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Primary Care Guidance for Persons With HIV - 2021

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28 Treatment Table 5. Routine Healthcare Maintenance for People With HIV (After Initial Assessment) Intervention Recommendation Comments Screening for and Prevention of Cancer (cont'd) Cervical cancer screening Age <21: Pap within 1 year of sexual activity, no later than age 21. Age 21–29: Pap at diagnosis of HIV, repeat yearly × 3, then if all normal—Pap every 3 years. Age <30 years: No HPV testing unless abnormalities are found on Pap test. Age ≥30 years: Pap only, same as 21–29 years. OR Pap with HPV testing. If both neg THEN Pap with HPV every 3 years. Note: In general, continue screening past 65 years. Abnormal Pap and/or HPV follow-up similar to general population. See Section II for further discussion. Anal cancer screening Digital anorectal exam: Perform at least annually if asymptomatic. Anal Pap: ere are no national guidelines at this time. Some experts recommend anal cytolog y for persons with HIV who have receptive anal sex, but only if high- resolution anoscopy is available. Abnormal anal Pap should prompt referral for high- resolution anoscopy. Hepatocellular carcinoma screening Alpha-fetoprotein (AFP) and liver ultrasound every 6 months. For patients with cirrhosis for any cause or chronic hepatitis B. Other Healthcare Maintenance Complete blood count and chemistry panel Perform as needed based upon underlying conditions and need for toxicity management for ART and other medications. — (cont'd)

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