15
Timepoint/Frequency of Testing
Every 6
Months
Every 12
Months
Treatment
Failure
Clinically
Indicated
If ART Initiation
is Delayed
c
Repeat HCV
screening for
at-risk
patients
k
Every 6–12 mos
Every 6–12 mos
Every 3–6 mos
If abnormal
at last
measurement
If normal at last
measurement
If normal at
baseline, annually
If normal at last
measurement
If normal at
baseline, annually
If on TAF
or TDF
l
i
Most patients with isolated HBcAb have resolved HBV infection with loss of HBsAb. Consider
performing an HBV viral load for confirmation. If the HBV viral load is positive, the patient may be
acutely infected (and will usually display other signs of acute hepatitis) or chronically infected. If negative,
the patient should be vaccinated. Refer to HIV Primary Care and the Adult and Adolescent Opportunistic
Infections Guidelines for more detailed recommendations.
j
HCV antibody may not be adequate for screening in the setting of recent HCV infection (acquisition
within past 6 months), or advanced immunodeficiency (CD4 count <100 cells/mm
3
). HCV RNA
screening is indicated in persons who have been successfully treated for HCV or who spontaneously
cleared prior infection. HCV antibody-negative patients with elevated ALT may need HCV RNA testing.
k
Injection drug users, persons with a history of incarceration, men with HIV who have unprotected sex
with men, and persons with percutaneous/parenteral exposure to blood in unregulated settings are at risk
of HCV infection.
l
Serum Na, K, HCO
3
, Cl, BUN, creatinine, glucose (preferably fasting ), and creatinine-based eGFR.
Serum phosphorus should be monitored in patients with chronic kidney disease who are on TAF- or
TDF-containing regimens.
m
Consult the Guidelines for the Management of Chronic Kidney Disease in HIV-Infected Patients:
Recommendations of the HIV Medicine Association of the Infectious Diseases Society of America for
recommendations on managing patients with renal disease. More frequent monitoring may be indicated
for patients with evidence of kidney disease (e.g., proteinuria, decreased glomerular function) or increased
risk of renal insufficiency (e.g., patients with diabetes, hypertension).
n
Consult the National Lipid Association's recommendations for management of patients with dyslipidemia.
o
Urine glucose and protein should be assessed before initiating TAF- or TDF-containing regimens, and
monitored during treatment with these regimens.
