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Comment from BHIVA and THT on UK Government Guidance on Coronavirus (COVID-19), Social Distancing to Protect Vulnerable Adults and Shielding to Protect Extremely Vulnerable Adults

Published 23 March 2020

Monday 23 March 2020

Extremely vulnerable populations and shielding

The British HIV Association (BHIVA) and the Terrence Higgins Trust (THT) have updated their 16 March 2020 statement on social distancing for people with HIV in the light of the latest UK Government Guidance, led by Public Health England (PHE) and the Department of Health & Social Care (DHSC), on ‘extremely vulnerable’ populations.

There remains no evidence to determine whether people with HIV are at greater risk of COVID-19 acquisition so people with HIV are not considered ‘extremely vulnerable’ and do not need to undertake ‘shielding’ unless they have one of the conditions listed in this guidance: We advise that patients with a CD4 less than 50, or people who have had an opportunistic illness within the last 6 months, should follow the shielding advice for the extremely vulnerable.

Social distancing

The previous guidance from Public Health England (PHE) on Social Distancing for Vulnerable Groups remains valid and includes people with a ‘weakened immune system as the result of HIV’: Based on the EACS and BHIVA statement from 20 March 2020 we advise that people not on ART or with a CD4 count less than 200 should follow social distancing advice stringently.

In summary:

1) People with a CD4 count <50 or opportunistic illness in last 6 months: follow shielding advice for extremely vulnerable;

2) People with CD4 <200, detectable viral load or not on ART: follow social distancing advice stringently;

3) People with CD4 >200 and undetectable on ART: follow general population advice (ie social distancing).

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