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about...
Infectious Disease Team
© 2013
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...HIV
You will be seen regularly by the same team of doctors at our out-patients clinic in
Mater Dei Hospital at MOP4 (Level –1 Medical Out-Patients block).
I have tested positive for HIV. What next?
 It is important to attend every visit
Finding out that you are HIV positive may be one of the most significant events in
your life. You may experience feelings of fear, numbness, anger or despair. It
might be difficult to appreciate this at the time, however, finding out that you are
HIV-positive puts you in a position where you can start to take steps towards looking after your health. Although the virus may not be eradicated completely, treatments are available which enable people with HIV to live much longer and healthier lives. The sooner your HIV infection is diagnosed, the sooner you can receive
appropriate medical care.
 If you cannot attend, please call us in advance on the contact numbers
below. Ask for the nurse in charge of the Infectious Disease Clinic so that
the appointment will be re-scheduled
 Ideally you should inform your personal GP of your condition and he or she
should be your first contact for minor complaints. We are ready to discuss
your progress with your GP if necessary, and with your consent. Your dentist should also be informed.
At the Mater Dei Hospital Infection Clinic, you will be seen regularly by the same
dedicated team of doctors, who together with our nurses and a pharmacist, are
ready to help and support you and answer any questions you may have in strict
confidence. Don’t worry if you don’t understand everything you are told. There’ll
be opportunities to get more information later. Every effort is made by our team to
ensure that confidentiality is a priority at all times.
What are HIV and AIDS?
HIV stands for human immunodeficiency virus. This is a virus in the group of
viruses called retroviruses. HIV destroys cells in the body called CD4 T-cells. CD4
T-cells are a type of white blood cell, and form part of the immune system. These
cells are vital to protect the body against various bacteria, viruses and other
'germs'.
AIDS stands for acquired immunodeficiency syndrome. This is a term which
covers the range of infections and illnesses which can result from a 'weakened'
immune system caused by HIV.
In case of any difficulty you may contact us on the following telephone
numbers :
When you are first infected with HIV you do not have AIDS. There is usually a time
lag of several years between first being infected with HIV, and then developing
infections and other AIDS-related problems. This is because it usually takes several years for the number of CD4 T-cells to reduce to a level where your immune
system is weakened.
Doctor:
2545 6070 (weekdays) or
2545 4470 (Thursday only)
Nurse :
2545 7450/1 (weekdays)
2545 4470 (Thursday only)
However, persons with HIV can pass the virus on to others whether or not
they have any symptoms. A person who is infected with HIV has the moral
and legal responsibility of ensuring that he or she does not knowingly pass
on the virus to any other person.
Pharmacist:
2545 6512
Secretary:
2545 5551
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When is anti-HIV treatment started?
Treatment is only started if and when necessary according to a hospital protocol. It
is given free of charge on prescription by our doctors to those entitled to it.
How is HIV transmitted and how can I prevent infecting others?
There is no vaccine against HIV. Therefore the main way to prevent infection by
HIV is to avoid activities that put you at risk such as sharing needles and sexual
contact.
As a general rule antiretroviral drugs are usually started if:

complications arise, or

your immunity (measured by the CD4 T-cell count) drops below a certain
level. The exact level when treatment may be advised can depend on
other factors such as symptoms, 'viral load', and CD4 count.
The best combination of treatment will be prescribed to you, if and when necessary. This usually consists of a number of tablets to be taken at strict times twice or
three times a day. Our dedicated pharmacist will be available at the out-patient’s
clinic to explain what you need to know about taking your medications. The pharmacist will also answer any questions you may have regarding treatment and sideeffects.
Sex and HIV
Having sex with an infected person is the most common way that the virus is
passed on. Semen, vaginal secretions and blood from an infected person contains
HIV. The virus can enter the body through the lining of the vagina, vulva, penis, or
mouth during sex.
The most effective way to prevent infecting another person with HIV, and to avoid
contracting other strains of HIV infection and other sexually transmitted infections,
is to abstain from sex, or act responsibly with only one sexual partner be faithful, properly using a good quality condom - when you have sex.
However, although condoms can greatly reduce your risk of getting HIV, they do
not eliminate the risk entirely. Condoms can break or develop small tears, and they
may not always be used properly.
Treatment and prevention of infections
If your CD4 count drops below a certain level, your immune system will be compromised and you may be more susceptible to infections that would not normally harm
you. These so called opportunistic infections can often be treated with antibiotics.
Even if you have not developed an infection, once the CD4 T-cells falls to a low
level you will normally be advised to take a regular dose of one or more antibiotics
or other drugs to prevent certain opportunistic infections from developing.
For a person to become infected with HIV, some infected blood, semen or vaginal
secretions have to get into the body.
HIV cannot be passed on from ordinary contact with someone with HIV such as
hugging, shaking hands, touching, or from sharing food, towels, utensils, swimming
pools or telephones. It is also thought that casual kissing does not transmit the virus.
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You can prevent the spread of HIV in other ways:
What is the treatment for HIV infection?
 Do not share your toothbrush or razor blade or leave it within reach of
children in the house
 If you are pregnant and have HIV infection then you need special antenatal care where treatment with anti-HIV drugs greatly reduces the risk of
passing on the virus to your baby. HIV can also be passed to babies
through breast milk during breastfeeding so mothers with HIV are
advised not to breast feed and to use formula milk.
 If you are an injecting drug user then do not share needles or any other
injecting equipment. Dispose of any used needles responsibly in a
sharps container at a local clinic or ask a member of our team where you
can obtain one
 Do not leave open wounds uncovered, and in case of an accident any
blood spills should be cleaned up using bleach and gloves.
What tests are done?
If you have tested ‘HIV positive’, it means that
you are infected with HIV. If you are confirmed to
have HIV then your doctor will take further blood
tests to check the amount of virus in your blood,
known as the viral load, and the CD4 count
which is the number of a particular type of white
cell (CD4 T-cells) in your blood. These tests are
repeated from time to time to monitor and assess the infection. These tests will also indicate
whether treatment with anti-HIV medication is necessary and if so, when would be
the best time to start. The response to treatment is also monitored by these tests.
A range of other tests is carried out to detect any other dormant infections, known
as opportunistic infections that may be present due to a suppressed immune system. You may be offered vaccination, for example, against Hepatitis B, if you test
negative for this. You will also be referred to the GU clinic, in confidence, for further
tests.
Since the late 1990s a number of drugs have been developed called antiretroviral drugs. These drugs do not clear the body of HIV, but they do slow down
the HIV infection in a very significant way.
There are several classes of these drugs which include: nucleoside analogue reverse transcriptase inhibitors (NRTIs), protease inhibitors (PI), and nonnucleoside reverse transcriptase inhibitor (NNRTI). The drugs in each class work
in different ways, but all work to stop the HIV from replicating itself and are given
in combination. This anti-HIV treatment is known as HAART – highly active antiretroviral therapy. The aim of treatment is to reduce the 'viral load' to low or
‘undetectable’ levels.
In most people who are treated with HAART,
the viral load reduces to very low levels, and
the number of CD4 T-cells, the CD4 count
rises. This means your immune system is no
longer as weakened and you are not likely to
develop opportunistic
infections.
However, it is extremely important to take the medications very regularly
and exactly as prescribed to maintain success and to help prevent the virus
from becoming resistant to the drugs. This will result in a very low viral count
and improvement in your immunity.
Not taking your medications regularly will result in major problems.
As with other powerful drugs, antiretroviral drugs can cause some side-effects in
some cases. In addition, some of these drugs react quite badly with other commonly used medications. It may be necessary to change an initial combination of
drugs to a different combination because of problems with side-effects, reactions,
or resistance of the virus to an initial drug. Therefore, different people with HIV
can take different combinations of drugs.
All blood tests and investigations are coded to further protect confidentiality
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