Important Information About COVID-19 Treatment For People Living With HIV – December 2021

COVID-19 has now been around for nearly 2 years. As time goes by and we learn more about the COVID-19 virus, the information we have about the best care for people living with HIV during the pandemic may change.

We also learn about why things go wrong and how sometimes the messages seem mixed. For example, some people with HIV were advised to shield early in the pandemic because their records suggested they were immunocompromised – when actually only some people with HIV (e.g. those with a low CD4) really needed to shield. We have seen a similar thing happen with regards to invitations for 3rd doses of the COVID vaccine – not all people living with HIV need to have this 3rd dose, although everyone should have a booster dose.

We have produced this information page to provide you with the latest advice on COVID vaccinations and treatment of COVID, if you are living with HIV.

COVID Vaccinations

All people with HIV are strongly recommended to have COVID-19 vaccines, in line with the national vaccination programme.

In England, people who have not had a vaccine are 5 times more likely to die from COVID than people who are fully vaccinated.

Some people living with HIV are also recommended to have a 3rd vaccine. This is different to a booster dose – it is an extra vaccine. People who have a 3rd vaccine should have a booster dose as well.

You will be eligible for a 3rd vaccine if:

– You have or have had a CD4 count of less than 200 in the last year

– You have a recurrent or persistently detectable viral load

– You have a current illness linked with a low immune system, such as tuberculosis or conditions know to occur in AIDS.

– You are not taking medication for your HIV infection (except long-term non-progressors).

A 3rd vaccine can be given 8 weeks after your 2nd COVID vaccination.

A booster dose can be given 12 weeks after your 3rd COVID vaccination, or 12 weeks after your 2nd COVID vaccination (if you do not need a 3rd vaccine).

Treatment For COVID Infection

Treatment in the community:

Thankfully, most people who get COVID recover fully without the need for treatment or admission to hospital.

From 16th December 2021, the NHS will be using new treatments for coronavirus which will be given to people most likely to have serious complications from COVID infection. These treatments will be prescribed by GPs or COVID medicine delivery units, and need to be given quickly after you start to feel unwell. They can stop you from getting seriously ill.

Some people living with HIV may be eligible for these treatments.

You are eligible if:

  • You have symptoms or COVID, with a positive COVID PCR test within the last 5 days

AND

  • You are a member of a high-risk group, which includes the following:

– Uncontrolled or untreated HIV or acute AIDS defining diagnosis

– On treatment for HIV, but with a CD4 less than 350

– On treatment with CD4 more than 350, but also have additional risk factors (e.g age 55 or older, on treatment for diabetes, obesity, heart failure, liver cirrhosis, kidney disease, homelessness or alcohol dependence).

If you are not sure if you are eligible, please contact us at Gateway Clinic on 0800 055 6442.

Most people who might benefit from community treatment of COVID-19 will receive a letter directly from the NHS. However, not all people living with HIV will be contacted in this way (for example, if your GP is unaware of your HIV infection, or it has not been coded on your GP record, then you will not get a letter).

As with the initial shielding advice though, we also know that some people may be contacted by the NHS but then be told they are not eligible. This will happen because the system cannot separate out those people living with HIV who have a good immune system and those who have a poor immune system.

If you meet the criteria for community treatment of COVID-19, you should:

1. Have a PCR test kit ready at home.

2. Take a PCR test if you get COVID-19 symptoms.

3. If the PCR test confirms that you have COVID-19, the NHS will call you to tell you how you might get a treatment.

1. Have a PCR test kit ready at home :

Some people who have HIV will be sent a PCR kit directly. If your GP doesn’t know about your HIV status, then this will not happen.

Call 119 for advice, selecting the option for Test & Trace, if:

  • You have not received a PCR test by 10 January 2022
  • You get symptoms of COVID-19 before your PCR kit arrives
  • You lose your PCR test or it has any damage/missing parts.

2. Take a PCR test if you get COVID-19 symptoms :

Use your PCR test if you develop any COVID-19 symptoms, even if they are mild; a high temperature, a new continuous cough (coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours), a loss or change to your sense of smell or taste.

If you get COVID-19 symptoms and don’t have a PCR test kit at home, you can still get a PCR test – phone 119 or visit https://www.gov.uk/get-coronavirus-test.

3. If the PCR test confirms that you have COVID-19 :

If the PCR test shows that you are positive for COVID-19, the NHS will contact you within 24 hours to arrange a telephone appointment with a health professional. If you are not contacted about treatment within 24 hours of your positive PCR test result, please contact your GP surgery or call 111. They can make an urgent referral.

Treatment In Hospital:

If you need to go to hospital because you become unwell with COVID infection, we strongly recommend you tell the healthcare team looking after you about all your medical conditions, including HIV. Please ask the hospital staff to contact Gateway Clinic to let us know that you are in hospital.

People living with HIV are entitled to the same care as anyone else for COVID-19, but sometimes we may need to make adjustments – for example, we may need to temporarily change your anti-retroviral therapy (ART) to avoid interactions with other drugs.

We hope you remain free of COVID-19. Please contact us at the clinic (0800 055 6442) if you have any concerns about anything on this page.