HIV infection in hospital

• Contact the infectious diseases team at the Queen Elizabeth University Hospital (QEUH) if HIV is suspected in an inpatient, or patient is known to be HIV positive.
• Ensure uninterrupted supply of anti-retroviral therapy (ARV). See the '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 the 'Anti-retroviral' section below for further information.

Anti-retrovirals

Before prescribing ARVs confirm current regimen with the patient and information on the clinical portal; particularly the up to date Infectious Diseases clinic letter and outpatient note. This should be used in conjunction with the prescription, which is saved in the Medication section of Clinical Documents. If further clarification is required, contact the Brownlee Pharmacy Team. GPs do not prescribe ARVs so do not rely on ECS for this information as it may be out of date. 

Ensure the full regimen is prescribed on HEPMA (or inpatient kardex if HEPMA is not used in your clinical area) at the correct time(s) of the day, as doses should be taken at the same time each day. Ensure doses are not late or missed and food requirements are met if appropriate.

The patient may have their own supply of ARVs 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. Always use the interaction checker website at www.hiv-druginteractions.org to check for interactions with ARVs in advance of prescribing. If further information is required, please contact the Brownlee Pharmacy Team for advice.

Post-exposure Prophylaxis (PEP)

See the GGC guideline 'Occupational and Non-Occupational Exposures to Bloodborne Viruses' on the Clinical Guidelines Platform.

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 up to 72 hours following the incident.

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 Infectious Diseases Team 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 (oncall pharmacist if out of hours).
• Check for potential drug interactions using the interaction checker website, www.hiv-druginteractions.org . If further advice is required during working hours, then contact the Brownlee Pharmacy Team.
• For patients who have significant risk of sexual exposure to HIV, contact the Sexual Health Service at the Sandyford Centre (Monday - Friday 9am - 4.30pm). Outside of these times NHSGGC A&E departments have the protocol for PEP following sexual exposure.
• HIV testing is available at Sandyford Central and multiple Sandyford Hubs in NHSGGC (see www.sandyford.org for details).
• Refer all incidents to occupational health.

Guideline reviewed: September 2022

Page updated: October 2023