View source for Routine follow-up for patients with HIV

{| class="wikitable"
! Intervention
! Recommendation
! Comments
|-
| Blood pressure check
| Perform annually in all patients
| 
|-
| Digital rectal exam
| Consider annually in all patients
| Inspect for anal warts, malignancy, prostate abnormalities in men
|-
| Ophthalmologic exam
| Perform dilated exam every 6–12 mo in patients with a CD4 count <50 cells/µL
| Exam with tonometry is advised every 2-3 y in all patients ≥50 y
|-
| Depression screening
| Perform annually in all patients
| Use conventional mental health interview or standardized test
|-
| Fasting glucose and/or HbA1c
| Perform every 6–12 mo in all patients
| Consider testing 1–3 mo after starting or modifying antiretroviral therapy. HbA1c may be used for screening. Consider threshold cutoff of 5.8%. HbA1c level should be performed every 6 mo in patients with diabetes mellitus
|-
| Fasting lipid profile
| Perform every 6–12 mo in all patients
| Consider testing 1–3 mo after starting or modifying antiretroviral therapy
|-
| Syphilis serology
| Perform annually in patients at risk for STDs
| More frequent testing may be indicated in patients at high risk for STDs
|-
| Gonorrhea and chlamydia testing
| Perform annually in patients at risk for STDs (see text for details)
| More frequent testing may be indicated in patients at high risk for STDs. Repeat testing 3 mo later if positive
|-
| Hepatitis C testing
| Perform annually in patients at risk, eg, injection drug users and MSM
| More frequent testing may be indicated in patients at high risk, especially if increase in serum transaminases
|-
| Trichomoniasis
| Perform annually in all women
| Repeat testing 3 mo later if positive
|-
| TST or IGRA
| Perform at baseline and annually in patients at risk for tuberculosis
| No need to repeat in patients with prior positive TST; additional tuberculosis testing may be indicated depending on potential exposure
|-
| Colorectal cancer screening
| Perform at age 50 y in asymptomatic patients at average risk
| More frequent testing is indicated in patients with a history of adenomatous polyps; testing at an earlier age may be advised in patients with a strong family history of colon cancer
|-
| Mammography
| Perform annually in all women age ≥50 y
| Some authorities advise initiation of screening starting at age 40 y based on an individual risk/benefit assessment
|-
| Cervical Pap smear
| Perform annually in all women after 2 normal Pap tests documented during the first year following HIV diagnosis
| 
|-
| Bone densitometry
| Perform baseline exam in postmenopausal women and men age ≥50 y
| Detection of premature bone loss requires periodic monitoring thereafter; risk factors for premature bone loss include white race, small body habitus, sedentary lifestyle, cigarette smoking, alcoholism, phenytoin therapy, corticosteroid therapy, hyperparathyroidism, vitamin D deficiency, thyroid disease, and hypogonadism
|-
| Abdominal ultrasonography
| Perform once in men aged 65–75 y who have ever smoked
| Screening test for abdominal aortic aneurysm
|-
| Patient education
| Address regularly in all patients
| Issues may include sexual behavior, alcohol and drug counseling, dietary teaching, weight reduction, smoking cessation, and seat belt use.
|}

== Further Reading ==

* Primary care guidelines for the management of persons infected with HIV: 2013 update by the HIV medicine association of the Infectious Diseases Society of America. ''Clin Infect Dis''. 2014 Jan;58(1):e1-34. doi: [https://doi.org/10.1093/cid/cit665 10.1093/cid/cit665].

[[Category:HIV]]