HIV Health MOT
Summary

Managing your HIV

My viral load

• You have probably come across the term “viral load” before. It indicates the amount of HIV in your body fluids and should be regularly measured at your HIV clinic1.

• As there is no cure for HIV, an “undetectable viral load” is the current goal of HIV treatment. It means you have fewer than 50 copies per millilitre in your blood, which means your antiretroviral medications are working effectively1,2. Having an undetectable viral load in the laboratory doesn’t mean that the virus is gone from your body1. An undetectable viral load means your immune system can recover, stay strong and reduces the risk of passing on the virus1.

• Use the links below for more information on viral load, and don’t forget to speak to your doctor about yours.
www.aidsmap.com/Viral-load/page/1044622/
www.tht.org.uk/myhiv/HIV-and-you/Simple-science/Whats-happening
www.labtestsonline.org.uk/understanding/analytes/viral-load/tab/test/

My HIV Treatment

• You might feel healthy right now, but HIV can damage the immune system and cause a range of illnesses3. Guidelines now recommend that everyone who has HIV can start treatment when they feel that the time is right. Starting treatment also reduces your viral load, which decreases your risk of passing on HIV.

• As a patient, you have the right to treatment which meets your needs and preferences4. All patients should be able to talk through their treatment options with their clinician in order to make treatment decisions together.

• Use the links below for more information on HIV treatment, and speak to your healthcare professional if you’re struggling to stick to your treatment or have any questions.

Support groups

• From time to time we all need a little help and support. Living with an HIV diagnosis is not an easy task, and sometimes things can be overwhelming, particularly if you’re not able to turn to friends and family for support.

• Getting involved with a support group can be a great way to connect with people who face similar challenges — you may even help others on the way. A selection of local and national groups is listed below. You can also check with your local HIV clinic for nearby groups.

Click here for a list of support groups across the UK and Ireland: http://patient.info/support/aids-and-hiv-1208

National UK:

London:

Bedfordshire:

Manchester:

Sussex:

Ireland:

Scotland:

If you prefer to speak to someone on the phone, you can always call the National Sexual Health Helpline on 0300 123 7123. It’s a confidential service where you can get advice about HIV and AIDS, sexual health, STDs, local services, clinics and support services. It’s free to call and is open from 9am-8pm Monday-Friday.

Your lifestyle

Exercise

• Exercise can reduce the risk of cardiovascular problems, as well as helping to strengthen your mental health by decreasing your chances of getting depression5.

• However, sticking to an exercise regime isn’t always easy. You may enjoy exercise more if you invest a little bit of time into planning and thinking about your exercise plan. See the links below for information on apps, and tips and tricks that can help you get into an exercise regime and stick to it:

Importance of working out
www.aidsmap.com/Starting-and-sticking-to-an-exercise-programme/page/1188930/
Easy workouts for people with HIV  www.hivplusmag.com/wellness/fitness/2013/06/19/workout-especially-hiv-positive-people
How to make exercise a habit
www.jamesclear.com/exercise-habit
Tips on how to stick to your workout
www.menshealth.com/fitness/20-ways-stick-to-workout
Exercise apps to get you started and keep you going
http://time.com/3772922/workout-apps-gym/
For questions on how HIV can affect your exercise routine www.hivplusmag.com/treatment/2015/03/04/how-get-or-stay-fit-when-you-have-health-issues

Diet

• Although having HIV doesn’t mean you have to follow a special diet, good nutrition can help to keep your body and immune system strong.

• If you are unsure about what a healthy diet looks like, follow the links below to find out more and gain some inspiration. You might find cooking to be a great way to relax and connect with a partner, your friends and family! Also consider talking to your HIV clinic, as they may be able to provide useful advice on your diet.

Healthy eating
www.aidsmap.com/Healthy-eating/page/2029215
Foods that strengthen your immune system
www.eatright.org/resource/health/diseases-and-conditions/hiv-aids/eating-well-with-hiv
Why not try one of these delicious recipes?
www.foodchain.org.uk/nutrition-and-hiv/recipes/

A healthy diet doesn’t have to leave a big hole in your wallet. Visit foodchain.org.uk for more information, cooking classes and recipes for you to try out.

Smoking

Anyone who has ever tried to stop smoking will know how hard it can be to actually quit. However, there are fantastic support groups and a vast amount of information out there to help you stay on track. From apps, emails, SMS, face-to-face sessions and quit kits, there are all kinds of things available to help you kick the habit. Visit www.nhs.uk/smokefree to see what could work for you. You should also make sure to bring it up the next time you visit your HIV clinic. That way you could leave your smoking days behind you sooner rather than later.
• Still not convinced? Check out these links to understand how smoking can affect your life with HIV:
www.aidsmap.com/Smoking/page/1045157/
www.tht.org.uk/myhiv/Staying-healthy/Alcohol-and-drugs/Smoking

• Enter your postcode to find your local stop smoking service on the link below:
nhs.uk/smokefree/help-and-advice/local-support-services-helplines

Drinking

• The government recommends that both men and women shouldn’t drink more than 14 units of alcohol each week. Calculate how many units of alcohol you drink here https://www.drinkaware.co.uk/understand-your-drinking/unit-calculator. As an added bonus, the calculator will also tell you how many calories your drinks contain, and how long you will have to exercise to burn them off again.

• For more detailed results and to find out if your drinking habit could affect your health, you can use this seven-day tracker https://www.drinkaware.co.uk/sevendaycalculator. If you would like to find out more information about responsible alcohol consumption and tips on how to cut back, visit https://www.drinkaware.co.uk/advice/are-you-drinking-too-much/do-you-need-to-cut-down/

• Don’t forget, there are lots of organisations out there who can give you advice and support, including Alcohol Concern, one of the UK’s largest alcohol charities, and Drinkline. Contact Alcohol Concern via their website www.alcoholconcern.org.uk, or phone Drinkline on 0300 123 1110.

Associated Conditions

Researchers believe that HIV can speed up the ageing process3,6. This means that young people with HIV can have ‘older’ immune systems, leading to early development of diseases that would normally affect older people. These may include heart disease, some cancers, osteoporosis and disorders of the liver, kidneys and brain7-13.

Your healthcare professional will be aware of this, and should be testing you regularly for any associated conditions. Find out more on these tests and how HIV affects your health in the long term by clicking through the links below.

Make sure to also stop by our health page to read more about conditions that are associated with HIV.

My Bones

• If you are over 40 years old, your healthcare professional can measure your bone mineral density (BMD) and do a test called FRAX (Fracture Risk Assessment Tool), which can tell you how high your chance is of breaking a bone. If you don’t have your BMD score you can still calculate your FRAX score here. Please note that the FRAX score can underestimate absolute fracture risk in people living with HIV, so often clinicians will tick the “secondary causes of osteoporosis” box in the assessment.

• Information on bone mineral changes http://i-base.info/guides/side/bone-mineral-changes

My Heart

• Ever wondered what your heart age was? If you’re over 30, you can use this calculator https://www.nhs.uk/tools/pages/heartage.aspx to find out. It will also show you how your heart age may change with lower cholesterol levels.

• QRISK2 is a common test your doctor may use to work out your risk of having a heart attack or stroke over the next ten years. It is based on a few medical questions that a healthcare professional will answer about you. These include questions on your blood pressure, cholesterol, body mass index, and other areas that affect your risk. https://www.qrisk.org/2017/

• Find out more about potential heart problems http://www.tht.org.uk/myhiv/Staying-healthy/Living-with-HIV-long-term/Heart-problems

• Keep your heart healthy http://www.foodchain.org.uk/nutrition-amp-hiv/other-conditions-associated-with-hiv/heart-health/

My Kidneys

• For more information about how HIV can affect your kidneys http://www.tht.org.uk/myhiv/Staying-healthy/Living-with-HIV-long-term/Kidney problems

• Kidney tests your doctor might run: The most common kidney tests you may hear about are eGFR and creatine clearance tests, which work out how well your kidneys are working to filter waste products in your blood. A urine test is also often used to check for waste products and proteins in a similar way. The tests need to be carried out by a healthcare professional14. As you age, these become more important as kidney disease is most common in older age http://www.nhs.uk/Conditions/Kidney-disease-chronic/Pages/Diagnosis.aspx

• More info on the tests available to check your kidneys are working fine http://www.aidsmap.com/Renal-function-tests/page/1733221/

Managing your HIV

My viral load

Indicates the amount of HIV in my body fluids and should be regularly measured at my HIV clinic

My HIV Treatment

As a patient, you have a right to treatment which meets your needs and preferences.

Support groups

Getting involved with a support group can be a great way to connect with people who face similar challenges.

Your lifestyle

Exercise

Exercise can reduce the risk of cardiovascular problems, as well as helping to strengthen your mental health by decreasing your chances of getting depression3

Diet

Although having HIV doesn’t mean you have to follow a special diet, good nutrition can help to keep your body and immune system strong.

Smoking

Anyone who has ever tried to stop smoking will know how hard it can be. However, there are fantastic support groups and a vast amount of information out there to help you stay on track.

Drinking

The government recommends that both men and women shouldn’t drink more than 14 units of alcohol each week.

Associated Conditions

My Bones

If you are over 40 years old, your healthcare professional can measure your bone mineral density (BMD) and do a test called FRAX (Fracture Risk Assessment Tool).

My Heart

QRISK2 is a common test your doctor may use to work out your risk of having a heart attack or stroke over the next ten years.

My Kidneys

The most common kidney tests you may hear about are eGFR and creatine clearance tests, which work out how well your kidneys are working to filter waste products in your blood.

HIV and Cancer

There are some links between certain cancers and HIV which you can discuss with your healthcare professional.

References

1. Aidsmap. Viral load factsheet. Available at: http://www.aidsmap.com/Viral-load/page/1044622/ [accessed June 2017]
2. Aidsmap. HIV lifecycle. Available at: http://www.aidsmap.com/pdf/HIV-lifecycle/page/1044602/design/fe30aa65-dc0f-4526-bbe9-fb7f285158a3 [accessed June 2017]
3. Deeks SG. Immune Dysfunction, Inflammation, and Accelerated Aging in Patients on Antiretroviral Therapy. Top HIV Med. 2009 Sep-Oct;17(4):118-23.
4. The NHS Constitution for England. Available from: www.gov.uk/government/publications/the-nhs-constitution-for-england (accessed September 2017)
5. Benefits of exercise. NHS Choices. Available at: http://www.nhs.uk/Livewell/fitness/Pages/whybeactive.aspx [accessed June 2017]
6. Effros RB et al. Workshop on HIV Infection and Aging: What Is Known and Future Research Directions. Clin Infect Dis. 2008 August 15; 47(4): 542–553.
7. Aidsmap. Chronic kidney disease and HIV factsheet. Available at: http://www.aidsmap.com/Chronic-kidney-disease-and-HIV/page/1045114/ [accessed June 2017]
8. Aidsmap. Cardiovascular disease factsheet. Available at: http://www.aidsmap.com/The-heart/page/1045105/ [accessed June 2017]
9. Aidsmap. Cognitive impairment and HIV factsheet. Available at: http://www.aidsmap.com/Cognitive-impairment-and-HIV/page/3135688/ [accessed May 2017]
10. Güerri-Fernández R et al. HIV infection, bone metabolism and fractures. Arq Bras Endocrinol Metabol.2014; 58(5):478-83.
11. Aidsmap. The liver factsheet. Available at http://www.aidsmap.com/The-liver/page/1045123/ [accessed June 2017]
12. Aidsmap. HIV, mental health & emotional wellbeing booklet. Available at http://www.aidsmap.com/HIV-mental-health-emotional-wellbeing/page/1321435/ [accessed June 2017]
13. Silverberg MJ et al. Cumulative Incidence of Cancer Among Persons With HIV in North America: A Cohort Study. Ann Intern Med. 2015 Oct 6;163(7):507-18.
14. NHS Choices. Chronic Kidney Disease. Available at: http://www.nhs.uk/conditions/Kidney-disease-chronic/Pages/Introduction.aspx. [last accessed June 2017]