Selecting a Treatment Regimen
Behavioral Intervention
ÎÎGeneral messages regarding risk reduction should be provided at
all health encounters, regardless of risk behaviors reported by the
patient or perceived risk on the part of the health care provider. Such
messages can be delivered by the provider, by others in the health
care setting, or by educational materials (eg, pamphlets, posters,
videos) in the health care setting (A-III).
ÎÎTailored messages are critical for patients who report persistent
high-risk behavior or who have symptoms or signs of STDs. In nearly
all situations, the provider should offer brief counseling. In general,
persons exhibiting risk behavior should also be referred to programs
capable of offering more extensive intervention programs (A-I).
Schedule of Care Evaluation for HIV Infected Adults (Table 7)
ÎÎAsymptomatic HIV-infected patients with normal CD4 cell counts
and low viral loads should be monitored with repeat viral load
measurements and CD4 cell counts every 3-4 months (B-II).
ÎÎCD4 cell counts should be followed both to assess the efficacy of
antiretroviral therapy and to determine the need for prophylaxis
against opportunistic infections (A-I).
ÎRepeat STD screening annually and TB screening periodically depending
Î
on symptoms and signs, behavioral risk and possible exposures (B-III).
ÎÎVaccinations for pneumococcal infection (A-II), influenza (A-III),
varicella (B-III) and hepatitis A (A-II) and B (A-II) should be offered
as indicated (Table 2). The likelihood of a response to any vaccine
is greatest in patients with higher CD4 counts or on suppressive
antiretroviral therapy.
Schedule of Care Evaluation for HIV Infected Children
ÎÎPerinatally infected infants and HIV-infected children should have the
following:
>> CD4 cell counts and viral loads monitored no less often than every 3 months (B-III).
>> Annual TB screening tests to diagnose LTBI; children with HIV infection are at
high risk for TB (A-III).
>> Childhood vaccinations should be given according to ACIP schedules for
HIV-infected infants and children (A-II).
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