11
Table 3. Routine Health Care Maintenance in the HIV-
Infected Adult
Intervention Recommendation Comments
Blood pressure
check
Perform annually in all patients
Digital rectal
exam
Consider annually in all patients. Inspect for anal warts,
malignancy, prostate
abnormalities in men.
Ophthalmologic
exam
Perform dilated exam every 6-12
months in patients with a CD4
count < 50
Exam with tonometry is advised
every 2-3 years in all patients 50
years of age or older
Depression
screening
Perform annually in all patients Use conventional mental health
interview or standardized test
Fasting
glucose and/
or Hemoglobin
A1C
Perform every 6-12 months in
all patients
Consider testing 1-3 months
aer starting or modifying
antiretroviral therapy.
Hemoglobin A1C may be
used for screening. Consider
threshold cut-off 5.8%.
Hemoglobin A1c level should
be performed every 6 months in
patients with diabetes mellitus.
Fasting lipid
profile
Perform every 6-12 months in
all patients
Consider testing 1-3 months
aer starting or modifying
antiretroviral therapy
Syphilis serolog y Perform annually in patients at
risk for STDs
More frequent testing may be
indicated in patients at high risk
for STDs
Gonorrhea
and chlamydia
testing
Perform annually in patients
at risk for STDs(see text for
details)
More frequent testing may be
indicated in patients at high
risk for STDs. Repeat testing 3
months later if positive
Hepatitis C
testing
Perform annually in patients at
risk e.g. injection drug users and
MSM
More frequent testing may be
indicated in patients at high risk
especially if increase in serum
transaminases
Trichomoniasis Perform annually in all women Repeat testing 3 months later if
positive
Tuberculin
screening test
(TST) or
interferon-
gamma releasing
assay (IGRA)
Perform at baseline and annually
in patients at risk for TB
No need to repeat in patients
with prior positive TST;
additional TB testing may
be indicated depending on
potential exposure
Continued on next page
Patient Management
