Primary Care Guidance for Persons with HIV
Key Points
Key Points
- This guidance from an expert panel of the HIV Medicine Association (HIVMA) of the Infectious Diseases Society of America (IDSA) updates the 2013 HIV primary care guidelines.
- These recommendations encompass the comprehensive care of persons with HIV, including comorbidity management
Diagnosis
...gnosis...
I. OPTIMIZING CARE ENGAGEMENT, MEDICATI...
...ersons with HIV should be provided timely ac...
...tes should make every effort to provide care in...
...care sites should implement programs incorporati...
...sites should utilize a multidisciplinary model...
...UATION AND IMMEDIATE FOLLOW-UP FOR PE...
...present and past medical history including HIV...
...c Tests for All Persons With H...
...ng Patients who have no documentation...
...ell Counts and Percentages...
...CD4 cell count with percentage should be o...
...Measurement of the CD8 cell count...
...IV RNA Levels A quantitative HIV RNA (viral...
HIV Resistance Testin...
...hould be assessed for transmitted drug resi...
...ng should be obtained for patients re-engag...
...e modification of ART, resistance te...
...transmitted integrase strand transfe...
...-Related Tests in Selected Patients
...r Tropism AssayTropism testing should b...
...B*5701...
...LA-B*5701 testing should be performed befor...
...ents who are positive for the HLA B*5701 ha...
...ratory Tests to Assess Safety and General He...
...e blood count with differential white blood cell c...
...use many antiretroviral drugs, HIV infection...
...eening for Coinfec...
...ing for Sexually Transmitted Infections (STIs) â...
...ersons with HIV should be screened fo...
...All persons having receptive vaginal sex s...
...philis
...uld be screened for syphilis upon initiati...
...puncture should always be performed for pati...
...ure should be performed in patients who exp...
...uberculosis (TB)...
...ion of care, persons with HIV without a h...
...HIV who are close contacts of persons with infecti...
...atitis A, B, and C...
...HIV should be screened for evidence of he...
...Persons with HIV should be screened fo...
...HIV should be screened for HCV antibody up...
...fants born to persons with HBV- and/...
...Persons who are not immune to HAV and HB...
...re not immune to HAV and HBV should be immuniz...
...es, Mumps, and Rubell...
...All persons with HIV born in 1957 or after should...
...R vaccine should be given to protect against m...
...icella Zoster VirusSerologic screening for varicel...
...ay Be Performed Under Certain Circu...
...diographyA baseline chest radiograph should b...
...Cancer Screening
...Persons with a uterus...
...s with a uterus who are >30 years old...
...ns with atypical squamous cells of unk...
...hysterectomy for benign disease, routine scree...
...ancer ScreeningPersons with a histo...
...lucose-6-Phosphate DehydrogenaseScreening...
...estingAll persons of childbearing potential shoul...
...Testosterone Level...
...serum testosterone levels are recommended i...
...Obtaining testosterone levels in women at b...
...Recommended for General Screening Purposes...
...g for HSV, CMV IgG, Toxoplasma IgG,...
...ng for serum cryptococcal antigen may be consi...
...INE HEALTHCARE MAINTENANCE CONSIDERATIONS F...
...ific Monitoring Following the Initial Assessme...
...tiation of ART, HIV RNA should be rechecked after...
CD4 cell count should be monitored to det...
...ening for Mental Health and Substan...
Screening for substance use should be d...
Screening for depression using validated screen...
...Vaccination for Infectious Diseases...
...lamydia, Gonorrhea, Trichomoniasis...
...syphilis, chlamydia, and gonorrhea in asy...
...having vaginal sex should be screened fo...
...ed messages are critical for patient...
...and Vaccination for Other Infectio...
...Perform tuberculosis screening annually in pe...
...eat testing is recommended in patients with...
...ccinations for pneumococcal infection, influenz...
Asymptomatic persons with CD4 >200 cell...
...s A and B (HAV, HBV)
...Those who are susceptible to infection should b...
Vaccination should be recommended for nonimmu...
...atients who are negative for HBsAg and HBsA...
...Vaccination for HAV is recommended for all no...
...papillomavirusPersons between 9–26 y...
...a Zoster Virus
...nts who are susceptible to VZV (those...
...aricella primary vaccination may be consid...
...ecombinant zoster vaccine, two dos...
...for and Prevention of Cancer...
...ts who smoke should be strongly encouraged to...
...g for prostate, breast, lung, and colon can...
...Biennial screening mammography is r...
...h HIV between 21–29 years of age should h...
...ersons >30 years of age, cervical Pap tes...
Anal cancer screening: Periodic...
...r hepatocellular carcinoma every 6 months b...
Other Healthcare Mainten...
...Complete blood count and chemistry pan...
...lysis should be monitored annually among t...
...persons with HIV should be asked about their re...
...t education should be provided at ever...
...ll persons with HIV should have semi-ann...
...BOLIC AND OTHER NONCOMMUNICABLE COMORBIDITIES...
...evels should be obtained prior to, and...
...ing blood glucose (FBG) and hemoglobin A1c (H...
...e bone densitometry (DXA) screening for osteopo...
...osterone replacement therapy for cisgender men sh...
...NSIDERATIONS FOR CISGENDER WOMEN AND TRA...
...on and Preconception Care...
...and Preconception CareAll persons with H...
...evention of Perinatal Transmission...
...rinatal transmission, all pregnant persons with HI...
...exposed to HIV in utero should be manage...
...gIn the US, persons with HIV should avoid...
...AL CONSIDERATIONS FOR CHILDREN...
...sed with HIV should undergo HIV resistance...
...dren with HIV should initiate ART,...
...and HIV RNA should be monitored no less than e...
...hood vaccinations should be administe...
...and children with HIV should be mana...
...ONSIDERATIONS FOR ADOLESCENT...
...ts with HIV require an individual and devel...
Adolescents with HIV should have a c...
...hould be administered according to ACIP sch...
...III. CONSIDERATIONS FOR TRANSGENDER AND GEND...
...er and gender diverse persons with...
...rms, medical records, and other documentation...
...nsgender persons should be offered...
...g should be conducted based on guidelines for...
...ial Assessment: History of the Present Illnes...
...2. Other Medical and Surgical Histo...
...Initial Assessment — Review of Systems and...
...4. Recommended Initial Laboratory Screening...
Treatment
...eatmen...
...e Healthcare Maintenance for People...
...t of Protease Inhibitors and Nonnucleoside Rev...
Gender Identity
Gender Identit...
...minology Associated with Gender Identity...
...rinciples of Care of Transgender and Gende...