The British HIV Association (BHIVA) has updated its interim guidance on initiation of antiretroviral treatment (ART) during the coronavirus pandemic. This updated version has replaced the first version which was released on 1st May 2020.
Services should seek the best local solutions to enable proper management of HIV patients, whilst protecting resources for the response to COVID-19 and possibly dealing with reduced laboratory capacity.
Key points include:
- There is emerging evidence that people with HIV may be at a higher risk of COVID-19 mortality, but it is not clear whether this is due to other co-morbidities or socio-demographic factors.
- ART should not be interrupted; the guideline notes that NHS England and NHS Improvement are monitoring the supply and demand of HIV medicines and are working with suppliers to ensure supply is maintained.
- Six-monthly monitoring can reasonably be deferred to the next planned appointment for most patients unless there are concerns. Non-essential monitoring should be deferred unless it will change short-term management.
- ART should not be switched unless absolutely necessary.
- Pragmatic first-line prescribing recommendations are included for use if capacity for clinic visits or monitoring is limited.
- Use of antiretrovirals to treat COVID-19 infections is not recommended outside of clinical trials.
The BHIVA stress that the guidance is temporary and advise that services should continue to operate as normal if they have the capacity to do so, but should follow the guidance in circumstances where access to investigations or appointments is limited.