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
...iagnosis...
...G CARE ENGAGEMENT, MEDICATION ADHERENCE...
...th HIV should be provided timely access to routin...
...tes should make every effort to pr...
...s should implement programs incorporating evidence...
...e sites should utilize a multidisciplinary m...
...L EVALUATION AND IMMEDIATE FOLLOW-UP FOR PE...
...nsive present and past medical hist...
...Tests for All Persons With HIV...
...Patients who have no documentation of th...
...ell Counts and Percentages...
A CD4 cell count with percentage should...
...urement of the CD8 cell count and the ratio...
...A Levels A quantitative HIV RNA (viral...
...stance Testing...
Patients should be assessed for transmitt...
Resistance testing should be obtained for patien...
...ide modification of ART, resistanc...
...ed integrase strand transfer inhibitor...
...d Tests in Selected Patients...
...ropism AssayTropism testing should be performed...
HLA B*5701...
...LA-B*5701 testing should be performed...
...ts who are positive for the HLA B*5701 hap...
...sts to Assess Safety and General Health...
...blood count with differential white bl...
...se many antiretroviral drugs, HIV infecti...
...creening for Coinfections...
...xually Transmitted Infections (STIs)...
...Persons with HIV should be screened for...
...ons having receptive vaginal sex sho...
...philis...
All patients should be screened for syphil...
...bar puncture should always be performed for...
...lumbar puncture should be performed i...
...t Tuberculosis (TB)...
...iation of care, persons with HIV without a histo...
...ersons with HIV who are close contacts of pe...
Hepatitis A, B, and C...
...s with HIV should be screened for evide...
...Persons with HIV should be screened for ev...
...Persons with HIV should be screened for HC...
...ts born to persons with HBV- and/or HC...
Persons who are not immune to HAV and HBV sho...
...ons who are not immune to HAV and HB...
...les, Mumps, and Rubella...
All persons with HIV born in 1957 or a...
...MR vaccine should be given to protect against me...
...la Zoster VirusSerologic screening for varicella...
...ts That May Be Performed Under Certain...
...diographyA baseline chest radiograph should...
...al Cancer Screening...
...Persons with a uterus wh...
...h a uterus who are >30 years old should hav...
...atypical squamous cells of unknown signif...
...llowing hysterectomy for benign disease, r...
...reeningPersons with a history of receptive...
...ucose-6-Phosphate DehydrogenaseScreening for gluco...
...tingAll persons of childbearing pot...
...tosterone Level...
...Morning serum testosterone levels are...
...taining testosterone levels in women a...
...ests NOT Recommended for General Sc...
...esting for HSV, CMV IgG, Toxoplasma IgG,...
...g for serum cryptococcal antigen ma...
...E HEALTHCARE MAINTENANCE CONSIDERATIONS FOR PEOPL...
...ic Monitoring Following the Initial Ass...
...iation of ART, HIV RNA should be reche...
...ount should be monitored to determine the need...
...creening for Mental Health and Substance...
...ning for substance use should be do...
...ning for depression using validated...
...eening and Vaccination for Infectious Dise...
...hlamydia, Gonorrhea, Trichomoniasis...
...Screening for syphilis, chlamydia, an...
...aving vaginal sex should be screened fo...
...lored messages are critical for patients w...
...d Vaccination for Other Infectious Diseases...
...uberculosis screening annually in persons at ri...
...t testing is recommended in patients wit...
...Vaccinations for pneumococcal infection, influ...
...omatic persons with CD4 >200 cells/m...
...tis A and B (HAV, HBV)...
...are susceptible to infection should be va...
...ination should be recommended for nonimmune sex...
...o are negative for HBsAg and HBsAb but...
...for HAV is recommended for all nonimmune individ...
...illomavirusPersons between 9–26 yea...
...ella Zoster Virus...
...o are susceptible to VZV (those who have not been...
...la primary vaccination may be considered in VZV-...
...ombinant zoster vaccine, two dose series, should...
...reening for and Prevention...
...ents who smoke should be strongly encouraged t...
...ning for prostate, breast, lung, and colon canc...
...nial screening mammography is recommended...
...ersons with HIV between 21–29 years of age...
...or persons >30 years of age, cervical Pap t...
...creening: Periodic anal cytology by anal...
...ng for hepatocellular carcinoma every 6...
...thcare Maintenance...
...od count and chemistry panels should be mon...
...alysis should be monitored annually a...
...with HIV should be asked about their repr...
...education should be provided at every visi...
...All persons with HIV should have semi-annual ora...
...ND OTHER NONCOMMUNICABLE COMORBIDI...
Lipid levels should be obtained prior to,...
...m or fasting blood glucose (FBG) and hemoglobin A1...
...ne bone densitometry (DXA) screening fo...
Testosterone replacement therapy for c...
...IDERATIONS FOR CISGENDER WOMEN AND TRANSGENDER ME...
...ception and Preconception Care...
...d Preconception CareAll persons with HI...
...ntion of Perinatal Transmission...
...perinatal transmission, all pregnant pers...
...Infants exposed to HIV in utero should be manag...
...edingIn the US, persons with HIV should a...
...CONSIDERATIONS FOR CHILDREN...
...diagnosed with HIV should undergo HIV res...
...n with HIV should initiate ART, regardless of CD4...
...counts and HIV RNA should be monitored n...
...inations should be administered according to...
...nts and children with HIV should be managed by a...
...CONSIDERATIONS FOR ADOLESCENT...
Adolescents with HIV require an individ...
Adolescents with HIV should have a coordinated, d...
...ccinations should be administered a...
...III. CONSIDERATIONS FOR TRANSGENDER AND...
...and gender diverse persons with HIV shoul...
...ake forms, medical records, and other documenta...
...rsons should be offered medical and/or surgical th...
...ning should be conducted based on guidelin...
...ble 1. Initial Assessment: History of the P...
...er Medical and Surgical HistoryHaving trouble view...
...al Assessment — Review of Systems...
...ecommended Initial Laboratory Screening and Othe...
Treatment
...atment...
...Healthcare Maintenance for People W...
...Effect of Protease Inhibitors and No...
Gender Identity
...r Identity...
...able 7. Terminology Associated with Gender Iden...
...Principles of Care of Transgender and Gender...