Diagnosis
4
HIV-Related Tests in Selected Patients
Coreceptor Tropism Assay
14. Tropism testing should be performed if the use of a CCR5 antagonist
is being considered.
HLA B*5701
15. HLA-B*5701 testing should be performed before initiating abacavir
therapy.
16. Patients who are positive for the HLA B*5701 haplotype are at high
risk for abacavir hypersensitivity reaction and should never be treated
with abacavir (and this should be noted appropriately in the medical
record).
Laboratory Tests to Assess Safety and General Health
17. A complete blood count with differential white blood cell count,
chemistry panel with calculated creatinine clearance (or estimated
glomerular filtration rate) and glucose level, and urinalysis should
be obtained upon initiation of care. (See Table 4)
18. Because many antiretroviral drugs, HIV infection itself, and host
factors are associated with increased cholesterol and triglyceride
levels, a lipid profile should be obtained upon initiation of care and
repeated fasting, if appropriate.
Screening for Coinfections
Screening for Sexually Transmitted Infections (STIs) —
Chlamydia, Gonorrhea, Trichomoniasis
19. Persons with HIV should be screened for gonorrhea and chlamydia
infection at initial presentation. Screening should include all sites
of contact (oral, anal, urethral [urine], and vaginal). Those found to
have gonorrhea or chlamydia on initial screening should be treated
and rescreened in 3 months because of high reinfection rates.
20. All persons having receptive vaginal sex should be screened for
trichomoniasis at entry into care. Those found to have trichomoniasis
on initial screening should be treated and rescreened in 3 months
because of high reinfection rates.