Initial assessment for patients with HIV - Revision history

Aidan: /* Initial Regimens */

2025-06-12T15:55:40Z

Initial Regimens

← Older revision		Revision as of 15:55, 12 June 2025
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	**Stribild: elvitegravir/cobicistat/tenofovir disoproxil/emtricitabine		**Stribild: elvitegravir/cobicistat/tenofovir disoproxil/emtricitabine
	**Complera: emtricitabine/rilpivirine/tenofovir disoproxil		**Complera: emtricitabine/rilpivirine/tenofovir disoproxil
			*Some practitioners use four-drug regimen (e.g. Biktarvy plus darunavir/cobicistat) until viral suppression, particularly in patients presenting with high viral loads
	*Don't forget to add [[TMP-SMX]] DS 1 tablet PO daily if presumed low CD4 count		*Don't forget to add [[TMP-SMX]] DS 1 tablet PO daily if presumed low CD4 count

Aidan at 15:10, 30 April 2021

2021-04-30T15:10:07Z

← Older revision		Revision as of 15:10, 30 April 2021
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	**Rubella serology		**Rubella serology
	**Trichomonas testing		**Trichomonas testing
			*Low threshold for CT chest/abdo/pelvis for lymphadenopathy and non-tuberculous mycobacteria in patients with low CD4 counts

			== Physical Examination ==
⚫	==Initial ~~regimens~~==

			* Assess for cutaneous Kaposi sarcoma

		⚫	==Initial Regimens==

	*All are integrase inhibitor with two nucleoside analogues		*All are integrase inhibitor with two nucleoside analogues
	*Consider one of the [[single-tablet regimens for HIV]]		*Consider one of the [[single-tablet regimens for HIV]]
			**Biktarvy 1 tablet PO once daily
	**Triumeq (if HLA B5701 negative): dolutegravir, abacavir, and lamivudine		**Triumeq (if HLA B5701 negative): dolutegravir, abacavir, and lamivudine
	**Truvada (tenofovir/TDF and emtricitabine) with either dolutegravir or raltegravir		**Truvada (tenofovir/TDF and emtricitabine) with either dolutegravir or raltegravir
	**Stribild: elvitegravir/cobicistat/tenofovir disoproxil/emtricitabine		**Stribild: elvitegravir/cobicistat/tenofovir disoproxil/emtricitabine
	**Complera: emtricitabine/rilpivirine/tenofovir disoproxil		**Complera: emtricitabine/rilpivirine/tenofovir disoproxil
			*Don't forget to add [[TMP-SMX]] DS 1 tablet PO daily if presumed low CD4 count

	==Further Reading==		==Further Reading==

Aidan: /* Investigations */

2021-03-30T15:41:23Z

Investigations

← Older revision		Revision as of 15:41, 30 March 2021
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	== History ==		==History==

	* Date and context of diagnosis		*Date and context of diagnosis
	* History of [[Opportunistic infections in HIV]]		*History of [[Opportunistic infections in HIV]]
	* Sexual history		*Sexual history

	== Investigations ==		==Investigations==

	* HIV-specific		*HIV-specific
	** CD4/CD8 count		**CD4/CD8 count
	** HIV-RNA viral load		**HIV-RNA viral load
	** HIV genotype		**HIV genotype
	** HLA *B5701 genotyping (for abacavir)		*HLA B5701 genotyping (for abacavir)
	** Genetic resistance assays (± tropism testing for CCR5 inhibitors)		**Genetic resistance assays (± tropism testing for CCR5 inhibitors)
	** G6PD deficiency		**G6PD deficiency
	* Routine		*Routine
	** CBC, lytes, creatinine		**CBC, lytes, creatinine
	** Fasting lipids, Hb A1c		**Fasting lipids, Hb A1c
	** Urinalysis (glucose and protein)		**Urinalysis (glucose and protein)
	** Consider bone mineral density testing and vitamin D levels		**Consider bone mineral density testing and vitamin D levels
	* STIs and coinfections		*STIs and coinfections
	** TB skin test		**TB skin test
	** Consider chest x-ray		**Consider chest x-ray
	** HAV-IgG, HBV-sAg/sAb/cAb, and HCV-Ab		**HAV-IgG, HBV-sAg/sAb/cAb, and HCV-Ab
	** Syphilis		**Syphilis
	** Three-site mucosal (genital/rectal/throat) NAAT for chlamydia and gonorrhea		**Three-site mucosal (genital/rectal/throat) NAAT for chlamydia and gonorrhea
	** Toxoplasma, varicella, CMV, and measles serologies		**Toxoplasma, varicella, CMV, and measles serologies
	* For women and trans men		*For cis women and trans men
	** Pap smear		**Pap smear
	** Rubella serology		**Rubella serology
	** Trichomonas testing		**Trichomonas testing

	== Initial regimens ==		==Initial regimens==

	* All are integrase inhibitor with two nucleoside analogues		*All are integrase inhibitor with two nucleoside analogues
	* Consider one of the [[single-tablet regimens for HIV]]		*Consider one of the [[single-tablet regimens for HIV]]
	** Triumeq (if HLA B5701 negative): dolutegravir, abacavir, and lamivudine		**Triumeq (if HLA B5701 negative): dolutegravir, abacavir, and lamivudine
	** Truvada (tenofovir/TDF and emtricitabine) with either dolutegravir or raltegravir		**Truvada (tenofovir/TDF and emtricitabine) with either dolutegravir or raltegravir
	** Stribild: elvitegravir/cobicistat/tenofovir disoproxil/emtricitabine		**Stribild: elvitegravir/cobicistat/tenofovir disoproxil/emtricitabine
	** Complera: emtricitabine/rilpivirine/tenofovir disoproxil		**Complera: emtricitabine/rilpivirine/tenofovir disoproxil

	== Further Reading ==		==Further Reading==

	* [http://occguidelines.com/guidelines/ Clinical Care Guidelines for Adults and Adolescents Living with HIV in Ontario, Canada]		*[http://occguidelines.com/guidelines/ Clinical Care Guidelines for Adults and Adolescents Living with HIV in Ontario, Canada]
	* Primary Care Guidelines for the Management of Persons Infected With HIV: 2013 Update. ''Clin Infect Dis''. 2014:58(1):e1–e34. doi: [https://doi.org/10.1093/cid/cit665 10.1093/cid/cit665]		*Primary Care Guidelines for the Management of Persons Infected With HIV: 2013 Update. ''Clin Infect Dis''. 2014:58(1):e1–e34. doi: [https://doi.org/10.1093/cid/cit665 10.1093/cid/cit665]

	[[Category:HIV]]		[[Category:HIV]]

Aidan: added resources

2019-09-25T16:30:51Z

added resources

← Older revision		Revision as of 16:30, 25 September 2019
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	** Stribild: elvitegravir/cobicistat/tenofovir disoproxil/emtricitabine		** Stribild: elvitegravir/cobicistat/tenofovir disoproxil/emtricitabine
	** Complera: emtricitabine/rilpivirine/tenofovir disoproxil		** Complera: emtricitabine/rilpivirine/tenofovir disoproxil

			== Further Reading ==

			* [http://occguidelines.com/guidelines/ Clinical Care Guidelines for Adults and Adolescents Living with HIV in Ontario, Canada]
			* Primary Care Guidelines for the Management of Persons Infected With HIV: 2013 Update. ''Clin Infect Dis''. 2014:58(1):e1–e34. doi: [https://doi.org/10.1093/cid/cit665 10.1093/cid/cit665]

	[[Category:HIV]]		[[Category:HIV]]

Aidan: Aidan moved page First clinic visit for HIV to Initial assessment for patients with HIV without leaving a redirect

2019-09-25T16:26:26Z

Aidan moved page First clinic visit for HIV to Initial assessment for patients with HIV without leaving a redirect

← Older revision		Revision as of 16:26, 25 September 2019
(No difference)

Aidan: /* Initial regimens */

2019-09-23T10:51:42Z

Initial regimens

← Older revision		Revision as of 10:51, 23 September 2019
Line 34:		Line 34:

	* All are integrase inhibitor with two nucleoside analogues		* All are integrase inhibitor with two nucleoside analogues
	* Consider one of the [[[single-tablet regimens for HIV]]		* Consider one of the [[single-tablet regimens for HIV]]
	** Triumeq (if HLA B5701 negative): dolutegravir, abacavir, and lamivudine		** Triumeq (if HLA B5701 negative): dolutegravir, abacavir, and lamivudine
	** Truvada (tenofovir/TDF and emtricitabine) with either dolutegravir or raltegravir		** Truvada (tenofovir/TDF and emtricitabine) with either dolutegravir or raltegravir

Aidan: /* Initial regimens */

2019-09-23T10:51:27Z

Initial regimens

← Older revision		Revision as of 10:51, 23 September 2019
Line 34:		Line 34:

	* All are integrase inhibitor with two nucleoside analogues		* All are integrase inhibitor with two nucleoside analogues
	* Consider one of the [~~HIV~~ single-tablet regimens]~~(Single-tablet regimens.md)~~		* Consider one of the [[[single-tablet regimens for HIV]]
	** Triumeq (if HLA B5701 negative): dolutegravir, abacavir, and lamivudine		** Triumeq (if HLA B5701 negative): dolutegravir, abacavir, and lamivudine
	** Truvada (tenofovir/TDF and emtricitabine) with either dolutegravir or raltegravir		** Truvada (tenofovir/TDF and emtricitabine) with either dolutegravir or raltegravir

Aidan: /* Investigations */ added OCC guideline testing

2019-09-23T00:53:45Z

Investigations: added OCC guideline testing

← Older revision		Revision as of 00:53, 23 September 2019
Line 8:		Line 8:

	* HIV-specific		* HIV-specific
	** CD4 count		** CD4/CD8 count
	** HIV-RNA viral load		** HIV-RNA viral load
			** HIV genotype
	** HLA B5701 genotyping (for abacavir)		** HLA *B5701 genotyping (for abacavir)
	** Genetic resistance assays		** Genetic resistance assays (± tropism testing for CCR5 inhibitors)
	** G6PD deficiency		** G6PD deficiency
⚫	* STIs and coinfections
⚫	** ~~Hepatitis~~ A, B, and C serologies
⚫	** Syphilis
⚫	** Three-site mucosal (genital/rectal/throat) NAAT for chlamydia and gonorrhea
	* Routine		* Routine
	** CBC, lytes, creatinine		** CBC, lytes, creatinine
	** Fasting lipids		** Fasting lipids, Hb A1c
	** Urinalysis (glucose and protein)		** Urinalysis (glucose and protein)
			** Consider bone mineral density testing and vitamin D levels
		⚫	* STIs and coinfections
			** TB skin test
			** Consider chest x-ray
			** HAV-IgG, HBV-sAg/sAb/cAb, and HCV-Ab
		⚫	** Syphilis
		⚫	** Three-site mucosal (genital/rectal/throat) NAAT for chlamydia and gonorrhea
		⚫	** Toxoplasma, varicella, CMV, and measles serologies
			* For women and trans men
			** Pap smear
			** Rubella serology
			** Trichomonas testing

	== Initial regimens ==		== Initial regimens ==

Aidan: /* History */ fixed link

2019-09-23T00:36:41Z

History: fixed link

← Older revision		Revision as of 00:36, 23 September 2019
Line 2:		Line 2:

	* Date and context of diagnosis		* Date and context of diagnosis
	* History of [~~HIV opportunistic infections](../Complications/~~Opportunistic infections~~/Opportunistic~~ ~~infections.md)~~		* History of [[Opportunistic infections in HIV]]
	* Sexual history		* Sexual history

Aidan at 15:11, 17 August 2019

2019-08-17T15:11:15Z

← Older revision		Revision as of 15:11, 17 August 2019
Line 1:		Line 1:
	= History =		== History ==

	* Date and context of diagnosis		* Date and context of diagnosis
Line 5:		Line 5:
	* Sexual history		* Sexual history

	= Investigations =		== Investigations ==

	* HIV-specific		* HIV-specific
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	** Urinalysis (glucose and protein)		** Urinalysis (glucose and protein)

	= Initial regimens =		== Initial regimens ==

	* All are integrase inhibitor with two nucleoside analogues		* All are integrase inhibitor with two nucleoside analogues