Blood Borne Viruses (BBVs)

Local Blood Borne Virus (BBV) Services

The Ayrshire and Arran Blood Borne Virus (BBV) Service is based at University Hospital Crosshouse. The unit provides specialist assessment, treatment and care for patients who have been diagnosed with HIV, Hepatitis C (HCV) and Hepatitis B (HBV).

The BBV specialist Team:-

BBV Nurses

The specialist nurse team have clinics within Crosshouse Hospital and community settings in North, East and South Ayrshire. The nurse team undertake blood tests, Fibroscans (to assess liver health), and sexual health screens. They offer support and advice to patients receiving treatment for HIV, HCV, and HBV.

BBV Clinicians

The BBV clinical team will be able to discuss the results of any tests / investigations that have been carried out and explain any changes to care. Clinics are held at Crosshouse Hospital but can also be done via telephone.

BBV Pharmacist

Specialist Pharmacist input to discuss medication regimens is available and can provide advice and information on the safe use of the medications the team prescribe. Consultations can be held via telephone.

Referral to the BBV service

Initial referral to the Ayrshire and Arran BBV Service is generally through GPs, Addiction Services, or hospital in- and Out-patient services, but referrals are accepted from any source. Once patients are referred to the service, they are assessed for the most suitable treatment options or monitored closely on a regular basis.

Patients are asked to contact the BBV team directly, should they develop any new symptoms or are concerned about any changes in their condition.

Patients who have been diagnosed with a BBV but who are not currently receiving treatment can also self-refer to the clinic.

If you have any queries or concerns, then please call the BBV team on: – 01563545508

What will happen at the BBV clinic?

HCV
HCV is usually a nurse-led service. Once referral is received, you will be offered an appointment at the clinic to complete an initial assessment. Most people will be seen at the start, during, and the end of treatment, which is usually 8 to 12 weeks long. At the clinic, you will be offered a blood test and may receive a fibroscan (this is a simple type of ultrasound that is used to measure inflammation in your liver). Some patients with more complex conditions will be referred to the medical pathway. The BBV nurse will explain your treatment options, and answer any questions you may have, and you will usually be offered oral treatment. The oral treatment has a high cure rate of around 90-95% with few side effects. If left untreated, HCV can cause lasting damage to the liver, including liver cancer.

HBV

Once referral is received, you will be offered an appointment with the BBV nurse at the clinic to have some bloods taken, and a fibroscan (this is a simple type of ultrasound that is used to measure inflammation in your liver). You will be invited back to clinic within a week or so, to discuss treatment or management options, and to complete an initial assessment with the BBV Clinician. Most people will be invited to the clinic twice per year.

Not everyone with HBV needs treatment – this will depend on the results of investigations, and any symptoms you have. Acute and chronic HBV sometimes clear from your body on its own (although this is much more likely with acute HBV).  Sometimes, your body’s immune system isn’t able to clear the virus on its own, and you may require treatment.

HIV
You will be invited to the BBV clinic within 2 weeks of the referral being received, where you will have an assessment by the BBV nurse including blood tests. Within another 2 weeks, you will be invited to the clinic and the BBV clinician will meet with you to complete an in-depth assessment. They will discuss treatment options with you and answer any questions you may have.

You will be offered an initial 3-month supply of medication. You will be invited back to clinic at 4 weeks so clinicians can test your blood again to check you are tolerating the treatment. You will be invited to the BBV clinic for bloods at 4 weeks, 12 weeks, 24 weeks and 52 weeks. After 1 year, you will be invited to attend the clinic every 6 months for a review.

On treatment, most people with HIV have an undetectable viral load within 3 to 6 months.

Testing for BBVs

A simple blood test is used to test for BBV’s.

Did you know that you can access testing for BBVs by speaking to your GP, booking an appointment at any of our Sexual Health Clinics, through the Terrence Higgins Trust, or your Addiction support worker or nurse if you have one.

What is Hepatitis B (HBV)?

The Hepatitis B virus (HBV) is carried in blood, semen and vaginal fluids. One way it can be transferred is through sexual intercourse with an infected person without a condom. The virus is also easy to pass on by sharing injecting equipment. It can also be transferred from mother to baby during pregnancy or birth.

Lots of people with hepatitis B don’t notice any symptoms and this can lead to it being missed. Symptoms can include:

• Stomach ache
• Jaundice (yellowing of the skin and whites of the eyes)
• Loss of appetite
• Tiredness
• Vomiting

Symptoms can last a number of weeks, and it can take some time to return to normal.

People infected with HBV as adults tend to recover fully, but around 1 in 10 remain infectious and then spread the infection onwards.

Hepatitis B vaccine – Immunisation in Scotland | NHS inform

People infected as children (under 5) or at birth are much less likely to clear the virus, and around 9 in 10 remain infectious through to adulthood.

HBV can affect the liver if undiagnosed or left untreated for a length of time. If you test positive, it is important to take medication for HBV regularly and attend any follow-up appointments recommended by the BBV clinical team.

What is Hepatitis C (HCV)?

Hepatitis C  is a blood borne virus (BBV), meaning it is carried in the blood. The virus can be passed on when blood from someone with the virus, enters the blood stream of someone else.

HCV can be passed on by:

• Sharing injecting equipment/ sharing drug use equipment
• From mother to baby during pregnancy
• Medical or dental treatment in countries which don’t have adequate infection control procedures or where Hep C is common
• Unsterilised piercing or tattoo equipment (although, in registered premises in the UK this should be safe)
• Sex (this is rare, although slightly more common among men who have sex with men).

Hepatitis C (Hep C) can be either acute (diagnosed within the first 6 months of infection), or chronic (diagnosed after the first 6 months of infection).

Symptoms 

Many people with HCV don’t notice any symptoms when they are first infected.

Early symptoms or acute Hep C might include:

• stomach ache
• loss of appetite
• tiredness
• nausea
• a temperature
• Jaundice (yellowing of the skin and whites of the eyes)

Later symptoms or chronic Hep C might include:

• Stomach ache
• Nausea, indigestion, or bloating
• Feeling tired all the time
• Itchy skin
• Brain fog
• Depression or anxiety
• Jaundice (yellowing of the skin and whites of the eyes)
• Joint pain

What is HIV?

HIV stands for Human Immunodeficiency Virus.

The Human Immunodeficiency Virus (HIV) is a virus which attacks the body’s immune system which, if left untreated, can leave the body vulnerable to infections with which it would normally cope.

It is estimated that a quarter of people living with HIV in Scotland are unaware of their infection. Those who are unaware of their status remain at risk to their own health and of unknowingly passing the infection onto others.

HIV is passed on through bodily fluids (e.g. blood, semen, vaginal fluid, breast milk etc.)

People can get the virus through:

• Vaginal or anal sex without a condom
• Sharing drug injecting equipment
• From mother to baby during pregnancy
• Coming into contact with contaminated blood e.g. needle stick injury or blood transfusion in setting with poor infection control procedures. (Blood and blood products in the UK are all screened for BBVs)

Symptoms

Many people will feel ill with flu-like symptoms around 2 to 6 weeks after infection, and this could last for up to 2 weeks. This is called primary HIV infection.

The most common symptoms of primary HIV infection or seroconversion are:

• Sore throat
• Fever
• Feeling tired
• Rash
• Swollen lymph nodes
• Muscle aches

Some people don’t have any symptoms at all during this stage.

After this stage, symptoms can disappear, and people may not experience any further symptoms for many years. Because of this, many people with HIV do not know they have the virus. During this time, the virus is still active in the body and can continue to cause damage to the immune system. 

Over time, the virus progressively weakens the immune system. This can lead to symptoms like:

• Swollen lymph nodes
• Weight loss
• Cough
• Night sweats
• Extreme tiredness

Harm Reduction

You can access injecting equipment provision (IEP) via community pharmacies or needle exchanges across Ayrshire.

Harm Reduction – Community Pharmacies

Alcohol and Drug Services – NHS Ayrshire & Arran

Use a condom for safer sex and to prevent STI’s. You can get condoms FREE OF CHARGE through our CCard scheme, or postal condom service. For more information click here.

You can access STI testing:

• At the Sexual Health Clinic. Contact the sexual health clinic to book an appointment on 01294 323 226.
• At some local pharmacies. Check which Pharmacy near you offers this by checking here.
• Launching soon 2025 via the shayr website – order a FREE Chlamydia/Gonorrhoea STI testing kit to your home, and post back to our local labs.