Initial assessment for patients with HIV

HIV: First clinic visit

History

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

Investigations

• HIV-specific
  • CD4 count
  • HIV-RNA viral load
  • HLA B5701 genotyping (for abacavir)
  • Genetic resistance assays
  • G6PD deficiency
• STIs and coinfections
  • Hepatitis A, B, and C serologies
  • Syphilis
  • Three-site mucosal (genital/rectal/throat) NAAT for chlamydia and gonorrhea
• Routine
  • CBC, lytes, creatinine
  • Fasting lipids
  • Urinalysis (glucose and protein)

Initial regimens

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