live a long, healthy life
The virus is NOT curable but is very controllable with daily medication
You were diagnosed with HIV today — this is a medical condition you can manage
Taking your medication every day is the single most important thing you can do
Your medication
Take your HIV medication (antiretroviral therapy) every day as prescribed
Never stop or skip doses without talking to your HIV doctor first
Stopping medication can allow the virus to become resistant and harder to treat
If you have side effects (nausea, headache, fatigue), they usually improve after 1–2 weeks
Contact your HIV clinic or pharmacist before stopping the medication
Follow-up appointments
HIV clinic appointment: within 1–2 weeks — this is critical
Blood tests (viral load and CD4 count) will be repeated at this visit
If you cannot get an HIV clinic appointment: return to the emergency department
Take your prescription immediately to the pharmacy — do not wait
Protecting others and yourself
HIV can be transmitted to sexual partners — use condoms until you are virally suppressed
"Undetectable = Untransmittable" (U=U): once your viral load is undetectable for 6 months, transmission risk is negligible
Do not share needles, syringes, or drug equipment
Tell sexual partners you have been exposed — they can be tested and start PEP if needed (within 72 hours of exposure)
HIV is NOT transmitted by casual contact: hugging, sharing food, toilets, or coughing
Return to the emergency department immediately if
Severe headache with stiff neck or sensitivity to light
Vision changes, floaters, or sudden vision loss
Confusion, memory problems, or weakness on one side of the body
Difficulty breathing or chest pain
Fever above 38.5 C that does not improve
Inability to swallow or severe throat pain
New rash, especially with blistering
Nausea or vomiting preventing you from taking your medication for more than 24 hours
Resources
AIDSinfo hotline: 1-800-448-0440
Ryan White HIV/AIDS Program for medication assistance: hrsa.gov/ryan-white-hiv-aids-program
CDC HIV resources: cdc.gov/hiv
References
Guidelines and key sources
DHHS Antiretroviral Therapy Guidelines 2024
Gulick RM, Pau AK, Agwu A, et al. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents With HIV. Office of AIDS Research Advisory Council, 2024
Benson C, Brooks J, Dhanireddy S, et al. Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents With HIV. IDSA/OARAC, 2025
White DAE, Giordano TP, Pasalar S, et al. Acute HIV Discovered During Routine HIV Screening With HIV Antigen-Antibody Combination Tests in 9 US Emergency Departments. Ann Emerg Med, 2018
PMID: 29310870
Acute HIV clinical features
Robb ML, Eller LA, Kibuuka H, et al. Prospective Study of Acute HIV-1 Infection in Adults in East Africa and Thailand. N Engl J Med, 2016
NEJM doi: 10.1056/NEJMoa1508952
Crowell TA, Colby DJ, Pinyakorn S, et al. Acute Retroviral Syndrome Is Associated With High Viral Burden, CD4 Depletion, and Immune Activation. Clin Infect Dis, 2018; PMID: 29228130
Immunocompromised host pneumonia
Cheng GS, Crothers K, Aliberti S, et al. Immunocompromised Host Pneumonia: Definitions and Diagnostic Criteria: ATS Workshop Report. Ann Am Thorac Soc, 2023
PMC9993146
Sepsis in immunocompromised patients
Deinhardt-Emmer S, Chousterman BG, Schefold JC, et al. Sepsis in Patients Who Are Immunocompromised: Diagnostic Challenges and Future Therapies. Lancet Respir Med, 2025
PMID: 40409328
Pediatric and STI references
Pediatric HIV ART guidelines 2024
Hazra R, Melvin AJ, Paul ME, et al. Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection. OARAC, 2024
ncbi.nlm.nih.gov/books/NBK586303
STI treatment guidelines
Workowski KA, Bachmann LH, Chan PA, et al. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep, 2021
PMC8344968
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.