UK CAA Guidance on Aeromedical Certification for HIV Positive Applicants
Following diagnosis or on declaration of HIV infection, the pilot should be declared unfit or certificate issue deferred until reports have been obtained from the reviews described in (a) to (e) below. These can be used to assess functional fitness and the prospective incapacitation risk.
(a) HIV Specialist Review
(b) Neurology Review
|(c) Neuropsychological Review
The pilot should undertake a baseline neuropsychological assessment. The tests should assess timed psychomotor tasks and memory tasks which require attention, learning and active monitoring or retrieval of information. These baseline tests may be used as a future comparator.
(d) Psychiatry Review (if clinically indicated)
(e) Cardiology Review (if clinically indicated)
As a guide the following are generally acceptable medications providing the applicant has no ongoing side-effects and their FBC, LFTs, lipids and fasting glucose are acceptable:
• Abacavir, Didanosine, Emtricitabine, Lamivudine, Tenofovir, Zidovudine, Atazabavur, Fosamprenavir, Lopinavir, Ritonavir, Nelfinavir, Saquinavir, Nevirapine, Efavirenz, Darunavir.
• Other medication will be considered on an individual basis assuming they are appropriately licensed and there is sufficient data on their safety available.
Certificate holders should be declared unfit whilst initiating, modifying or discontinuing ART and may be reassessed after a period of 2 months, although in some cases it may be at least 6 months before recertification, by means of a report from their treating HIV specialist, to include recent
CD4+ counts and viral loads and confirmation of an absence of ongoing side-effects from medication or symptoms related to HIV seropositivity.
|3 Monthly||Viral loads and CD4+ count (can be submitted as part of a 6 monthly report from HIV specialist to include neurology review, if applicant remains stable with no symptoms related to infection or treatment)
|6 Monthly||Report with neurology review - see (b) above
If on ART, blood results should include LFTs and FBC
|12 Monthly||If on ART, blood results should include lipids and fasting glucose
|Cognitive Function Assessments (can be Licence Proficiency Check or Medical Flight Test with a Flight Examiner where risk of disease progression is low). Impaired performance will require further neuropsychological assessment to be compared with baseline testing and any deficits will require that the pilot is declared unfit.|
|New symptoms or results outside acceptable limits are likely to lead to an unfit assessment and should be referred to/assessed in consultation with the AMS in accordance with the class of certificate held.