10
Screening for Anal Human Papillomavirus
Î HIV-infected men and women with human papillomavirus (HPV)
infection are at increased risk for anal dysplasia and cancer. MSM,
women with a history of receptive anal intercourse or abnormal
cervical Pap test results, and all HIV-infected persons with genital
warts should have anal Pap tests (WR-M).
Î HPV vaccination is recommended for all females ages 9-26 years and
all males ages 9-21 years. Males 22-26 years of age should also be
vaccinated if not vaccinated at younger ages (SR-H).
Serum Testosterone Level
Î Morning serum testosterone level testing is recommended in adult
men with decreased libido, erectile dysfunction, reduced bone
mass or low trauma fractures, hot flashes, or sweats, and should be
considered in the setting of less-specific symptoms such as fatigue
and depression (SR-M).
Î Obtaining testosterone levels in women in nonresearch settings is
NOT recommended (SR-L).
Other Laboratory Tests
Î Routine testing for cryptococcal infection with serum cryptococcal
antigen or for disseminated Mycobacterium avium complex infection by
culture of blood for acid-fast bacilli is NOT recommended, but may be
considered in selected patients with CD4 cell counts <50/μL (SR-M).
Chest Radiology
Î A baseline chest radiograph should be obtained in all HIV-infected
patients with 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 (SR-M).
Diagnosis and Assessment
