Friday 13 March 2020
Following CROI 2020, there continues to be no evidence that people with HIV are at higher risk of COVID-19, or severe disease if affected, and no evidence regarding the impact of viral load or CD4 on either of these.
You may have read that the HIV drug lopinavir/ritonavir (Kaletra) is being studied as a possible treatment for COVID-19 but this is based on very limited evidence for similar viruses. So far there is no good evidence that lopinavir/ritonavir is beneficial, and no evidence that other HIV drugs will help. For anyone taking HIV drugs for treatment or prevention, we recommend continuing to take treatment as recommended, and not increasing the dose or switching to other medications unless otherwise indicated.
There has been one case report published of a man with HIV and diabetes who was hospitalised with COVID-19, treated with lopinavir/ritonavir and who subsequently recovered. However, this provides no further information on the impact of either HIV per se, or lopinavir/ritonavir, on COVID-19: https://onlinelibrary.wiley.com/doi/10.1002/jmv.25732
We continue to recommend following national advice as provided here https://www.gov.uk/guidance/coronavirus-covid-19-information-for-the-public and encouraging people with HIV to ensure they have had their flu and appropriate pneumococcal vaccines (as per BHIVA vaccine guidelines.) We also advise that patients have at least 30-days medication available and sufficient supply to allow for possible travel restrictions or quarantine, if they are planning to leave the UK.
Individual organisations will be making their own contingency plans, and most non-urgent services are being asked to minimise face-to-face appointments. As the set-up and capacity of services will vary significantly, we cannot give specific recommendations, but if people have examples of good practice they wish to share, BHIVA can facilitate this. Sensible steps include updating your website if you have one, using out-of-office replies to direct patients to appropriate advice and ensuring all patient-facing staff are aware of the latest national information and guidance.
We advise against prescribing longer than usual medication supplies as stocks can be fragile at any time. Please also note, for those of you based in England, NHSE have instructed us to avoid signing new people up to Homecare as they need to focus on maintaining current capacity.
As things stand, we intend to go ahead as planned with the BHIVA Spring conference at the end of April. It is likely that we will know more about the impact of the coronavirus epidemic in the UK by the end of March / beginning of April. We will continue to monitor the situation and official advice.
In the event of public health measures such as travel restrictions or a ban on large public events, affected registrants will receive a full refund of their registration fee. We will update the website in response to further developments. Please check the website regularly for updates about our plans.