Question

What should HIV positive people do if hospitalised with COVID-19

26 May 2020. Related: All topics, COVID-19.

Hi

I am HIV positive and on effective treatment. What should I do if I have to go to hospital because of COVID-19?

Answer

Answer: Simon Collins

Hi

Thanks for your question. Most of the Q&As below are based on information from the British HIV Association.

• Do I need to disclose my HIV status?

Yes, this will always be better. Your medical team will need to know about any other medical conditions. They will need to make sure your HIV meds are not stopped.

COVID-19 is very serious. The hospital knowing your HIV status will give you the best chance of coming through.

Also, COVID-19 can reduce your CD4 count and make testing for other infections more difficult.

• Should I continue my HIV meds?

Yes. Anyone with COVID-19 should continue taking HIV meds.

As with any trip to the hospital, take your current meds with you, including your HIV medicines. It is good to write a list to give to the hospital – or even just take a picture of the boxes on your phone.

If you have COVID-19 you will want your viral load to stay undetectable.

If you stop your HIV meds, your viral load could increase very quickly – even within a week. This would make both HIV and COVID-19 more complicated.

You could develop resistance to HIV meds or get new symptoms if your CD4 count drops.

• How can I take meds if I get very sick?

If you are too ill to take pills, the hospital can still make sure you are treated.

Some meds are available as solutions, or can be crushed and dissolved.

For example, if you cannot eat you will still be fed by a tube through your nose. Your meds can be given at the same time.

Some HIV meds can be crushed and dissolved, and some are available as liquids.

This link is to professional advice in this situation.

If you can’t swallow pills, this link is a PDF guide to which HIV meds can be taken in other ways.

• Are any HIV meds effective against COVID-19? Should I switch my drugs?

No to both questions.

Some HIV meds are being studied for COVID-19 but there is no evidence yet that they work.

Early COVID-19 studies using lopinavir/r were not effective. This is called Kaletra in the UK and Aluvia in some other countries. There is no evidence that tenofovir/emtricitabine (TD/FTC), which is also used for PrEP, is effective either.

Please just continue your regular meds, at the same time and the same dose. Unless there is a medical reason, there is no need to switch HIV meds.

• Will people with HIV and COVID-19 be able to get intensive care?

Yes.

HIV positive people will still have the same rights to access all medical services.

You will be assessed in the same way as anyone else. This will include your overall health and your wishes for your care.

• What is the best treatment for COVID-19?

This is a really good question (and this answer is from i-Base not BHIVA).

Although many research studies are taking place, only a few have reported results. These are already enough though for you to talk about options with your doctors.

You might want to join a study. However, the more serious your COVID-19, the more important it will be to use drugs that are likely to work.

Many randomised studies still include no treatment as one of the options. However, by May 2020 there are other ways to get treatment. One, for example, is to ask for compassionate access to remdesivir.

Other promising treatments include anakinra, anticoagulants, or possibly convalescent plasma or interferon.

These options are likely to depend on your individual health at the time.

The i-Base information service can talk about these options. You can ask a question online, email: questions@i-Base.org.uk or call the phoneline on 0808 800 6013.

• Where can I get more information?

The BHIVA website has a COVID-19 section, which is updated regularly.

Current links (please check the dates) include:

• A Q&A on COVID-19 and HIV.
• UK HIV community support services available during COVID-19.
• A statement on risk of HIV and COVID-19.
• Advice on shielding for HIV doctors, GPs and people living with HIV.

Source

This answer is based on information from British HIV Association on 15 May 2020.