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Bloodborne Viruses

BBV Guidelines
  • For up to date BBV guidelines, please refer to the NHSGGC Clinical Guideline Portal
  • August 2022 – BBV Patient Risk Assessment Letter and Form is being reviewed, and will be updated soon.
What are Blood Borne Viruses?

Blood borne viruses are transmitted (spread) from person to person via blood and or other bodily fluids for example through sharing of injecting equipment and to varying degrees through sexual activity. The most prevalent BBVs are HIV, Hepatitis C and Hepatitis B.

People can often live for many years without experiencing any symptoms, therefore not knowing they are infected. Unfortunately this can mean that by the time the virus is diagnosed, the impact on an individual’s health are far more serious.

The risk of transmission will depend on a number of factors for example:

  •  route of transmission,
  •  infectiousness of the virus
  •  whether or not the person is receiving treatment for example for HIV.
Hep C

Hepatitis C is a virus that damages the liver. left untreated, hepatitis C can lead to liver disease and liver cancer. People often have no symptoms and therefore the only way to know for sure if someone has hepatitis C is via testing.

In the UK, Hepatitis C is almost exclusively transmitted through sharing of injecting equipment. While possible, it is far less commonly acquired through unprotected sex, mother to baby transmission, blood transfusions abroad, sharing of toothbrushes/razors. Like HIV, it is not passed through social contact with those who are affected.

Although there is no vaccine to protect against the infection, hepatitis C is curable with a short course of tablets, without significant side effects. With new treatments, everyone who is diagnosed positive is eligible for assessment and treatment, regardless of stage of disease or other health and social factors.

While it is important to test those who have ever been at risk, or who are at on-going risk to find undiagnosed infection, if elimination in Scotland is to be achieved, there is also need to re-engage those individuals who were previously diagnosed with hepatitis C, but did not stay in treatment or were not able to engage with the old interferon-based treatment regimes. These individuals should also be offered re-referral to treatment services.

HIV

HIV (Human Immunodeficiency Virus) is a blood borne virus that is most commonly passed on through unprotected sex. It can also be transmitted through:

  • sharing needles, syringes and other injecting equipment,
  • and from mother to baby during pregnancy, birth or breastfeeding.

If left untreated, a person’s immune system can become severely damaged and they may develop a number of opportunistic infections which can be life threatening. This late stage of HIV infection is referred to as AIDS (Acquired Immune Deficiency Syndrome).  There are very effective treatments for HIV which can stop most people from developing AIDS. The earlier someone is tested and diagnosed, the better their outcomes will be.

Adhering to treatment not only means an individual can live a healthy life, it can also stop the onward spread of HIV. This is known as Treatment as Prevention – Those individuals who take their treatment regularly and have an undetectable viral load for 6 months or more, have been shown not to be able to pass the virus to others during sexual intercourse.

The risk of transmitting and/or acquiring HIV can also be reduced through use of

Treatment and care for HIV is provided in NHSGGC via the Brownlee service.

National Data Portal

PHS  produce reports which provide up-to-date epidemiological summaries in relation to BBVs and STIs in Scotland, highlighting key trends and identifying areas for priority action. HPS Website – All surveillance reports

For information on the epidemiology of HIV in UK  see Public Health England website.

Injecting Equipment Services in NHSGGC

The NHSGGC Injecting Equipment Provision service offers sterile needles, syringes and other equipment free of charge to people who inject drugs.  The service provides a valuable public health benefit for individuals and communities by reducing the spread of blood borne viruses and other related infections.  This service is provided by community pharmacies throughout Greater Glasgow and Clyde NHS area, the Glasgow Drug Crisis Centre some Alcohol and Drug Recovery Services and some third sector organisations for example Waverley Care and the Simon Community may also be able to provide.  Community pharmacies provide a wide range of health care information and advice and are important contact points that give immediate access to a health care professional.

To find out where you or someone else can access Injecting Equipment Provision in NHSGCG visit www.needleexchange.scot

Public Health Scotland and SDF have produced good practice guidance on Injecting Equipment Provision in Scotland.

Public Health Scotland provides information on the provision of injecting equipment. This includes the number of outlets, attendances and the types of injecting equipment distributed to people who inject illicit drugs (including Novel Psychoactive Substances and Image and Performance Enhancing Drugs) in Scotland.

Patient Information

Leaflet 1 – BBV Testing leaflet – currently being updated

Leaflet 2 – Waiting for results

Leaflet 3 – BBV – negative results

Leaflet 4 – HIV – Newly Diagnosed

Leaflet 5 – Hep C – Newly Diagnosed 

Leaflet 6 – Hep B – Newly Diagnosed

Leaflet 7 – Basic information on HIV 

Leaflet 8 – What you need to know about PEP  This leaflet is also available in French; Urdu; Arabic   

Leaflet 9 – Living with Hep C (2017)

BBV Training

It is important that staff and services who work with anyone who might be at risk are aware of BBVs, key prevention messages and either how to do a test or refer someone for testing.

A range of free BBV training is available to those working within NHSGGC.

NHS Learn Pro – GGC116 Blood Borne Viruses

NHS Learn Pro – GGC149 HIV Stigma       

The Scottish Drugs Forum also provides both online and in person see Scottish Drugs Forum (SDF) and has a number of resources relating to BBV Staff who require further advice, information or support around HIV/BBV testing or related patient issues should contact the Sandyford BBV Failsafe on 0141 211 8639 or email the professional helpline ggc.sandyfordprofessionalsupport@nhs.scot

For Staff – Occupational Exposure to BBV

If you need to report an incident or require advice, please contact Occupational Health on 0141 201 5610. The line is open Monday – Friday, 8am – 6pm.

Any incidents that occur out with these times should be reported to your local Accident & Emergency unit. Please ensure that you then report your injury to Occupational Health on the next working day.

BBV Guidelines – Occupational Health – Needlestick and other injuries