Initial assessment for patients with HIV: Difference between revisions
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* HIV-specific |
* HIV-specific |
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| − | ** CD4 count |
+ | ** CD4/CD8 count |
** HIV-RNA viral load |
** HIV-RNA viral load |
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| + | ** HIV genotype |
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| − | ** 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 |
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| ⚫ | |||
| ⚫ | |||
| ⚫ | |||
| ⚫ | |||
* Routine |
* Routine |
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** CBC, lytes, creatinine |
** CBC, lytes, creatinine |
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| − | ** Fasting lipids |
+ | ** Fasting lipids, Hb A1c |
** Urinalysis (glucose and protein) |
** Urinalysis (glucose and protein) |
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| + | ** Consider bone mineral density testing and vitamin D levels |
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| ⚫ | |||
| + | ** TB skin test |
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| + | ** Consider chest x-ray |
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| + | ** HAV-IgG, HBV-sAg/sAb/cAb, and HCV-Ab |
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| ⚫ | |||
| ⚫ | |||
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| + | * For women and trans men |
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| + | ** Pap smear |
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| + | ** Rubella serology |
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| + | ** Trichomonas testing |
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== Initial regimens == |
== Initial regimens == |
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Revision as of 20:53, 22 September 2019
History
- Date and context of diagnosis
- History of Opportunistic infections in HIV
- Sexual history
Investigations
- HIV-specific
- CD4/CD8 count
- HIV-RNA viral load
- HIV genotype
- HLA *B5701 genotyping (for abacavir)
- Genetic resistance assays (± tropism testing for CCR5 inhibitors)
- G6PD deficiency
- Routine
- CBC, lytes, creatinine
- Fasting lipids, Hb A1c
- 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
- 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
