6
Diagnosis
Measles, Mumps, and Rubella
31. All persons with HIV born in 1957 or after should be tested for
immunity to measles, mumps, and rubella (MMR) by measuring
antibodies.
32. MMR vaccine should be given to protect against measles, mumps,
and rubella if persons were born in 1957 or after and have not
received this vaccine or do not have immunity to these infections.
Varicella Zoster Virus
33. Serologic screening for varicella zoster virus (VZV) may be considered
for persons who have not had chickenpox or shingles and who have
not been previously vaccinated. (See Section III)
Tests That May Be Performed Under Certain Circumstances
Chest Radiography
34. A baseline chest radiograph should be obtained in all persons with
HIV who have a positive tuberculosis screening test result to rule out
active tuberculosis. It may also be useful in other patients who are
likely to have preexisting lung abnormalities.
Cervical Cancer Screening
35. Persons with a uterus who are <30 years old should have a cervical
Papanicolaou (Pap) test performed within one year of the onset
of sexual activity but not later than 21 years of age. Persons with
HIV between 21–29 years who have a uterus should have a cervical
Pap test at diagnosis, if not performed within the last year. Routine
human papillomavirus (HPV) testing is
NOT recommended for
women with HIV <30 years of age, unless Pap test is abnormal.
36. Persons with a uterus who are >30 years old should have a cervical
Pap test performed at diagnosis. A Pap test alone or in combination
with HPV testing can be performed.
37. Persons with atypical squamous cells of unknown significance (ASC-
US) on cytology or negative cytology with positive high-risk HPV
(HRHPV) may have the Pap smear repeated in one year or should
undergo colposcopy. If the Pap test shows negative cytology but
HRHPV 16 or 18, atypical squamous cells and cannot rule out high-
grade squamous intraepithelial lesion (ASC-H), atypical glandular
cells, low-grade or high-grade squamous intraepithelial lesion,
or squamous carcinoma noted by Pap testing, the patient should
undergo colposcopy and directed biopsy, with further treatment as
indicated by results of evaluation.
