Selecting a Treatment Regimen
Table 5. Laboratory Monitoring Schedule for HIV-Infected
Patients Before and After Initiation of Antiretroviral
Therapy
a
(continued)
Laboratory
Test
Timepoint/Frequency of Testing
Entry
into
Care
Follow Up
Before
Initiation of
ART
ART
Initiation or
Modification
b
Follow-Up 2-8
Weeks After
ART Initiation
or Modification
Hepatitis C
Serology, with
Confirmation of
Positive Results
Basic Chemistry
g,h
Every 6-12 mos
ALT, AST, T.
bilirubin
Every 6-12 mos
CBC with
Differential
Every 3-6 mos
If on ZDV
Fasting Lipid
Profile
If normal,
annually
Consider 4-8 wks
aer starting new
ART regimen
that affects lipids
Fasting Glucose or
Hemoglobin A1C
If normal,
annually
Urinalysis
g
Pregnancy Test
In women with
child-bearing
potential
a
is table pertains to laboratory tests done to select an ARV regimen and monitor for treatment
responses or ART toxicities. Please refer to the HIV Primary Care guidelines for guidance on other
laboratory tests generally recommended for primary health care maintenance of HIV patients.
(http://aidsinfo.nih.gov/contentfiles/lvguidelines/adultandadolescentgl.pdf )
b
ART may be modified because of treatment failure, adverse effects, or for regimen simplification.
c
If HIV RNA is detectable at 2 to 8 weeks, repeat every 4 to 8 weeks until viral load is suppressed to
<200 copies/mL, and thereaer, every 3 to 6 months.
d
In patients on ART, viral load typically is measured every 3 to 4 months. However, for adherent
patients with consistently suppressed viral load and stable immunologic status for more than 2 years,
monitoring can be extended to 6 month intervals.
e
In ART-naive patients, if resistance testing was performed at entry into care, repeat testing before
initiation of ART is optional. e exception is pregnant women; repeat testing is recommended in
this case. In virologically suppressed patients who are switching therapy because of toxicity or for
convenience, viral amplification will not be possible. erefore, resistance testing should not be
performed. Results from prior resistance testing can be helpful in constructing a new regimen.
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