Barts and The London HIV Service
HIV is a complex condition and patients may need specialist care for a range of problems from time to time. Our multi-disciplinary clinics mean that if specialist care is required, then we can call on a range of experts to provide the right care when needed. Click on the links below to find out about our multi-disciplinary services:
Our pregnant patients are given first-class treatment to make sure that mother and baby do well throughout pregnancy, birth and beyond. With the right antenatal treatment the chances of a baby being born HIV positive when the mother is HIV positive is now less than 1%.
If you are diagnosed with an unusual skin condition that cannot be managed by your GP or pharmacist and is linked to being HIV positive, then you will be referred to our skin specialist who will provide the right treatment for you.
Good nutrition supports a healthy immune system and will help to maintaining a healthy lifestyle. If, for any reason, you experience unplanned weight loss or high cholesterol levels, then your diet will be reviewed by a member of our dietetic team who will make the appropriate dietary recommendations for you to follow.
HIV patients diagnosed with Hepatitis B or C will receive specialist care in our Hepatitis clinic. Treatment for hepatitis C is given through this clinic and patients are supported by an experienced team including a medical consultant, a senior nurse, dietician and psychiatrist. Hepatitis is a liver infection which is spread through contact with infected blood and other bodily fluids. Acute infection (short term) does not cause any long-term damage to the liver but chronic (long term) infection may lead to serious complications of the liver and needs to be treated with medication. For the small number of HIV positive patients who do have serious liver disease as a result for hepatitis or from any other cause, there is a joint HIV/liver clinic in association with our Professor of Hepatology, Graham Foster.
Lipodystrophy (managing facial fat loss)
We offer our patients a specialist service for the management of facial fat loss (lipoatrophy).
The cause of facial fat loss is not completely understood. It commonly occurred with the earliest HIV treatments but thankfully with current treatment it has become rare. It leads to sunken cheeks and temples. Patients may say "they feel well but look ill", and we recognise that any change in facial appearance can be distressing.
Following a multi-disciplinary team review which involves a dietitian, psychologist and doctor, some patients may be given treatment to improve the appearance of the face. The procedure includes multiple fine needle injections into the affected skin under local anaesthetic. Results take several weeks and several sessions may be necessary but benefits are usually long lasting.
The service has been available since 2003 and over 120 patients have completed a course of treatment.
If you need re-habilitation following a stay in hospital or because some of your symptoms relating to HIV are affecting your mobility, then our physiotherapy team will help you get back into good physical condition.
The psychological impact of HIV is very variable, but the diagnosis often has an impact on people’s mental wellbeing. Issues may arise at the time of diagnosis, when starting or changing treatment or around negotiating sexual relationships. Depression, anxiety and sexual dysfunction are all much more common amongst HIV positive people than in the general population.
Counselling is available within the service through our superb team of highly experienced specialist psychologists. You can self-refer (you decide you really need to speak to someone about your feelings and make the appointment) or a referral may be suggested by your doctor or nurse.
HIV can lead to a patient experiencing kidney (renal) problems. We operate a joint clinic with colleagues from renal services and together we are able to provide the best care for HIV patients experiencing renal complications.
Patients with HIV may be more susceptible to some cancers and it is thought this may be as a result of the immune system being suppressed – the good news is cancer in HIV patients is not common and is often of the most treatable sort. If specialist care is required, our joint oncology and HIV clinics provide a seamless approach to caring for patients.
Very poor immunity can lead to eye infections such as retinitis and our ophthalmology clinic provides first class care for patients experiencing eye infections and other optical health issues.
Caring for HIV patients with drug-taking behaviours can be complex and requires specialist support and help. Nurses in our specialist addiction clinic will help such patients by ensuring they have access to all the medical and emotional support they require.
If you are taking HIV therapy, your CD4 count is above 250 and your viral load has been undetectable for at least 12 months you may be able to have your care managed within the stable patient clinic. You can discuss this with your regular clinic doctor at your appointment.
This clinic is run by very experienced senior nurses, who will manage your care with the support of your regular clinic doctor. You will be seen three times a year, twice by a senior nurse and once by your regular doctor.
Your bloods will be taken at the clinic appointment and you will be informed of the results approximately two weeks later, either by letter, phone text, or email (you can choose which you prefer). The emphasis in this appointment is to reduce your clinic visits as much as possible and to help you manage your HIV and long-term health generally.
These appointments are throughout the week, with an evening clinic starting early in 2008.
Women living with HIV can have issues that need special support. The women’s health clinic is a service to address issues such as cervical screening as this must be carried out more often in women with HIV. We also provide advice and care for family planning and conception issues especially to support women who want to start a family. We advise how to plan conception in a safe way for themselves, their partners and their babies. We will also help with sexual health issues. The clinic is run by our women’s health nurse, who is a senior nurse with experience in this specialist area. Our nurse provides this service in conjunction with your regular clinic doctor.
It is important for men living with HIV to have regular sexual health screens if they are sexually active, mainly because many sexually transmitted infections may not always present with symptoms, so you may not know you have one.
Usually, if you have no symptoms then the nurses can provide a sexual health screen as part of your regular blood or other clinic appointment. You just need to ask, although the nurses may also talk to you about this service also.
However if you have symptoms, we also provide a specialist clinic run by our men’s sexual health nurse, who is a senior nurse with experience in this specialist area. This clinic is by appointment only and you should ring and discuss your problem with the men’s sexual health nurse to ensure that it is appropriate for you to attend. Our nurse can also provide you with appropriate information and support and help access you into another clinic if necessary.
If for any reason you become worried about your health, then you can call our SOS clinic to make an appointment. You may choose to use this service is if anything has changed about your health and you think it may be due to HIV or your treatment. When calling, a nurse will discuss your concerns with you and establish the next best course of action. It may be that you will be given an SOS clinic appointment to be seen by a doctor or you may be advised to visit your GP or seek immediate medical help from your local accident and emergency unit. If you are worried about the effects of your treatment and want to stop or change the way that you take it, always contact us first.
SOS clinic opening times:
There is an SOS clinic every day in the afternoon. It is important that you ring and book an appointment rather than just turn up at clinic, as it may then not be possible to give your problem the time that it needs.
SOS Address:
Andrewes Unit
3rd Floor
KGV Block
St Bartholowmew’s Hosptial
SOS daytime telephone number:
020 7601 7738 and choose the option to speak to a nurse.
SOS evening telephone number:
020 7377 7000 ask for bleep 0121 or attend your nearest A&E department.