HIV Primary Care

Publication Date: November 13, 2013

Key Points

Key Points

The prognosis of persons with HIV-infected persons are increasingly developing common health problems that also affect the general population. Some of these conditions may be related to HIV infection itself or its treatment.

HIV-infected persons should be managed and monitored for all relevant age- and sex-specific health problems.

Figure 1. Primary Care Management of HIV


Figure 2. HIV Testing Algorithm


Diagnosis and Assessment

...sis and Assessment...

...al Assessment—History—Present and PastH...


...ial Assessment—Review of Systems and Physic...


...comprehensive present and past medical hi...


...Disease Tests: Serological Assays for HIV

...o have no documentation of their HIV se...


...l Counts and Percentage...

...CD4 cell count with percentage should be...

...nt of the CD8 cell count and the ratio...


...sma HIV RNA Leve...

...ntitative HIV RNA (viral load) level sho...


...V Resistance Testing...

...ause drug-resistant virus can be transmitted...

...eferred, repeat testing at the time of antiretrovi...

...ance testing is also indicated for p...

...failing to respond to integrase strand transfer...


...eceptor Tropism Assay...

...ing should be performed if the use of a CCR5 ant...


...boratory Tes...

...e Blood Cell Count and Chemistry Panel...

A complete blood cell count with differ...

...se-6-Phosphate Dehydrogenase...

...glucose-6-phosphate dehydrogenase (G6PD) deficien...

Fasting Lipid...

...many antiretroviral drugs, HIV infection i...

...5701 Screening

...701 testing should be performed be...

...are positive for the HLA B*5701 haplotype ar...

...d Calculated Creatinine Clearanc...

...inalysis should be performed and baseline calcu...

...nd calculated creatinine clearance assay shoul...


...d Comorbidity Laboratory Tests...

Tuberculosis Scree...

...of care, HIV-infected patients without a histo...

...itive test results should be treated for latent...

...epeat testing is recommended in patients with...

...tients who are close contacts of pe...

...ogic Testing for Toxoplasma g...

...HIV-infected patients should be tested for prio...

Toxoplasma-seronegative adults, representing...

...iral Hepatitis Screening and Vaccination Recommend...

...-infected patients should be screened for...

...e susceptible to infection should be vaccinated ag...

...ing should be repeated 1-2 months after the thi...

...ould be recommended for nonimmune...

...o are negative for HBsAg and HBsAb...

...infected patients should be screened f...

...sting should be ordered on all those with a p...

- and/or HCV-infected women should be tested fo...

...cination is recommended for all suscept...

Hepatitis A vaccination is recommended for all s...

...ccine may be considered for all other noni...

...creening and Vaccination Recommendations f...

...er risk of cytomegalovirus (CMV) in...

...ho are susceptible to varicella zoster vi...

...ry vaccination may be considered in HIV-infected...

...cted children ages 1-8 years with CD4 cell percent...

...reening for Syphilis

...l patients should be screened for syp...

...ncture should always be performed for pa...

A lumbar puncture should be performe...

...or Other Sexually Transmitted Diseas...

All women should be screened for trichomoni...

...ould be screened for gonorrhea and chlamydi...

Retesting in 3 months is indicated in me...

...s should be screened for all of these condition...

...er Screening and Prevention...

...women should have a cervical Pap smear perfo...

...atypical squamous cells (both ASC-US [aty...

...ening for Anal Human Papil...

...men and women with human papillomavirus (H...

...ccination is recommended for all females ages 9...

...Testosterone Leve...

...g serum testosterone level testing is recommended...

...testosterone levels in women in nonresearch...

...aboratory Tests...

...esting for cryptococcal infection with serum crypt...

...st Radiology

...radiograph should be obtained in all HIV...


Patient Management

...ent Management...

...ne Health Care Maintenance in the HIV-Infected...


...Immunizations for HIV-Infected AdultsHaving tro...


Behavioral Intervention

...ehavioral Interv...

...messages regarding risk reduction should...


...ed messages are critical for patients who repor...


Schedule of Care Evaluation for HIV-Infected Patients

...hedule of Care Evaluation for HIV-Infe...

...ults

...is generally monitored every 3-4 mon...

...counts should be monitored both t...

...should generally be monitored every 3-4...

STD screening and tuberculosis scre...

...nations for pneumococcal infection, (SR, H)218...

...uenza, (SR, H)21881...

...cella, (SR, M)21881

...itis A (SR, H)2188...

...B (SR, H)21881...


Special Considerations for Women and the Prevention of Mother-to-Child Transmission

...Considerations for Women and the Prevention of...

...ion and Preconception Care...

...V-infected women of childbearing age s...


...reast Cancer Screeni...

...uld be performed annually in women age >50 yea...

...0-49 years, providers should perform individualize...


Menopaus...

...cement therapy, particularly if prol...

...ment therapy may be considered in women who experi...


Mother-to-Child Transm...

...ction of their fetus, pregnant women should...

...exposed to HIV in utero should receive antiretrovi...

...h-risk exposed infants should have virol...


...al Considerations for Children...

-infected infants should undergo H...

...e of the rapid progression of disease,...

...er the first year of life, initiati...

...unts and viral loads should be monitored no le...

...ldhood vaccinations should be administ...

...d infants and children should be managed b...


...Considerations for Adolescents...

...infected adolescents require an individual...

...s infected with HIV should have a coordinat...


...tabolic Comorbidities Associated Wit...

...ing blood glucose and/or hemoglobi...

...sting lipid levels should be obtained p...

...nsitometry (dual-energy x-ray absorptiometry,...


...mizing Patient Adherence to HIV Car...

...-infected patients should be provided timely acc...

...should make every effort to provide c...

...care sites should utilize a multidisciplinary m...

...patients should be evaluated for depres...