Initial assessment for patients with HIV: Difference between revisions
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+ | ==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 cis women and trans men |
| − | ** |
+ | **Pap smear |
| − | ** |
+ | **Rubella serology |
| − | ** |
+ | **Trichomonas testing |
| − | == |
+ | ==Initial regimens== |
| − | * |
+ | *All are integrase inhibitor with two nucleoside analogues |
| − | * |
+ | *Consider one of the [[single-tablet regimens for HIV]] |
| − | ** |
+ | **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 |
| − | == |
+ | ==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]] |
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Revision as of 11:41, 30 March 2021
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 cis women and trans men
- Pap smear
- Rubella serology
- Trichomonas testing
Initial regimens
- All are integrase inhibitor with two nucleoside analogues
- Consider one of the single-tablet regimens for HIV
- 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
Further Reading
- 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: 10.1093/cid/cit665
