Friday 15 May 2020
In response to questions from the HIV community on what to expect, and what to do, if you are an HIV positive person who is admitted to hospital with COVID-19, the British HIV Association (BHIVA) has given the following advice to answer the main points that have been raised.
We strongly recommend you tell the health care team looking after you about all your medical conditions, including HIV. This is to ensure that you get the right medication and the right tests. For example, if you have a low CD4 count, there are lung infections that cause symptoms very similar to COVID-19 but these could be missed if the right tests are not done.
Absolutely yes! It is a good idea to have a list of your medications with you so they can be prescribed as soon as possible if you are admitted. Take a picture of the packaging on your phone if that helps. Keeping your viral load undetectable and your immune system stable will maximise your ability to fight COVID-19. Also, if you stop your medication, your viral load will rise and a risk that your HIV will develop resistance to some of the medication, and that you will develop new symptoms. Finally, if you stop taking meds, your CD4 may drop very quickly, especially if you have COVID-19, which puts you at risk of HIV-related illnesses.
If you are so unwell that you cannot eat you will be fed by a tube through your nose. Some HIV meds can be crushed and dissolved, and some are available as liquids. There is BHIVA guidance on this in our joint statement with the Intensive Care Society (reference 1.)
Although some HIV medications are being studied to treat or prevent COVID-19, there is no evidence yet that they work. Studies so far for the HIV drug lopinavir/ritonavir (brand name Kaletra) have not shown any benefit for people hospitalised with COVID-19. There is no good evidence that tenofovir/emtricitabine (brand name Truvada), which is also used for PrEP, is effective either. You should continue to take your HIV treatment (or PrEP) as directed by your clinic, do not take more than recommended and, unless there is another reason (such as side effects), you should not switch your HIV treatment.
Absolutely not! There are no fixed 'rules' and if you have HIV you will be assessed in exactly the same way as anyone else. When people are sick enough to need intensive care they are assessed on an individual basis as to whether that is the best course of action. This will depend on how sick you are, your usual level of health and your own wishes.
For the latest advice on HIV and COVID-19 check the BHIVA website COVID-19 section, which is updated regularly. This includes a Q&A on COVID-19 and HIV, 19 March 2020 (reference 2); a directory of HIV community support services across the UK available during COVID-19, which is regularly updated (reference 3); a statement from EACS and BHIVA, 30 April 2020 (reference 4); and advice for HIV clinicians, GPs and people living with HIV, 23 April 2020 (reference 5.)
For further information, please contact Jo Josh +44 (0)7787 530922 or email [email protected].
3. Directory of COVID-19 support services from HIV community organisations
Monday 27 April 2020
4. EACS & BHIVA Statement on risk of COVID-19 for people living with HIV (PLWH)
Thursday 30 April 2020
5. COVID-19 & shielding: advice for HIV clinicians, GPs and people living with HIV
Thursday 23 April 2020