Covid-19 Treatments in Scotland: Information for People Living with HIV

New treatments for Covid-19 infections have been introduced in Scotland, and are now available for eligible members of a high-risk group.

Currently, three main types of treatment are in use: 

• Antivirals, which prevent SARS-CoV-2 (the virus that causes Covid-19) from reproducing. Available medications are:
  • Remdesevir, which is administered by injection into a vein. It is given in some cases to hospitalised people only. 
  • Molnupiravir, which is given as a course of tablets. It is available through the PANORAMIC trial or routine outpatient NHS care.
• Neutralising monoclonal antibodies (nMAB) are proteins designed to ‘mop up’ SARS-CoV-2 so that it cannot infect cells. They reduce the risk of hospital admissions, and of dying from a Covid-19 infection. Available medications: 
  • A combination of Casirivimab and imdevimab, given by injection into a vein. This treatment is less effective against the Omicron variant so is only used in some hospitalised people. 
  • Sotrovimab, which is given by injection into a vein. It is given to some hospitalised people and is also available for non-hospitalised people.
• Anti-IL-6 monoclonal antibodies are used to reduce levels of inflammation in some hospitalised people. There are two types, tocilizumab and sarilumab. 

Some individuals, who are members of the high-risk group, are eligible for these medications. They are given as a routine NHS outpatient treatment. You are eligible for the new treatments if meet both of the following conditions: 

• You have Covid-19 symptoms and a positive PCR test, no older than 5 days old. 
• You are a member of a high-risk group. This includes the following people with HIV: 
  • Those with uncontrolled/untreated HIV – i.e., not taking any antiretroviral treatments (ART), such as HIV medications and tablets – or those who are taking ART but have a viral load of more than 200 copies/ml. 
  • Those with an acute AIDS defining diagnosis.  
  • Those who are on stable treatment for HIV, with CD4 count less than 350. 
  • Those who are on stable treatment for HIV with CD4 more than 350, but have additional risk factors, such as they are over 55 years old, have other health conditions, are homeless, or are dependent on alcohol. 

Eligible individuals will be contacted by their HIV clinic by letter, phone, or text with information about how to access treatment, if it is needed.  

Most clinics in Scotland have already begun contacting eligible patients. However, if you have not been contacted but have Covid-19 symptoms and are in a high-risk group:  

• Take a Covid-19 test as soon as possible. You will find the latest information on testing on the NHS Inform website, or you can call 0800 028 2816.  
• If ordering a test online, if you are eligible for the new Covid-19 treatments, state that you are an essential worker to receive a priority PCR test. 
• If there is a lack of availability of PCR tests, you can also take a lateral flow test and report your result either online or by phone on 0800 008 6587 while you await a PCR test. This will ensure there is no delay in accessing treatment.  
• Upon receiving a positive result, contact your local Health Board to access treatment. The clinical team will assess you to determine whether treatment is appropriate. Some of those in a high-risk group will not require treatment.  

More detailed information about the newly available Covid-19 treatments is available on the BHIVA website. This information applies to people living with HIV across the UK. 

All information is correct at the time of posting. The situation is changing very quickly however, so always check the NHS Inform website for up-to-date information on Covid-19 treatments.