HIV infection in hospital

• Contact the infectious diseases unit at the Queen Elizabeth University Hospital (QEUH, see Appendix 6 for contact details) if HIV is suspected in an inpatient or patient is known HIV positive.
• Ensure uninterrupted supply of anti-retroviral therapy. See 'Anti-retroviral' section below for information on how to obtain supply if the patient does not have their own with them.
• Drug Interactions are common. See 'Anti-retroviral' section below for further information.

Anti-retrovirals

Before prescribing anti-retrovirals confirm current regimen with the patient and information on the clinical portal, particularly the up to date Infectious Diseases clinic letter and eform. If further clarification is required then contact the Brownlee Pharmacy Department at Gartnavel General Hospital (see Appendix 6 for contact details). GPs do not supply anti-retrovirals so do not rely on information on ECS as this is often out of date. 

Ensure full regimen is prescribed on the kardex at the correct time(s) of the day as doses should be taken at the same time each day. Ensure doses are not missed.

The patient may have their own supply of anti-retroviral therapy with them. If not then order a supply from the pharmacy department who will obtain it from the Pharmacy Distribution Centre. If supply is not likely to arrive on the ward before the next scheduled dose, then it can be obtained from ward 5c at the QEUH.

Drug interactions are common. A useful website to check for interactions is www.hiv-druginteractions.org. If further information is required then please contact the HIV pharmacist for advice (see Appendix 6 for contact details).

Post-exposure Prophylaxis (PEP)

See guideline titled 'NHSGGC Management of Occupational and Non Occupational Exposures to BBV' on NHSGGC StaffNet, Clinical Guideline Electronic Resource Directory, and search in 'Infection' section.

Assess recipients of blood borne virus exposure urgently, as soon as possible after injury. Ideally PEP should be given within 2 hours of injury but is still beneficial beyond this time.

General management:

• Assess the injury.
• Administer first aid.
• Assess the source risk and need for blood borne virus testing in conjunction with the index patient's clinical team.
• Contact the Brownlee Centre, Gartnavel General Hospital (see Appendix 6 for contact details) for all patients who are assessed as requiring PEP or if there is uncertainty.
• Obtain post-exposure prophylaxis medication (PEP packs) through A&E or pharmacy. Check for potential drug interactions (contact pharmacy, Appendix 6 for contact details).
• For patients with sexual exposure to HIV, contact the Sexual Health Service at the Sandyford Centre (see Appendix 6 for contact details).
• HIV counselling and testing is provided at the Brownlee Centre, Sandyford Central and multiple Sandyford Hubs in NHSGGC (see www.sandyford.org for details).
• Refer all incidents to occupational health.

Last reviewed February 2018