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Primary Care Guidance for Persons With HIV - 2021

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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.

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