4. Complex HIV care
If you are in the UK, and diagnosed relatively soon after you acquired HIV, then it is most likely that you will NOT need complex HIV care as described in this section. You are more likely to get everything you need for your HIV care as described in Standard 3 (HIV outpatient care and treatment). There may still some circumstances where more complex care will be needed. The three main areas of complex care need are described here in Standard 4. This, though, focuses on physical health. Emotional wellbeing and mental health are discussed in Standard 6 (Psychological Care).
4b. Comorbidities, co-infections and cancers
Having another health condition as well as HIV is called a comorbidity. If this is an infection, then it is called a co-infection (with your HIV).
People who are diagnosed with HIV today, and taking modern ARTART: Anti-Retroviral Treatment. For most people, this means taking three or more Anti-RetroVirals (ARVs), though it may be fewer in some cases. ARV: Anti-RetroViral .This is the name given to the drugs used in Anti-Retroviral Treatment (ART). For many people, a single tablet can contain all ARVs needed for your treatment. But others may need to take more than one tablet. as they should, are likely to have a life expectancy similar to someone who is HIV negative. This means that over our lifetimes, we may develop common conditions associated with getting older, such as those affecting the heart, kidneys or the liver. There should be regular age-appropriate screenings for these conditions. Some of these could be done by your GP.
People living with HIV can be at increased risk of other infections such as TBTB: tuberculosis. This is a bacterial infection that is passed on by breathing in tiny droplets from the coughs or sneezes of a person who has TB. Some people living with HIV are increased risk of TB if their immune system is weak. , hepatitis Bthis is caused by a virus that infects the liver. It’s easy to pass on during sex or by sharing injecting equipment. Most people who get it make a full recovery, but for some, it can be more serious. A vaccine is available. , and hepatitis Cthis is the most common type of viral hepatitis. It’s caused by a blood-borne virus that attacks the liver and is easily spread by sharing drug injecting equipment. It can also be spread through sex. Without treatment, the virus can cause liver disease that, over a long period, can be fatal. Most people will be offered a 12-week course of tablets with few side effects and a high cure rate. There is no vaccine against hepatitis C.. Everyone who is diagnosed as HIV positive should be assessed and monitored for TBTB: tuberculosis. This is a bacterial infection that is passed on by breathing in tiny droplets from the coughs or sneezes of a person who has TB. Some people living with HIV are increased risk of TB if their immune system is weak. , hepatitis Bthis is caused by a virus that infects the liver. It’s easy to pass on during sex or by sharing injecting equipment. Most people who get it make a full recovery, but for some, it can be more serious. A vaccine is available. and hepatitis Cthis is the most common type of viral hepatitis. It’s caused by a blood-borne virus that attacks the liver and is easily spread by sharing drug injecting equipment. It can also be spread through sex. Without treatment, the virus can cause liver disease that, over a long period, can be fatal. Most people will be offered a 12-week course of tablets with few side effects and a high cure rate. There is no vaccine against hepatitis C. during ongoing HIV treatment.
People living with HIV may also be at slightly increased risk of some cancers.
Treatment for any of these conditions should be done by a team of specialists using a joined-up care plan. This team should involve your HIV specialist, together with doctors and nurses from other specialist areas, and may also include pharmacists and your GP. Good communication between the different areas is needed to make sure you get the best treatment. You should be offered the same standard of care as anyone else. All other treatments you receive should be checked to make sure that they don’t interact with your HIV treatment. This is discussed in a bit more detail in Standard 3c (Antiretroviral prescribing).
Key messages
You should be screened according to national standards for diseases associated with ageing, such as heart disease, liver or kidney disease, or cancers. This will usually be done at your HIV clinic. Your GP may also screen or test you for some conditions.
You should be screened for co-infections such as TBTB: tuberculosis. This is a bacterial infection that is passed on by breathing in tiny droplets from the coughs or sneezes of a person who has TB. Some people living with HIV are increased risk of TB if their immune system is weak. and hepatitis Bthis is caused by a virus that infects the liver. It’s easy to pass on during sex or by sharing injecting equipment. Most people who get it make a full recovery, but for some, it can be more serious. A vaccine is available. and hepatitis Cthis is the most common type of viral hepatitis. It’s caused by a blood-borne virus that attacks the liver and is easily spread by sharing drug injecting equipment. It can also be spread through sex. Without treatment, the virus can cause liver disease that, over a long period, can be fatal. Most people will be offered a 12-week course of tablets with few side effects and a high cure rate. There is no vaccine against hepatitis C. when you are first diagnosed with HIV.
If you need treatment for any other conditions, it should usually be provided by a multidisciplinary team involving an HIV specialist. They must make sure that any other treatment given does not interact with your HIV treatment.