Other Infectious Disease Testing
Herpes viruses
>> Anti-CMV IgG (for low risk) (B-III)
Hepatitis B, HBsAg, HBsAb & HBcAb (A-III)
Hepatitis C, HCV antibody (B-III)
>> If positive: HCV RNA by PCR (A-II).
TB skin test (TST) initially (A-I) and if CD4 rises > 200/mm3 (A-III)
Pap smear (C-III)
Anti-Toxoplasma IgG initially (B-III); repeat if baseline negative and
CD4 decreases to < 00, especially if unable to take TMP/SMX (C-III)
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Syphilis serology (A-II)
>> If positive: LP for suspected late latent disease (A-II)
Schedule of Care
Follow CD4 count and HIV RNA at 4-8 wks, then q3-4 months
when CD4 stable and HIV RNA undetectable (B-II)
FBS and lipids at onset and 4-6 weeks after starting treatment (A-III)
Immunize against influenza (A-III), pneumococcus, HAV, HBV and
VZV (A-II) as indicated (Table 2)
Re-evaluate STD status annually and TB status as indicated
Children
CD4 count and HIV RNA ≤ q3 months (B-III)
Annual TB skin test (A-III)
Vaccinate according to ACIP schedules (A-II)
Women
Pregnancy counseling (A-III) and PRN testing (B-III)
Pap smear at baseline, 6 months and yearly (A-I)
Annual mammography >50 years (A-I), 40-49 years (B-II)
Consider bone density >50 years and at risk (B-III)
Pregnancy
Treat all HIV+ pregnancies and all HIV-infected infants with ART (A-I)
Test all HIV-infected infants for resistance (A-II)
Give HIV prophylaxis to all HIV-exposed newborns and test at
2-3 weeks, 1-2 months and 4-6 months (A-II)
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