Screening for Syphilis
ÎÎAll patients should be screened for syphilis upon initiation of care and
periodically thereafter depending on risk (A-II).
ÎÎA lumbar puncture should always be performed in patients with
reactive syphilis serology and neurologic or ocular symptoms or signs
and in patients with late latent syphilis (> 1 year's duration) (A-II).
ÎÎPatients who experience serologic treatment failure should also
undergo lumbar puncture (B-III).
Screening for Ano-Genital Human Papillomavirus (HPV)
ÎÎHIV-infected men and women with HPV infection are at increased risk
for anal dysplasia and cancer. Men who have sex with men, women
with a history of abnormal cervical Pap test, and all HIV infected
persons with genital warts should be considered for ano-genital HPV
screening and anal Pap tests (C-III).
Serum Testosterone Level
ÎÎProviders should consider obtaining a morning serum total
testosterone level in male patients who complain of fatigue, weight
loss, loss of libido or erectile dysfunction, or depressive symptoms or
who have evidence of reduced bone mineral density (C-III).
Other Laboratory Tests
ÎÎRoutine testing for cryptococcal infection by determination of serum
cryptococcal antigen or for disseminated Mycobacterium avium
complex infection by culture of blood for acid-fast bacilli is not
recommended (B-II).
Chest Radiography
ÎÎA baseline chest radiograph should be obtained in all HIV-infected
patients with a positive TB screening test to rule out active
tuberculosis and may also be useful in other patients who are likely to
have pre-existing lung abnormalities (B-III).
Staging
ÎÎPatients may be staged according to the CDC AIDS Surveillance
Definition for epidemiologic and reporting purposes (C-III). (Table 1)
Table 1. Centers for Disease Control and Prevention (CDC)
Staging System for Classification of HIV-Infected Adults
CDC Classification
CD4 cell count, cells/mm3
(CD4 cell percentage)
B
C
≥ 500 (≥ 29%)
200-500 (14%-28%)
< 200 (< 14%)
6
A
A1
A2
A3
B1
B2
B3
C1
C2
C3
